scholarly journals Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients

2021 ◽  
Vol 18 (17) ◽  
pp. 9236
Author(s):  
Alessandro Patti ◽  
Daniel Neunhaeuserer ◽  
Andrea Gasperetti ◽  
Veronica Baioccato ◽  
Marco Vecchiato ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Exercise Testing ◽  
Respiratory Exchange Ratio ◽  
Cardiopulmonary Exercise Testing ◽  
Cross Sectional Study ◽  
Peak Exercise ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Linear Slope

The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO2: ρ = 0.57, p < 0.01) and cardiorespiratory efficiency (VE/VCO2 slope: r = −0.32, p < 0.05; oxygen uptake efficiency slope (OUES): r = 0.48, p < 0.01). Indeed, the RER mag was significantly different between the subgroups stratified by Weber’s fitness class or a ventilatory efficiency class. Our study is the first to investigate recovery of the RER in a population of KTRs, which correlates well with known prognostic CPET markers of cardiorespiratory fitness, determining the RER mag as the most meaningful RER overshoot parameter. Thus, the RER recovery might be included in CPET evaluations to further improve prognostic risk stratifications in KTRs and other chronic diseases.

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.

Cross-sectional study of BK virus infection in pediatric kidney transplant recipients

2007 ◽  
Vol 11 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Marta Fogeda ◽  
Patricia Muñoz ◽  
Augusto Luque ◽  
Ma Dolores Morales ◽  
Emilio Bouza ◽  
...  
Keyword(s):  
Virus Infection ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Bk Virus ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

scholarly journals Novel urinary exosomal biomarkers of acute T cell-mediated rejection in kidney transplant recipients: A cross-sectional study

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0204204 ◽  
Author(s):  
Jeong-Hoon Lim ◽  
Chan-Hyeong Lee ◽  
Kyu Yeun Kim ◽  
Hee-Yeon Jung ◽  
Ji-Young Choi ◽  
...  
Keyword(s):  
T Cell ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

scholarly journals First and second morning spot urine protein measurements for the assessment of proteinuria: a diagnostic accuracy study in kidney transplant recipients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maja Mrevlje ◽  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Jelka Lindič ◽  
Jadranka-Buturović-Ponikvar ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Urine Protein ◽  
Cross Sectional ◽  
Spot Urine ◽  
Protein Excretion ◽  
Measures Of Agreement

Abstract Background Quantification of proteinuria in kidney transplant recipients is important for diagnostic and prognostic purposes. Apart from correlation tests, there have been few evaluations of spot urine protein measurements in kidney transplantation. Methods In this cross-sectional study involving 151 transplanted patients, we investigated measures of agreement (bias and accuracy) between the estimated protein excretion rate (ePER), determined from the protein-to-creatinine ratio in the first and second morning urine, and 24-h proteinuria and studied their performance at different levels of proteinuria. Measures of agreement were reanalyzed in relation to allograft histology in 76 patients with kidney biopsies performed for cause before enrolment in the study. Results For ePER in the first morning urine, percent bias ranged from 1 to 28% and accuracy (within 30% of 24-h collection) ranged from 56 to 73%. For the second morning urine, percent bias ranged from 2 to 11%, and accuracy ranged from 71 to 78%. The accuracy of ePER (within 30%) in first and second morning urine progressively increased from 56 and 71% for low-grade proteinuria (150–299 mg/day) to 60 and 74% for moderate proteinuria (300–999 mg/day), and to 73 and 78% for high-grade proteinuria (≥1000 mg/day). Measures of agreement were similar across histologic phenotypes of allograft injury. Conclusions The ability of ePER to accurately predict 24-h proteinuria in kidney transplant recipients is modest. However, accuracy improves with an increase in proteinuria. Given the similar accuracy of ePER measurements in first and second morning urine, second morning urine can be used to monitor protein excretion.

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