Transition from Antigenemia to Quantitative Nucleic Acid Amplification Testing in Kidney Transplant Recipients Receiving Preemptive Therapy for Cytomegalovirus Infection.

2021 ◽  
Author(s):  
Mônica Rika Nakamura ◽  
Lúcio R. Requião-Moura ◽  
Roberto Mayer Gallo ◽  
Camila Botelho ◽  
Júlia Taddeo ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Nucleic Acid ◽  
Acute Rejection ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Nucleic Acid Amplification ◽  
Rt Pcr ◽  
Cmv Infection ◽  
Preemptive Treatment ◽  
The Impact

Abstract Due to the high costs, the strategy to reduce the impact of cytomegalovirus (CMV) after kidney transplant (KT) involves preemptive treatment in low and middle-income countries. Thus, this retrospective cohort study compared the performance of antigenemia transitioned to quantitative nucleic acid amplification testing, RT-PCR, in KT recipients receiving preemptive treatment as a strategy to prevent CMV infection. Between 2016 and 2018, 363 patients were enrolled and received preemptive treatment based on antigenemia (n=177) or RT-PCR (n=186). The primary outcome was CMV infection or disease. There were no differences in one-year cumulative incidence of CMV-related events (50.8% vs. 44.1%, P=0.20), neither in time to diagnosis (47.0 vs. 47.0 days) among patients conducted by antigenemia vs. RT-PCR, respectively. The length of CMV first treatment was longer with RT-PCR (20.0 vs. 27.5 days, P<0.001), while the rate of retreatment was not different (14.7% vs. 11.8%, P=0.48). In the Cox regression, the variables associated with CMV-related events were acute rejection within 30 days (HR=2.05, p=0.01) and 30-day glomerular filtration rate (HR=0.98, p<0.001). In conclusion, acute rejection and glomerular filtration rate are risk factors for CMV infection and disease, showing comparable performance in the impact of CMV-related events between antigenemia and RT-PCR for preemptive treatment.

scholarly journals The Impact of Interlaboratory Differences in Cystatin C Assay Measurement on Glomerular Filtration Rate Estimation

2011 ◽  
Vol 6 (9) ◽  
pp. 2150-2156 ◽  
Author(s):  
Christine A. White ◽  
Andrew D. Rule ◽  
Christine P. Collier ◽  
Ayub Akbari ◽  
John C. Lieske ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Rate Estimation ◽  
Glomerular Filtration Rate Estimation ◽  
The Impact

Ascending and Transverse Aortic Arch Repair: The Impact of Glomerular Filtration Rate on Mortality

2008 ◽  
Vol 247 (3) ◽  
pp. 524-529 ◽  
Author(s):  
Anthony L. Estrera ◽  
Charles C. Miller ◽  
Jaswanth Madisetty ◽  
Sebastian Bourgeois ◽  
Ali Azizzadeh ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Aortic Arch ◽  
Filtration Rate ◽  
Aortic Arch Repair ◽  
The Impact

scholarly journals The Cornish experience of the ASSIST-CKD project

2017 ◽  
Vol 55 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Anna L Barton ◽  
Angela S Mallard ◽  
Anthea Patterson ◽  
Nicola Thomas ◽  
Stephen Dickinson ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
General Practitioner ◽  
Glomerular Filtration ◽  
General Practitioners ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Number Of Patients ◽  
National Quality ◽  
Improvement Programme ◽  
The Impact

Introduction The ASSIST-CKD project is a national quality improvement programme, aiming to decrease the number of patients presenting late to renal services by enabling laboratories to review up to five years of estimated glomerular filtration rate results graphically and report deteriorating patients to their general practitioner. Aim To assess the impact of the project on the laboratory, and of patient reporting on general practitioner management and the local renal service. Method Each week two searches were performed (Search A: maximum age 65 years, maximum eGFR 50 ml/min/1.73 m2 and Search B: Age 66–120 years, maximum eGFR 40 ml/min/1.73 m2) on patients with an estimated glomerular filtration rate requested by their general practitioner within the previous seven days. Patients showing deterioration in estimated glomerular filtration rate had a printed graph sent to their general practitioner. Feedback on the graphs and their impact on patient management were obtained from the general practitioners via a questionnaire. Results A median of 37 patients/week were listed for review for Search A, with 32% reported; and Search B a median of 227 patients/week listed, 32% reported. General practitioner surgery questionnaires (29) showed the reports were well received. Of general practitioners responding to the questionnaire, 67% had reviewed a patient earlier than intended, 54% had reviewed local guidance, 48% had emailed the renal team and 48% had referred a patient on receipt of a graph; 34% had shown a graph to their patients, of whom 70% found that useful. Conclusion There is some evidence that ASSIST-CKD reporting has enhanced patient care; however, further long-term assessment is still required.

scholarly journals The impact of hormonal contraceptives on blood pressure, urinary albumin excretion and glomerular filtration rate

2007 ◽  
Vol 63 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Jarir Atthobari ◽  
Ron T. Gansevoort ◽  
Sipke T. Visser ◽  
Paul E. de Jong ◽  
Lolkje T. W. de Jong-van den Berg ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Hormonal Contraceptives ◽  
Albumin Excretion ◽  
The Impact

scholarly journals Ketoacid Analogues Supplementation in Chronic Kidney Disease and Future Perspectives

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2071 ◽  
Author(s):  
Laetitia Koppe ◽  
Mariana Cassani de Oliveira ◽  
Denis Fouque
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Uremic Toxins ◽  
Protein Diet ◽  
Current Evidence ◽  
Low Protein ◽  
The Impact

Diet is a key component of care during chronic kidney disease (CKD). Nutritional interventions, and, specifically, a restricted protein diet has been under debate for decades. In order to reduce the risk of nutritional disorders in very-low protein diets (VLDP), supplementation by nitrogen-free ketoacid analogues (KAs) have been proposed. The aim of this review is to summarize the potential effects of this dietary therapy on renal function, uremic toxins levels, and nutritional and metabolic parameters and propose future directions. The purpose of this paper is also to select all experimental and randomized clinical studies (RCTs) that have compared VLDP + KA to normal diet or/and low protein diet (LPD). We reviewed the SCOPUS, WEB of SCIENCES, CENTRAL, and PUBMED databases from their inception to 1 January, 2019. Following duplicate removal and application of exclusion criteria, 23 RCTs and 12 experimental studies were included. LPD/VLPD + KAs appear nutritionally safe even if how muscle protein metabolism adapts to an LPD/VLPD + KAs is still largely unknown. VLPD + KAs seem to reduce uremic toxins production but the impact on intestinal microbiota remains unexplored. All studies observed a reduction of acidosis, phosphorus, and possibly sodium intake, while still providing adequate calcium intake. The impact of this diet on carbohydrate and bone parameters are only preliminary and need to be confirmed with RCTs. The Modification of Diet in Renal Disease study, the largest RCTs, failed to demonstrate a benefit in the primary outcome of the decline rate for the glomerular filtration rate. However, the design of this study was challenged and data were subsequently reanalyzed. However, when adherent patients were selected, with a rapid rate of progression and a long-term follow up, more recent meta-analysis and RCTs suggest that these diets can reduce the loss of the glomerular filtration rate in addition to the beneficial effects of renin-angiotensin-aldosterone system (RAAS) inhibitors. The current evidence suggests that KAs supplemented LPD diets should be included as part of the clinical recommendations for both the nutritional prevention and metabolic management of CKD. More research is needed to examine the effectiveness of KAs especially on uremic toxins. A reflection about the dose and composition of the KAs supplement, the cost-effective features, and their indication to reduce the frequency of dialysis needs to be completed.

Abstract 1527: Impact Of Glomerular Filtration Rate On Outcome In Consecutive Patients With Stemi In Clinical Practice: Results Of The Acos-registry

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Anselm K Gitt ◽  
Harm Wienbergen ◽  
Frank Towae ◽  
Martin G Gottwik ◽  
Jochen Senges
Keyword(s):  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Clinical Practice ◽  
Hospital Mortality ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Reperfusion Therapy ◽  
Severe Renal Failure ◽  
Cardiovascular Morbidity And Mortality ◽  
The Impact

Background: Patients with renal failure have a higher cardiovascular morbidity and mortality. Little is known about the impact of renal failure on the acute outcome of ST-elevation myocardial infarction (STEMI) in clinical practice. Methods: Between 2000 and 2002 a total of 8303 consecutive patients with STEMI were enrolled into the multicenter ACOS-registry in Germany. We examined the impact of the glomerular filtration rate (GFR) on hospital outcome in clinical practice. GFR was calculated using the Cockroft-Gault-Formula. Results: Patients with reduced GFR were older, more often female, more often had prior myocardial infarctions and coronary interventions, a higher prevalence of concomitant diseases and a worse TIMI-risk score. than patients with GFR >90 ml/min. Patients with impaired GFR did receive acute reperfusion therapy significantly less often. After adjustment for these differences by multivariate regression analysis, renal failure was associated with significant higher hospital mortality (GFR 30–59 ml/min: OR 2.38; GFR < 30 ml/min: OR 5.18, p<0.01). Conclusion: In consecutive STEMI-patients severe renal failure (GFR<30 ml/min) was independently associated with a more than 5-fold increased hospital mortality in clinical practice.

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