scholarly journals Urine Bacteriology in Post-Kidney Transplant Patients with Double-J Stents

2021 ◽  
Vol 7 (4) ◽  
pp. 358-364
Author(s):  
S Abu ◽  
MC Igbokwe ◽  
OO Olatise ◽  
M Okafor ◽  
SO Asaolu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Urinary Tract ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Bacterial Colonisation ◽  
Transplant Patients ◽  
Stage Renal Disease ◽  
Tract Infections ◽  
End Stage

Background: Kidney transplantation is the gold standard treatment modality for patients with end-stage renal disease. Ureteric stenting is commonly used during kidney transplantation to reduce the incidence of ureteric complications post-transplantation. The presence of ureteric stents could be complicated by bacterial colonisation and urinary tract infections. Objective: To identify the urinary flora in patients with double-J stents following kidney transplantation and establish bacteria colonisation and their antimicrobial susceptibility. Methods: Over one-year, single urine samples of consecutive 100 post-renal transplant patients were subjected to bacteriologic analysis. Early morning midstream urine was obtained into a sterile bottle from all the participants for laboratory analysis. Results: The mean age of post kidney transplantation patients was 47.6 ±12.3 years. Hypertension and diabetes were the commonest co-morbidities associated with End-Stage-Renal-Disease (ESRD), accounting for 61% and 28%, respectively. E. coli was the commonest isolate (70.4%). Microbiological evidence of Urinary Tract Infection (UTI) revealed by pyuria (pus cells >4/HPF) was found in 40.9%. Tigecycline, nitrofurantoin and tetracycline showed the highest sensitivity pattern in 9%, 8% and 8%, respectively, with significant resistance against cephalosporins and fluoroquinolones. Conclusion: The fourth week of double-J ureteric stent insertion in kidney transplant recipients showed a high incidence of urinary bacterial colonisation.

scholarly journals 1770. Access to Kidney Transplantation in Persons Living with HIV and End-stage Renal Disease in Network 6

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S652-S653
Author(s):  
Ruth O Adekunle ◽  
Rebecca Zhang ◽  
Zhensheng Wang ◽  
Rachel Patzer ◽  
Aneesh Mehta
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Categorical Variables ◽  
Persons Living With Hiv ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living With Hiv ◽  
Hiv Negative

Abstract Background As persons living with HIV (PLWH) live longer, end-stage renal disease (ESRD) is emerging as a significant cause of morbidity and mortality. PLWH had a three-fold increased risk of ESRD, while also experiencing lower survival rates on dialysis compared with the general population. There are limited data on the incidence and prevalence of PLWH on dialysis. Our objective was to determine the incidence of PLWH on dialysis in ESRD Network 6 (GA, NC, SC) and assess their referral to kidney transplantation and waitlisting on the deceased donor waiting list. Methods We merged data from the Southeast Transplant Referral Dataset with the United States Renal Data System Medicare Part D Prescription Claims. PLWH were defined as having a prescription for antiretroviral medications or primary cause of ESRD being HIV-associated nephropathy. Descriptive analysis was performed using Student’s t-test for continuous variables and chi-squared test for categorical variables. Results The dataset contained 24,587 patients (471 HIV positive) that initiated an ESRD service between 2012 and 2015. Incidence of PLWH on dialysis was 1.92%. Compared with HIV negative persons, PLWH were younger (median age 49 vs. 58, P < 0.001) and more often black (90% vs. 57%, P < 0.001). There were similar rates of referral among PLWH and HIV-negative persons (50% vs. 51%, P = 0.81), though PLWH were statistical significantly less likely to be waitlisted (8% vs. 15%, P < 0.001). PLWH had longer median time to be referred (240 days vs. 147 days, P < 0.001) and waitlisted compared with HIV-negative persons (611 days vs. 420 days, P = 0.04). Conclusion This pilot study offers the first ESRD Network-level characterization of PLWH receiving an ESRD service proceeding through the steps of kidney transplantation. PLWH were less likely to traverse the steps of kidney transplant compared with those HIV negative, highlighting the need for targeted interventions to improve access to kidney transplant in PLWH. Disclosures All authors: No reported disclosures.

scholarly journals Robot-assisted kidney transplantation. First experience

2020 ◽  
Vol 22 (2) ◽  
pp. 125-131
Author(s):  
S. V. Shchekaturov ◽  
I. V. Semeniakin ◽  
A. K. Zokoev ◽  
T. B. Makhmudov ◽  
R. R. Poghosyan
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Graft Function ◽  
Surgical Techniques ◽  
Clinical Report ◽  
Robot Assisted ◽  
Stage Renal Disease ◽  
End Stage

Kidney transplantation is the preferred renal replacement therapy for patients with end-stage renal disease. Traditional surgical approaches consisting of vascular and urinary outflow reconstruction during kidney transplant have been sufficiently studied and standardized. However, surgical techniques are still evolving. The objective of this clinical report is to focus the attention of kidney transplant surgeons and specialists on the currently trending robot-assisted kidney transplantation (RAKT) as a minimally invasive procedure for surgical treatment of patients with end-stage renal disease. In our first experience, good primary graft function was achieved. This shows that RAKT is a surgical option. With considerable number of surgeries and experience, RAKT outcomes would be improved significantly.

scholarly journals Progression of coronary artery calcification in conventional hemodialysis, nocturnal hemodialysis, and kidney transplantation

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244639
Author(s):  
Thijs T. Jansz ◽  
Akin Özyilmaz ◽  
Franka E. van Reekum ◽  
Franciscus T. J. Boereboom ◽  
Pim A. de Jong ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Coronary Artery ◽  
Renal Disease ◽  
Kidney Transplant ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Nocturnal Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Conventional Hemodialysis

Introduction Cardiovascular disease is the leading cause of death in end-stage renal disease (ESRD) and is strongly associated with vascular calcification. An important driver of vascular calcification is high phosphate levels, but these become lower when patients initiate nocturnal hemodialysis or receive a kidney transplant. However, it is unknown whether nocturnal hemodialysis or kidney transplantation mitigate vascular calcification. Therefore, we compared progression of coronary artery calcification (CAC) between patients treated with conventional hemodialysis, nocturnal hemodialysis, and kidney transplant recipients. Methods We measured CAC annually up to 3 years in 114 patients with ESRD that were transplantation candidates: 32 that continued conventional hemodialysis, 34 that initiated nocturnal hemodialysis (≥4x 8 hours/week), and 48 that received a kidney transplant. We compared CAC progression between groups as the difference in square root transformed volume scores per year (ΔCAC SQRV) using linear mixed models. Reference category was conventional hemodialysis. Results The mean age of the study population was 53 ±13 years, 75 (66%) were male, and median dialysis duration was 28 (IQR 12–56) months. Median CAC score at enrollment was 171 (IQR 10–647), which did not differ significantly between treatment groups (P = 0.83). Compared to conventional hemodialysis, CAC progression was non-significantly different in nocturnal hemodialysis -0.10 (95% CI -0.77 to 0.57) and kidney transplantation -0.33 (95% CI -0.96 to 0.29) in adjusted models. Conclusions Nocturnal hemodialysis and kidney transplantation are not associated with significantly less CAC progression compared to conventional hemodialysis during up to 3 years follow-up. Further studies are needed to confirm these findings, to determine which type of calcification is measured with CAC in end-stage renal disease, and whether that reflects cardiovascular risk.

P1732RECURRENCE OF GLOMERULONEPHRITIS POST TRANSPLANT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Umesh Lingaraj ◽  
Ricken Mehta ◽  
Shivaprasad SM ◽  
Kishan A ◽  
Leelavathi V ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Glomerulonephritis (GN) is a major cause of end stage renal disease (ESRD)1. It represents the primary cause of end stage renal disease (ESRD) for 25% of the dialysis population1 and 45% of the transplant population. For patients with GN requiring renal replacement therapy, kidney transplantation is associated with superior outcomes compared with dialysis2. The possibility of recurrence of the original disease after transplantation was described in a seminal paper more than 40 years ago, and it is now clear that all forms of GN may recur after kidney transplantation.3 To study the recurrence of glomerulonephritis post-transplant in a tertiary care centre. Method 120 renal transplant recipients were analyzed from September 2015 to August 2019 at the Institute of Nephro-Urology, Bangalore. It was a retrospective analysis of data Results 120 adult patients underwent kidney transplantation, out of these 70 had GN as primary cause of kidney disease. 85.8% were males, 14.2 % females. 58.9 % were biopsy proven GN, remaining 41.1 % diagnosed based on history and clinical presentation. All but one patient had their first transplant. Out of these kidney transplant recipients 08 (11.4%) had recurrence of GN.  From these 4/08 was recurrent IgA N, 2/08 were PGNMID, 1/08 MGN, 1/08 aHUS. Graft loss due to recurrent GN was seen in 1/08 patients (12.5%). Conclusion Our study showed that 11.4 % of kidney transplant recipients with GN as their cause of ESRD had recurrent GN post kidney transplantation. IgAN was the most type of GN that recurred most frequently followed by PGNMID. Recurrence of GN was in par with other studies and did not affect graft survival

Bladder capacity in kidney transplant patients with end-stage renal disease

2014 ◽  
Vol 47 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Miho Song ◽  
Junsoo Park ◽  
Young Hoon Kim ◽  
Duck Jong Han ◽  
Sang Hoon Song ◽  
...  
Keyword(s):  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Bladder Capacity ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Determinants of willingness to accept kidney transplantation among chronic kidney disease patients in Ghana

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
V. Boima ◽  
M. B. Amissah-Arthur ◽  
E. Yorke ◽  
D. Dey ◽  
Delali Fiagbe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Willingness To Accept ◽  
Willingness To Donate ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background The burden of chronic kidney disease in Africa is three to four times higher compared to high-income countries and the cost of treatment is beyond the reach of most affected persons. The best treatment for end stage renal disease is kidney transplantation which is not available in most African countries. As kidney transplantation surgery is emerging in Ghana, this study assessed factors which could influence the willingness of patients with chronic kidney disease to accept it as a mode of treatment. Methods This cross-sectional survey was carried out among patients with chronic kidney disease in Korle-Bu Teaching Hospital. A consecutive sampling method was used to recruit consenting patients. A structured questionnaire and standardized research instruments were used to obtain information on demographic, socio-economic characteristics, knowledge about transplantation, perception of transplantation, religiosity and spirituality. Logistic regression model was used to assess the determinants of willingness to accept a kidney transplant. Results 342 CKD patients participated in the study of which 56.7% (n = 194) were male. The mean age of the participants was 50.24 ± 17.08 years. The proportion of participants who were willing to accept a kidney transplant was 67.3% (95%CI: 62.0–72.2%). The factors which influenced participants’ willingness to accept this treatment included; willingness to attend a class on kidney transplantation (p < 0.016), willingness to donate a kidney if they had the chance (p < 0.005), perception that a living person could donate a kidney (p < 0.001) and perceived improvement in quality of life after transplantation (p < 0.005). The barriers for accepting kidney transplantation were anticipated complications of transplant surgery and financial constraints. Conclusion More than two-thirds of CKD patients were willing to accept a kidney transplant and this is influenced by multiple factors. Government health agencies must consider full or partial coverage of kidney transplantation through the existing national health insurance scheme. Further, efficient educational programmes are required to improve both patients’ and physicians’ knowledge on the importance of kidney transplantation in the management of end stage renal disease in Ghana.

scholarly journals Willingness to pay for kidney transplantation among chronic kidney disease patients in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244437
Author(s):  
V. Boima ◽  
K. Agyabeng ◽  
V. Ganu ◽  
D. Dey ◽  
E. Yorke ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
Willingness To Pay ◽  
Kidney Transplant ◽  
Treatment Option ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Background Kidney transplantation is the preferred treatment for patients with end stage renal disease. However, it is largely unavailable in many sub-Sahara African countries including Ghana. In Ghana, treatment for end stage renal disease including transplantation, is usually financed out-of-pocket. As efforts continue to be made to expand the kidney transplantation programme in Ghana, it remains unclear whether patients with Chronic Kidney Disease (CKD) would be willing to pay for a kidney transplant. Aim The aim of the study was to assess CKD patients’ willingness to pay for kidney transplantation as a treatment option for end stage renal disease in Ghana. Methods A facility based cross-sectional study conducted at the Renal Outpatient clinic and Dialysis Unit of Korle-Bu Teaching Hospital among 342 CKD patients 18 years and above including those receiving haemodialysis. A consecutive sampling approach was used to recruit patients. Structured questionnaires were administered to obtain information on demographic, socio-economic, knowledge about transplant, perception of transplantation and willingness to pay for transplant. In addition, the INSPIRIT questionnaire was used to assess patients’ level of religiosity and spirituality. Contingent valuation method (CVM) method was used to assess willingness to pay (WTP) for kidney transplantation. Logistic regression model was used to determine the significant predictors of WTP. Results The average age of respondents was 50.2 ± 17.1 years with most (56.7% (194/342) being male. Overall, 90 out of the 342 study participants (26.3%, 95%CI: 21.7–31.3%) were willing to pay for a kidney transplant at the current going price (≥ $ 17,550) or more. The median amount participants were willing to pay below the current price was $986 (IQR: $197 –$1972). Among those willing to accept (67.3%, 230/342), 29.1% (67/230) were willing to pay for kidney transplant at the prevailing price. Wealth quintile, social support in terms of number of family friends one could talk to about personal issues and number of family members one can call on for help were the only factors identified to be significantly predictive of willingness to pay (p-value < 0.05). Conclusion The overall willingness to pay for kidney transplant is low among chronic kidney disease patients attending Korle-Bu Teaching Hospital. Patients with higher socio-economic status and those with more family members one can call on for help were more likely to pay for kidney transplantation. The study’s findings give policy makers an understanding of CKD patients circumstances regarding affordability of the medical management of CKD including kidney transplantation. This can help develop pricing models to attain an ideal poise between a cost effective but sustainable kidney transplant programme and improve patient access to this ultimate treatment option.

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