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.

Evaluation of Quality of Life among Kidney Transplant Patients- A Cross Sectional Study

2021 ◽  
Vol 15 (11) ◽  
pp. 3087-3089
Author(s):  
Rashida Jabeen ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Sadia Khan
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Kidney transplantation is the famous and most important choice of treatment of renal replacement therapies (RRTs) because of its positive impact on morbidity, survival and cost. The health related quality of life is becoming important outcome. Quality of life is usually impaired in patients who have renal transplant because of renal transplant patients have anxiety, lack of social, physical and emotional support and diminished ability to take care of themselves. The basic purpose of renal transplantation is to achieve maximum quality of life with minimum side effects. Methods: A cross sectional study was conducted at Rukhsana Akhtar Bahria International Orchard Hospital Lahore after approval from institution board of university of Lahore. 36 patients were enrolled in study by using purposive sampling technique. After taking informed consent all Kidney transplant patients aged between 18 years to 60 years, visited the post-transplantation OPD and continuously in follow-up sessions were included in study. A validated and standard WHO questionnaire of “Kidney Disease and Quality of Life (KDQOL-36™)” was used for data collection. Data was entered and analyzed in SPSS version.21.Chi-square test was applied to find out significant association between qualitative variables. P -Value < 0.05will be considered as statistically significant. Results: Majority of patients were from 40-49 years 10(27.0%). Females were more as compared to men (20(55.6) vs 16(44.4%)). 10(27.8) patients can read and write and 8(22.2%) have done matriculation. More patients live in Urban area as compared to rural area(19(52.8%) vs 17(47.2%)).8(22.2%) patients have less than 1 year of post kidney transplantation time and 19(52.8%) have 1 to 3 years. All the seven domains of KDQOL show poor QOL. General Health, Physical function and physical and emotional function shows average QOL and Emotional, social, daily activities and overall KDQOL shows poor QOL. There was insignificant association with age, gender, education; residential area and Post kidney transplantation length of time (years)(p-value > 0.05). Conclusions: After renal transplantation HRQOL becomes very important factor. After kidney transplantation HRQOL depends on many factors. It was concluded from current study that the HRQOL was not as good as it should be. Over the period of transplantation time patient’s quality of life remain same. The society, government, family, and medical staff need to support patients so they can also improve their QOL. Key word: Renal Diseases, Kidney transplant, Quality of life, KDQOL-36

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.

Psychological symptoms, quality of life and adherence to immunosuppressive therapy in kidney transplant recipients: a cross-sectional study

2020 ◽  
Vol 5 (6) ◽  
pp. 264-271
Author(s):  
Ujjwal Dahiya ◽  
Kamli Prakesh ◽  
Sandeep Mahajan ◽  
Nand Kumar
Keyword(s):  
Quality Of Life ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Psychological Symptoms ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

Aim: To assess psychological symptoms, quality of life and adherence to immunosuppressive therapy in kidney transplant recipients. Design: Cross-sectional study was conducted in kidney transplant recipients. Methods: This cross-sectional study included a total of 96 consecutive patients at least 3 months after kidney transplantation from September 2019 to November 2019. Psychological symptoms (anxiety, stress and depression) were assessed using the Depression, Anxiety and Stress Scale. The World Health Organization Quality of Life Instrument was used to assess quality of life in kidney transplant recipients. Adherence to immunosuppressive therapy was assessed by the Morisky Green Levine (MGL) adherence scale. The demographic and clinical details were assessed with a validated self-structured questionnaire. Results: The study included a young adult male population with a mean age of 38.82±10.53 years. The majority of patients reported at least some psychological abnormalities, with mild stress being the most common and presenting in 73% of patients. Importantly, 29% and 21% of patients reported anxiety and depression. Stress was significantly associated with gender, post-transplantation infection and hospitalisation. Anxiety was significantly associated with low family income and post-transplant complication of infection. Psychological symptoms significantly affected the various domains of quality of life of the patients. None of the surveyed patients had low adherence, while 56 (58.3%) had medium adherence to immunosuppressive therapy. Patients with medium adherence to immunosuppressive therapy had significantly lower scores in physical (p=0.01) and social relationship (p= 0.004) domains of quality of life. Conclusion: A significant number of young and stable kidney transplant recipients have presented with psychological symptoms (mainly depression) that affected their quality of life. The presence of psychological symptoms can not only hamper quality of life, but also affect their compliance to drugs. Impact: Psychological health is an important concern after kidney transplantation. Nurses should include assessment of psychological symptoms in their care that would further help in improving quality of life and adherence to drugs in kidney transplant recipients.

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.

scholarly journals Sclerostin is an independent risk factor for all-cause mortality in kidney transplant recipients

2020 ◽  
Vol 24 (12) ◽  
pp. 1177-1183
Author(s):  
Shufei Zeng ◽  
Torsten Slowinski ◽  
Wolfgang Pommer ◽  
Ahmed A. Hasan ◽  
Mohamed M. S. Gaballa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kaplan Meier ◽  
All Cause Mortality

Abstract Background Sclerostin is a hormone contributing to the bone-vascular wall cross talk and has been implicated in cardiovascular events and mortality in patients with chronic kidney disease (CKD). We analyzed the relationship between sclerostin and mortality in renal transplant recipients. Methods 600 stable renal transplant recipients (367men, 233 women) were followed for all-cause mortality for 3 years. Blood and urine samples for analysis and clinical data were collected at study entry. We performed Kaplan–Meier survival analysis and Cox regression models considering confounding factors such as age, eGFR, cold ischemia time, HbA1c, phosphate, calcium, and albumin. Optimal cut-off values for the Cox regression model were calculated based on ROC analysis. Results Sixty-five patients died during the observation period. Nonsurvivors (n = 65; sclerostin 57.31 ± 30.28 pmol/L) had higher plasma sclerostin levels than survivors (n = 535; sclerostin 47.52 ± 24.87 pmol/L) (p = 0.0036). Kaplan–Meier curve showed that baseline plasma sclerostin concentrations were associated with all-cause mortality in stable kidney transplant recipients (p = 0.0085, log-rank test). After multiple Cox regression analysis, plasma levels of sclerostin remained an independent predictor of all-cause mortality (hazard ratio, 1.011; 95% CI 1.002–1.020; p = 0.0137). Conclusions Baseline plasma sclerostin is an independent risk factor for all-cause mortality in patients after kidney transplantation.

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