scholarly journals Fatores relacionados a ansiedade e depressão em pacientes transplantados renais

2020 ◽  
Vol 10 (32) ◽  
pp. 113-123
Author(s):  
Darci Ramos Fernandes ◽  
Roseline De Oliveira Calisto Lima ◽  
Elizabeth Santos de Andrade Malheiros ◽  
Vivian Silva Brito ◽  
Sueli Coelho da Silva Carneiro ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Measurement Scale ◽  
Anxiety And Depression ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Depression Measurement ◽  
Cross Sectional Design ◽  
Student’S T

Verificar fatores associados à ansiedade e depressão em transplantados renais. Estudo quantitativo, delineamento transversal realizado em Hospital de alta complexidade, com 80 transplantados renais, maiores de 18 anos. Utilizou-se a Escala de medida de ansiedade e depressão hospitalar - HADS. Os dados foram analisados por estatística descritiva simples, Teste-t de Student ou ANOVA, Mann Whitney, Kruskal-Wallis ou Dunnet, e coeficiente de correlação de Spearman. Prevalência de ansiedade em 25% e depressão em 15% dos pesquisados; predomínio do gênero feminino, idades entre 30 a 59 anos; ter companheiro fixo favoreceu sintomas de ansiedade; sedentarismo estava associado a sintomas de ansiedade e depressão, receptores de doador falecido apresentaram mais ansiedade; quanto maior tempo de transplante, mais ansiedade e depressão. Concluiu-se que conhecimento científico, habilidade técnica e empatia são ferramentas indispensáveis diante dessas situações, pois favorecem suporte multiprofissional, interdisciplinar e humanizado, sensíveis às demandas dos pacientes transplantados renais.Descritores: Ansiedade, Depressão, Transplante Renal. Factors related to anxiety and depression in kidney transplant patientsAbstract: To verify factors associated with anxiety and depression in renal transplant recipients.  Quantitative study, cross-sectional design carried out in a hospital of high complexity, with 80 renal transplant recipients, over 18 years of age. The Hospital Anxiety and Depression Measurement Scale - HADS was used.  The data were analyzed by simple descriptive statistics, Student’s t-test or ANOVA, Mann Whitney, Kruskal-Wallis or Dunnet, and spearman correlation efficiency. Prevalence of anxiety in 25% and depression in 15% of those surveyed;  predominance of females, ages between  30  and  59 years old;  having a fixed companion favored anxiety symptoms; sedentary lifestyle was associated  symptoms  of anxiety and depression, recipients of deceased donors presented more anxiety; the longer transplant time, more anxiety and depression. It was concluded that scientific knowledge, technical skill, and empathy are indispensable tools in these situations, because they favor multiprofessional, interdisciplinary and humanized support, sensitives to the demands of the patients renal transplant recipients.Descriptors: Anxiety, Depression, Kidney Transplant. Factores relacionados con la ansiedad y la depresión en pacientes con trasplante de riñónResumen: Se objetivó verificar los factores asociados a la ansiedad y la depresión en pacientes trasplantados de los riñones. Método: estudio cuantitativo, diseño transversal realizado en un hospital de alta complejidad, con 80 receptores de trasplante renal, mayores de 18 años. Se utilizó la Escala de Medición de Ansiedad y Depresión Hospitalaria - HADS. Los datos fueron analizados por estadísticas descriptivas simples, la prueba t de Student o ANOVA, Mann Whitney, Kruskal-Wallis o Dunnet, y el coeficiente de correlación de Spearman. Resultados: prevalencia de ansiedad en el 25% y depresión en el 15% de los encuestados; predominio en personas del género femenino, de 30 a 59 años; tener una pareja estable favoreció los síntomas de ansiedad; el estilo de vida sedentario se asoció con los síntomas de ansiedad y depresión, los receptores de donantes fallecidos mostraron más ansiedad; cuanto mayor sea el tiempo desde el transplante, más ansiedad y depresión. Se concluyó que los conocimientos científicos, la habilidad técnica y la empatía son herramientas indispensables en estas situaciones, ya que favorecen el apoyo multiprofesional, interdisciplinario y humanizado, sensible a las demandas de los pacientes trasplantados renales.Descriptores: Ansiedad, Depresión, Trasplante de Riñón.

scholarly journals Proteinuria in Kidney Transplant Recipients

2020 ◽  
Vol 17 (2) ◽  
pp. 61-63
Author(s):  
Md Habibur Rahman ◽  
Tohid Mohammad Saiful Hossain ◽  
AKM Khurshidul Alam ◽  
Shahidul Islam Selim ◽  
Nilima Barman ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
P Value ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Female Ratio ◽  
Transplant Patients

Objectives: Proteinurea is one of the major causes of early graft rejection and high degree mortality in renal transplant patients. Our objective was to assess risk in post transplant patient for proteinurea and it’s appropriate management. Methods: This cross sectional study includes fifty adult kidney allograft recipients, transplanted in kidney transplant unit of Urology Department, Bangabandhu Sheikh Mujib Medical University in the period of January 2012 to December 2012. Results: In our series, proteinuria was detected in 44% of the renal transplant recipients in variant amount. In this study the male and female ratio was 7:3. There was a highly significant level of proteinuria in proteinuric group than that of non-proteinuric group [538.09 (313.36) mg/24 hr vs. 44.48 (23.39) mg/24 hr; p value <0.0001]. Acute rejection and death was found in 22% and 8% recipients respectively, which were more observed in proteinuric group. Conclusion: Based on these data, proteinuria should be monitored periodically at posttransplant period and investigation of the cause should be pursued vigorously. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.61-63

Human BK Polyomavirus Nephropathy (BKVN) In Non- Kidney-Transplant Patients

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S118-S118
Author(s):  
Y Chen Wongworawat ◽  
C Zuppan
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Bk Polyomavirus ◽  
Pathologic Features ◽  
Renal Biopsies ◽  
Renal Transplant Patients

Abstract Introduction/Objective Human BK polyomavirus nephropathy (BKVN) occurs in up to 10% of renal transplant recipients, and can result in graft loss. Transplant biopsy is the gold standard to diagnose BKVN, and SV40 immunohistochemical (IHC) staining is helpful in confirming the diagnosis. BKVN is uncommon outside the setting of renal transplantation. To understand more about its occurrence in other contexts, we reviewed our renal biopsies files for cases of BKVN. Methods Our renal biopsy files for the past 20 years were reviewed for all cases with a diagnosis of BKVN or polyoma virus infection, and the clinical characteristics of the affected patients noted. Results Evidence of BKVN was found in 44 renal biopsies, of which 39 (86%) were renal transplant patients. Of the remaining five patients (14%), two had undergone heart transplantation, one lung transplantation, one was undergoing chemotherapy for acute lymphoblastic leukemia, and one patient had active HIV infection. All patients had elevated serum creatinine, and four out of five patients had documented BK viremia. Four of the five biopsies showed typical tubular injury with viral nuclear cytopathic changes (inclusions). In the lung transplant patient, the biopsy showed advanced chronic tubulointerstitial injury without distinct viral inclusions, but SV40 staining confirmed the presence of BK virus antigen. Conclusion The BKVN is distinctly uncommon outside the context of kidney transplantation. In our series, 14% of patients with BKVN were not kidney transplant recipients, but all were immune compromised in some fashion. The pathologic features of BKVN appear similar, regardless of whether the host is a renal transplant recipient or not. Although uncommon, it is important to consider the possibility of BKVN in non-renal transplant patients with persistent or progressive renal dysfunction.

scholarly journals COVID-19 in Renal Transplant Recipients: Case Series and a Brief Review of Current Evidence

Nephron ◽  
2020 ◽  
pp. 1-7
Author(s):  
Muhammed Ahmed Elhadedy ◽  
Yazin Marie ◽  
Ahmed Halawa
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Therapy Monitoring ◽  
Intensive Therapy ◽  
Current Evidence ◽  
Intensive Care Treatment ◽  
Renal Transplant Recipients ◽  
Supportive Treatment ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

By April 26, 2020, infections related to coronavirus disease 2019 (COVID-19) affected people from 210 countries and caused 203,818 reported deaths worldwide. A few studies discussed the outcome of COVID-19 in kidney transplant recipients. This short series demonstrates our experience in managing COVID-19 disease in renal transplant patients in the absence of strong evidence. We report 8 cases of kidney transplant recipients infected with COVID-19 (median age = 48.5 years; range = 21–71 years), including 4 males and 4 females. The most frequently associated comorbidity was hypertension. The most common presenting features were fever and cough. The main radiological investigation was a portable chest X-ray. Other common features included lymphopenia, high C-reactive protein, and a very high ferritin level. Overall, 1 patient was managed as an outpatient, the remaining 7 required hospital admission, 1 of them referred to the intensive therapy unit. Management included supportive treatment (intravenous fluid therapy, monitoring renal function, and symptomatic treatment with or without ward-based oxygen therapy depending on oxygen saturation) and discontinuation of the antiproliferative immunosuppressive drugs. Seven patients recovered and discharged home to self-isolate. One patient required intensive care treatment and mechanical ventilation. Supportive treatment could be sufficient for the management or to be tried first. We also found that short hospital stay with self-isolation on discharge reduces the burden on the health service and protect the staff and the public.

Correlation between clinical outcome and tissue inflammatory response in kidney transplant recipients with cryptococcosis

2020 ◽  
Vol 78 (7) ◽  
Author(s):  
Angela S Nishikaku ◽  
Marcel V Soldá ◽  
Giannina Ricci ◽  
Vinicius Ponzio ◽  
Carla Pagliari ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Transforming Growth Factor ◽  
Granulomatous Inflammation ◽  
Protective Role ◽  
Tissue Response ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Tissue Samples

ABSTRACT Cryptococcosis is the second most common invasive fungal infection reported in renal transplant recipients. Tissue granulomatous inflammation is necessary to contain Cryptococcus infection. This study aims to analyze the granuloma patterns and in situ expression of regulatory T (Treg) immune response in tissue samples from 12 renal transplant recipients with cryptococcosis. Fungal isolates were molecularly identified as Cryptococcus neoformans species complex. A detailed characterization of granulomas in tissue samples from 12 kidney transplant recipients with cryptococcosis was described by checking six lung and six skin biopsies by conventional histology and for immunohistochemical detection of CD4 and Treg markers: forkhead box P3 (FoxP3), interleukin (IL)-10 and transforming-growth factor (TGF)-β. Granulomas were classified as compact, loose or mixed. Patients with mixed (n = 4) and compact (n = 3) granulomatous inflammation patterns were associated with a better prognosis and presented a higher number of CD4+FoxP3+T cells compared to the group of patients with loose granulomas. In counterpart, three out of five patients with loose granulomas died with cryptococcosis. We suggest that Treg may have a protective role in the tissue response to Cryptococcus infection given its association with compact and mixed granulomas in patients with better clinical outcomes.

scholarly journals Urinary Excretion of N1-methyl-2-pyridone-5-carboxamide and N1-methylnicotinamide in Renal Transplant Recipients and Donors

2020 ◽  
Vol 9 (2) ◽  
pp. 437 ◽  
Author(s):  
Carolien P. J. Deen ◽  
Anna van der Veen ◽  
António W. Gomes-Neto ◽  
Johanna M. Geleijnse ◽  
Karin J. Borgonjen-van den Berg ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Nutritional Status ◽  
Urinary Excretion ◽  
Kidney Function ◽  
Density Lipoprotein ◽  
Kidney Donation ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Kidney Donors

N1-methylnicotinamide (N1-MN) and N1-methyl-2-pyridone-5-carboxamide (2Py) are successive end products of NAD+ catabolism. N1-MN excretion in 24-h urine is the established biomarker of niacin nutritional status, and recently shown to be reduced in renal transplant recipients (RTR). However, it is unclear whether 2Py excretion is increased in this population, and, if so, whether a shift in excretion of N1-MN to 2Py can be attributed to kidney function. Hence, we assessed the 24-h urinary excretion of 2Py and N1-MN in RTR and kidney donors before and after kidney donation, and investigated associations of the urinary ratio of 2Py to N1-MN (2Py/N1-MN) with kidney function, and independent determinants of urinary 2Py/N1-MN in RTR. The urinary excretion of 2Py and N1-MN was measured in a cross-sectional cohort of 660 RTR and 275 healthy kidney donors with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear regression analyses were used to investigate associations and determinants of urinary 2Py/N1-MN. Median 2Py excretion was 178.1 (130.3–242.8) μmol/day in RTR, compared to 155.6 (119.6–217.6) μmol/day in kidney donors (p < 0.001). In kidney donors, urinary 2Py/N1-MN increased significantly after kidney donation (4.0 ± 1.4 to 5.2 ± 1.5, respectively; p < 0.001). Smoking, alcohol consumption, diabetes, high-density lipoprotein (HDL), high-sensitivity C-reactive protein (hs-CRP) and estimated glomerular filtration rate (eGFR) were identified as independent determinants of urinary 2Py/N1-MN in RTR. In conclusion, the 24-h urinary excretion of 2Py is higher in RTR than in kidney donors, and urinary 2Py/N1-MN increases after kidney donation. As our data furthermore reveal strong associations of urinary 2Py/N1-MN with kidney function, interpretation of both N1-MN and 2Py excretion may be recommended for assessment of niacin nutritional status in conditions of impaired kidney function.

Sarcopenia and its components in adult renal transplant recipients: prevalence and association with body adiposity

2019 ◽  
Vol 122 (12) ◽  
pp. 1386-1397 ◽  
Author(s):  
Ana Paula Medeiros Menna Barreto ◽  
Maria Inês Barreto Silva ◽  
Karine Scanci da Silva Pontes ◽  
Mariana Silva da Costa ◽  
Kelli Trindade de Carvalho Rosina ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Muscle Mass ◽  
Physical Performance ◽  
Muscle Function ◽  
Adverse Outcomes ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Body Adiposity ◽  
European Working

AbstractSarcopenia is a progressive and generalised skeletal muscle disorder associated with adverse outcomes. Ageing causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of the present study was to evaluate the prevalence of sarcopenia using guidelines recommended by the European Working Group on Sarcopenia in Older People (EWGSOP, 2010; EWGSOP2, 2018) and the Foundation of the National Institutes of Health (FNIH) and analyse the relationship between sarcopenia and body adiposity in adult renal transplant recipients (RTR). This was a cross-sectional study of adult RTR (BMI ≥ 18·5 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry (DXA) and anthropometry. Glomerular filtration rate was estimated (eGFR) by CKD-Epidemiology Collaboration equation. The prevalence of sarcopenia in adult RTR (n 185; 57 % men, 50 (se 0·82) years and eGFR 55·80 (se 1·52) ml/min) was 7 % (FNIH), 11 % (EWGSOP2) and 17 % (EWGSOP). Low muscle mass, muscle function and physical performance affected, respectively, up to 28, 46 and 10 % of the participants. According to EWGSOP and EWGSOP2, body adiposity evaluated by anthropometry and DXA (percentage trunk fat) was lower in participants with sarcopenia. Conversely, according to the FNIH criteria, RTR with sarcopenia presented higher waist:height ratio. The present study suggests that adult RTR sarcopenia prevalence varies according to the diagnostic criteria; low muscle mass, low muscle function and low physical performance are common conditions; the association of body adiposity and sarcopenia depends on the criteria used to define this syndrome; and the FNIH criteria detected higher adiposity in individuals with sarcopenia.

scholarly journals Efficacy and Safety of Sitagliptin for the Treatment of New-Onset Diabetes after Renal Transplantation

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Brian P. Boerner ◽  
Clifford D. Miles ◽  
Vijay Shivaswamy
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Hemoglobin A1c ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
First Line ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is a common comorbidity after renal transplantation. Though metformin is the first-line agent for the treatment of type 2 diabetes, in renal transplant recipients, metformin is frequently avoided due to concerns about renal dysfunction and risk for lactic acidosis. Therefore, alternative first-line agents for the treatment of NODAT in renal transplant recipients are needed. Sitagliptin, a dipeptidyl-peptidase-4 (DPP-4) inhibitor, has a low incidence of hypoglycemia, is weight neutral, and, in a small study, did not affect immunosuppressant levels. However, long-term sitagliptin use for the treatment of NODAT in kidney transplant recipients has not been studied. We retrospectively analyzed renal transplant recipients diagnosed with NODAT and treated with sitagliptin to assess safety and efficacy. Twenty-two patients were started on sitagliptin alone. After 12 months of followup, 19/22 patients remained on sitagliptin alone with a significant improvement in hemoglobin A1c. Renal function and immunosuppressant levels remained stable. Analysis of long-term followup (32.5±17.8 months) revealed that 17/22 patients remained on sitagliptin (mean hemoglobin A1c < 7%) with 9/17 patients remaining on sitagliptin alone. Transplant-specific adverse events were rare. Sitagliptin appears safe and efficacious for the treatment of NODAT in kidney transplant recipients.

The Search for Bioethical Criteria to Select Renal Transplant Recipients: A Response to the Honourable Judge Jean-Louis Baudouin

Dialogue ◽  
1991 ◽  
Vol 30 (3) ◽  
pp. 425-434
Author(s):  
Stuart F. Spicker
Keyword(s):  
Bone Marrow ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Nobel Prize ◽  
Immune Reaction ◽  
Human Kidney ◽  
Program Committee ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Human Immune

In selecting for discussion the general theme of the donation and sharing of cells, tissues and organs (typically accomplished by transfusion and other forms of surgical transplantation) the program committee of the Second Congress of the Canadian Bioethics Society appears to have been astonishingly prescient in anticipating that two North American physicians —clinical researchers rather than “basic” scientists, by the way —would receive, as they did just over a month ago, Nobel Prizes in Physiology or Medicine for their medical achievements.1 Dr. Joseph Murray was cited in part for successfully performing, in 1954, the first human kidney transplant (the recipient lived eight years), as well as for discovering how to minimize the body's rejection of this organ; Dr. Donnall Thomas was cited for work he accomplished in 1956 —the first bone-marrow cell transfusion to a 16-year-old patient (who is still alive) such that the human immune reaction of a graft to this recipient's body could be medically managed to avoid rejection of the transplanted material (Economist 1990). Having mentioned these awards, I should note that Dr. George Hitchings had already received the Nobel Prize in Medicine in 1988, being credited with the discovery of a powerful immunosuppressant, azathioprine, which greatly improved the survival of the recipients of unmatched graft transplants.

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