scholarly journals RENAL TRANSPLANT RECIPIENTS

2015 ◽  
Vol 22 (05) ◽  
pp. 590-595
Author(s):  
Ruhina Akbar ◽  
Naeem Kauser ◽  
Naveed Hussain
Keyword(s):  
Renal Transplant ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Renal Transplant Recipients ◽  
Lipid Modification ◽  
Transplant Recipients ◽  
Kidney Dialysis ◽  
Post Transplant ◽  
The Mean ◽  
Hba1c Levels

Introduction: Good glycemic control and lipid modification are potentiallyimportant intervention for improving outcome after kidney transplantation. Objective: Todetermine the frequency of dyslipidemia and its types in renal transplant recipients (RTRs),and to observe impact of hyperglycemia on their lipid profile. Design: Case control study.Period: June 2011 to May 2012. Setting: Kidney Dialysis Department of Jinnah HospitalLahore, Urology Department of Mayo Hospital Lahore and Pathology Department AllamaIqbal Medical College Lahore. Patients and Methods: A total of 40 RTR were included in thestudy. An equal number of sex and age matched healthy subjects were considered as controlgroup. The patients were on regular post transplant follow up in Kidney Dialysis Department ofJinnah Hospital Lahore and Urology Department of Mayo Hospital Lahore and had no clinicalor laboratory evidence of graft rejection, post-transplant diabetes mellitus, hypertension or intercurrent infection. Total cholesterol (TC), triglyceride (TG), High density Lipoprotein-Cholesterol(HDL-C), and Glycohemoglobin A1c (HbA1c) were estimated in all subjects. These subjectswere divided into Diabetic and non-diabetic groups, according to level of HbA1c. Results:The mean age of the RTR was 34.5± 9.02 years and the mean duration of transplant was36.70 ± 38.07 months. RTRs showed significantly high mean levels of TG (p< 0.002), TC (p<0.00), LDL-C (p< 0.01), and HDL-C (p< 0.05) as compared to the control subjects. ElevatedTC, TG, LDL-C and low HDL was observed in 32.5%, 72.5%, 52.5%, and 60% of total RTR,respectively. The mean levels of TC, TG and HDL-C were increased in Diabetic transplant groupas compared to non-diabetic RTR. Percentage of elevated TC, TG, LDL-C and decreased HDLin diabetic group of RTR versus non diabetic RTR was 43.7% Vs 25% , 81.2% Vs 66.6%, , 62.5%Vs 44.4%, and 50% Vs 66.6% respectively. There was a positive relationship between HbA1cand lipid profile (TC, TG, and LDL – C) in both Diabetic and Non Diabetic Group. A statisticallysignificant correlation of the mean HbA1c levels with TG level was observed in Diabetic RTR.Conclusion: Dyslipidemia in our RTRs was observed as elevated levels of TC, TG and LDL-C. Indiabetic RTR, a statistically significant positive correlation of the HbA1c levels with TG level wasobserved. More rigorous glycemic control and lipid modification will reduce the development ofmicrovascular complications.

scholarly journals Impact of Diabetes Mellitus on Renal transplant outcome

2021 ◽  
pp. 057-064
Author(s):  
Abbasi Muhammad Tanzeel ◽  
Arif Mariam ◽  
Saleem Nayyar
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Glycemic Control ◽  
Diabetic Patients ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
Metabolic Complication ◽  
Wide Range ◽  
The Impact ◽  
Hba1c Levels

Diabetes Mellitus (DM) is a potent risk factor for post-transplant cardiovascular complications and infections. Management of diabetes and its complications in renal transplant recipients is a challenging task. This is a frequently encountered predicament in transplant setups. An erratic glycemic control during dialysis is a predictor of poor graft and patient outcomes after kidney transplantation. Literature review reveals majority studies explaining post-transplant diabetes and its role in graft and patient survival. However, a wide range of opinion exists about the impact of pre-transplant DM on transplant outcomes. Measurement of HbA1c levels is a significant tool for assessment of glycemic control. A target HbA1c level of <7% is recommended for diabetic patients irrespective of presence or absence of Chronic Kidney Disease (CKD). However, diabetic patients with CKD are at risk of hypoglycemia owing to decreased insulin metabolism so it is safe to keep HbA1c levels between 7-8% in this population. Immunosuppressive medications have a strong contributory role in deterioration of glycemic control. So, it is imperative to achieve strict pre-transplant diabetes control in order to avoid post-transplant complications. Post-transplant diabetes mellitus (PTDM) has been a subject of a large number of trials and is not only considered a serious metabolic complication but also a predisposing factor of diabetic nephropathy in transplanted kidney.

scholarly journals Radical prostatectomy outcomes in renal transplant recipients: a retrospective case series of Thai patients

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun Sirisopana ◽  
Pocharapong Jenjitranant ◽  
Premsant Sangkum ◽  
Kittinut Kijvikai ◽  
Suthep Pacharatakul ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Renal Transplant ◽  
Operative Time ◽  
Case Series ◽  
Urinary Continence ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Estimated Blood Loss ◽  
The Mean

Abstract Background The incidence of prostate cancer in renal transplant recipients (RTR) is similar to the general population. Radical prostatectomy (RP) is the standard of care in the management of clinically localized cancer, but is considered complicated due to the presence of adhesions, and the location of transplanted ureter/kidney. To date, a few case series or studies on RP in RTR have been published, especially in Asian patients. This study aimed to evaluate the efficacy and safety and report the experience with RP on RTR. Methods We retrospectively reviewed data of 1270 patients who underwent RP from January 2008 to March 2020, of which 5 patients were RTR. All available baseline characteristics, perioperative and postoperative data (operative time, estimated blood loss (EBL), complications, length of hospital stay, complication), pathological stage, Gleason score, surgical margin status, and pre/postoperative creatinine were reviewed. Results Of the 5 RTR who underwent RPs (1 open radical prostatectomy (ORP), 1 laparoscopic radical prostatectomy (LRP), 2 robotic-assisted laparoscopic radical prostatectomies (RALRP), and 1 Retzius-sparing RALRP (RS-RALRP)) prostatectomy, the mean age (± SD) was 70 (± 5.62) years. In LRP and RALRP cases, the standard ports were moved slightly medially to prevent graft injury. The mean operative time ranged from 190 to 365 min. The longest operative time and highest EBL (630 ml) was the ORP case due to severe adhesion in Retzius space. For LRP and RALRP cases, the operative times seemed comparable and had EBL of ≤ 300 ml. All RPs were successful without any major intra-operative complication. There was no significant change in graft function. The restorations of urinary continence were within 1 month in RS-RALRP, approximately 6 months in RALRP, and about 1 year in ORP and LRP. Three patients with positive surgical margins had prostate-specific antigen (PSA) persistence at the first follow-up and 1 had later PSA recurrence. Two patients with negative margins were free from biochemical recurrence at 47 and 3 months after their RP. Conclusions Our series suggested that all RP techniques are safe and feasible mode of treatment for localized prostate cancer in RTR.

scholarly journals Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Nephron ◽  
2021 ◽  
pp. 1-13
Author(s):  
Ana Elena Rodríguez-Rodríguez ◽  
Esteban Porrini ◽  
Mads Hornum ◽  
Javier Donate-Correa ◽  
Raúl Morales-Febles ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Cell Function ◽  
Cell Damage ◽  
Current Evidence ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Β Cell Function

Post-transplant diabetes mellitus (PTDM) is a frequent and relevant complication after renal transplantation: it affects 20–30% of renal transplant recipients and increases the risk for cardiovascular and infectious events. Thus, understanding pathogenesis of PTDM would help limiting its consequences. In this review, we analyse novel aspects of PTDM, based on studies of the last decade, such as the clinical evolution of PTDM, early and late, the reversibility rate, diagnostic criteria, risk factors, including pre-transplant metabolic syndrome and insulin resistance (IR) and the interaction between these factors and immunosuppressive medications. Also, we discuss novel pathogenic factors, in particular the role of β-cell function in an environment of IR and common pathways between pre-existing cell damage and tacrolimus-induced toxicity. The relevant role of prediabetes in the pathogenesis of PTDM and cardiovascular disease is also addressed. Finally, current evidence on PTDM treatment is discussed.

Effects of immunosuppressive therapy on lipid profile in renal transplant recipients

1994 ◽  
Vol 109 (1-2) ◽  
pp. 135
Author(s):  
M. Breto´ ◽  
I. Beneyto ◽  
L.M. Pallardo´ ◽  
J. Sa´nchez ◽  
A. Rochera ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Lipid Profile ◽  
Immunosuppressive Therapy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals High Plasma Branched-Chain Amino Acids Are Associated with Higher Risk of Post-Transplant Diabetes Mellitus in Renal Transplant Recipients

2020 ◽  
Vol 9 (2) ◽  
pp. 511 ◽  
Author(s):  
Maryse C. J. Osté ◽  
Jose L. Flores-Guerrero ◽  
Eke G. Gruppen ◽  
Lyanne M. Kieneker ◽  
Margery A. Connelly ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Amino Acids ◽  
Renal Transplant ◽  
Branched Chain Amino Acids ◽  
Resonance Spectroscopy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Branched Chain

Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2–6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08–1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.

Vaccination titres pre- and post-transplant in paediatric renal transplant recipients and the impact of immunosuppressive therapy

2018 ◽  
Vol 33 (5) ◽  
pp. 897-910 ◽  
Author(s):  
Britta Höcker ◽  
Martin Aguilar ◽  
Paul Schnitzler ◽  
Lars Pape ◽  
Martin Bald ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Immunosuppressive Therapy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
The Impact
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