scholarly journals The association of serum dephosphorylated-uncarboxylated matrix gamma carboxyglutamate protein (dp-ucMGP) as a marker of vascular vitamin K status with allograft function in kidney transplant recipients

2019 ◽  
Vol 9 (3) ◽  
pp. e24-e24
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Zahra Shahvegharasl ◽  
Pouya Fathalizadeh ◽  
Sajjad Pourasghary ◽  
Mohammadali Mohajel Shoja ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Serum Level ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Vitamin K ◽  
High Serum ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Allograft Function

Introduction: Kidney transplantation has considerably increased the survival and life quality of patients with end-stage renal disease. Objectives: The current study was designed to investigate the circulating level of dephosphorylateduncarboxylated matrix gamma carboxyglutamate protein (dp-ucMGP) as a marker of vitamin K status and vascular calcification in kidney transplant recipients as well as its association with the allograft function. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated in the post-transplant phase (about 6-12 months after kidney transplantation). The serum levels of dp-ucMGP, urea, creatinine and other biochemical indices were determined. Results: The mean serum level of dp-ucMGP was 3.78±3.79 µg/L. Most of the participants (80%) had a normal range of serum dp-ucMGP (<4 µg/L). However, 10 % had high serum dp-ucMGP (>12 µg/L). Serum dp-ucMGP did not have any statistical significant association with serum urea, creatinine and kidney function (P>0.05). Conclusion: Further epidemiologic studies are needed to assess the time trends of dp-ucMGP after renal transplant and its relation to kidney function, since high serum level of dp-ucMGP may make kidney transplant recipients prone to various cardiovascular disease (CVD) and transplant rejection.

scholarly journals Kidney Function-Dependence of Vitamin K-Status Parameters: Results from the TransplantLines Biobank and Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3069
Author(s):  
Daan Kremer ◽  
Dion Groothof ◽  
Charlotte A. Keyzer ◽  
Coby Eelderink ◽  
Tim J. Knobbe ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Cohort Studies ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Vitamin K ◽  
Matrix Gla Protein ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Blood Concentrations ◽  
K Deficiency

High circulating dephosphorylated (dp) uncarboxylated (uc) matrix Gla protein (MGP) and uc osteocalcin (OC) concentrations are regarded as markers of vitamin K-deficiency. However, because MGP and OC are small molecules, they may potentially pass the glomerulus, and their blood concentrations may strongly depend on kidney function. However, many studies with vitamin K-status parameters do not structurally adjust for baseline kidney function, and detailed studies on kidney function-dependence of vitamin K-status markers are lacking. We therefore measured plasma dp-ucMGP using a chemiluminescent assay in 578 kidney transplant recipients (41% females, age 56 ± 13y, 7.5 (3.2 to 13.7)y after transplantation, eGFR 49 ± 17 mL/min/1.73 m2) participating in the prospective TransplantLines Cohort Studies. Additionally, dp-carboxylated MGP, ucOC and carboxylated OC were measured using ELISA in plasma of a subgroup of 60 participants. Finally, dp-ucMGP was measured in a separate cohort of 124 kidney transplant recipients before and three months after kidney transplantation. Dp-ucMGP positively correlated with creatinine, cystatin C, and negatively with eGFR (Spearman’s ρ 0.54, 0.60, and −0.54, respectively, p < 0.001 for all), and each 10 mL/min/1.73 m2 increase in eGFR was associated with a 14.0% lower dp-ucMGP. Additionally, dp-ucMGP strongly declined after kidney transplantation (pretransplantation: 1252 (868 to 1744) pmol/L to posttransplantation: 609 (451 to 914) pmol/L, p < 0.001). Proportions of dp-ucMGP over total MGP and ucOC over total OC were not associated with eGFR. This study highlights that dp-ucMGP is strongly associated with kidney function, and that levels strongly decrease after kidney transplantation. We therefore propose adequate adjustment for kidney function, or the use of kidney function-independent parameters such as proportion of uncarboxylated MGP or OC in the assessment of vitamin K-status in clinical practice and research.

scholarly journals Severely Disseminated Kaposi Sarcoma after ABO-Incompatible Kidney Transplantation Treated Successfully with Paclitaxel and Gemcitabine Combined with Hemodialysis

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Tobias Bomholt ◽  
Anders Krarup-Hansen ◽  
Martin Egfjord ◽  
Søren Schwartz Sørensen ◽  
Niels Junker
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Kaposi Sarcoma ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Serious Adverse Events ◽  
Human Herpes Virus 8 ◽  
Positron Emission ◽  
Vascular Proliferation

Kaposi Sarcoma (KS) is driven by human herpes virus 8 causing vascular proliferation which is induced by loss of immune function most often due to HIV or immunosuppressants. KS occurs with increased incidence in kidney transplant recipients, but rarely is disseminated. We report a 64-year-old male who developed severely disseminated KS 5 months after ABO-incompatible kidney-transplantation. No guidelines for chemotherapy exist in this case and reduced kidney function and impaired immune system complicates the use of systemic chemotherapy in kidney transplant recipients. A combination of paclitaxel and gemcitabine followed by two days of hemodialysis treatment was chosen since paclitaxel can be given in full dose independently of kidney function and gemcitabine is metabolised to 2′,2′-difluorodeoxyuridine which is found to be highly dialysable. The present treatment was well tolerated by the patient with one episode of leukopenia and elevated alanine transaminase during treatment which resolved. There were no serious adverse events and the patient obtained a complete remission verified by Positron Emission Tomography CT after ending chemotherapy and at one-year follow up.

scholarly journals The association of two single-nucleotide polymorphisms of the FOXP3 gene (rs3761548 and rs3761547) with renal allograft function and survival in kidney transplant recipients

2020 ◽  
Vol 7 (2) ◽  
pp. e21-e21
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Seyed Sadroddin Rasi Hashemi ◽  
Solmaz Oloufi ◽  
Leili Aghebati Maleki ◽  
Dariush Shanehbandi ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Kidney Transplant ◽  
Creatinine Level ◽  
Kidney Function ◽  
Renal Allograft ◽  
Regulatory Protein ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Allograft Function

Introduction: The FOXP3 protein is an immune regulatory protein that specifically maintains the function and differentiation of regulatory T cells (Tregs) and prevents autoimmunity. Variations in FOXP3 gene may alter its function and also the immune response. Objectives: The present study was conducted to investigate the association of the FOXP3 gene polymorphisms -3499 A/G and -3279 A/C with renal allograft function and survival in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 150 eligible kidney transplant recipients were evaluated. Kidney function was evaluated at three- and five-year post-transplant using serum creatinine level and glomerular filtration rate as indicators. Genotyping of the study participants was performed using the PCR– restriction fragment length polymorphism method. Results: The frequencies of AA, AG, and GG genotypes of the -3499 A/G polymorphism were 62.42%, 29.53%, and 8.05%, respectively. For the -3279 A/C polymorphism, the frequencies of the AA, AC, and CC genotypes were 21.33%, 32%, and 46.67%, respectively. The mean ± SD of serum creatinine level, three and five years after transplantation were 1.70 ± 1.58 and 1.87 ± 1.94, respectively. Serum creatinine level and kidney function did not show any significant association with these polymorphisms. Conclusion: In the present study, only 10% of participants experienced episodes of severe kidney dysfunction and we did not find any significant association between kidney function and the subjects’ genotypes. Further epidemiologic studies with greater sample sizes may be needed to clarify this association.

scholarly journals Changes in AZGP1 Serum Levels and Correlation With Pulse Wave Velocity After Kidney Transplantation

2021 ◽  
Vol 8 ◽  
Author(s):  
Thomas Daniel Kraemer ◽  
Inga Soerensen-Zender ◽  
Nima Memaran ◽  
Hermann Haller ◽  
Anette Melk ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Pulse Wave Velocity ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Inverse Correlation ◽  
Serum Levels ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Background: Zinc-alpha 2-glycoprotein (AZGP1), a secreted protein with ubiquitous tissue expression, has been controversially linked to the risk of cardiovascular disease. In a cohort of kidney transplant recipients, we measured serum AZGP1 levels after transplantation over a 2 year period and tested for an association with pulse wave velocity as an important parameter indicating future cardiovascular events.Methods: Annual blood sampling and pulse wave velocity measurements were longitudinally performed in 113 kidney transplant recipients. AZGP1 was measured in serum samples using standard ELISA. Association of AZGP1 with pulse wave velocity was longitudinally assessed during follow up of 2 years by mixed longitudinal modeling.Results: AZGP1 serum levels declined significantly after kidney transplantation. This decline was dependent on allograft function as indicated by inverse correlation with eGFR. When corrected for eGFR multivariable analysis revealed an inverse correlation between AZGP1 and pulse wave velocity. This analysis further showed independent associations of older age, higher blood pressure, and higher calcium phosphate product with higher pulse wave velocity.Conclusions: Improved kidney function after transplantation leads to a decline in AZGP1 serum levels. Independent of kidney function and other cardiovascular risk factors lower AZGP1 levels are associated with higher pulse wave velocity in the 2 years after kidney transplantation. These data suggest that AZGP1 might be a potential biomarker for cardiovascular health and a target for improving cardiovascular outcome.

scholarly journals The Increase in Paraoxonase 1 Is Associated With Decrease in Left Ventricular Volume in Kidney Transplant Recipients

2021 ◽  
Vol 8 ◽  
Author(s):  
Philip W. Connelly ◽  
Andrew T. Yan ◽  
Michelle M. Nash ◽  
Rachel M. Wald ◽  
Charmaine Lok ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Left Ventricular Volume ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Paraoxonase 1 ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
To Receive

Background: Patients on dialysis have impaired cardiac function, in part due to increased fluid volume and ventricular stress. Restored kidney function through transplantation reduces left ventricular volume in both systole and diastole. We previously reported that the decrease in NT-proB-type natriuretic peptide (NT-proBNP) was associated with a decrease in adiponectin. Paraoxonase 1 (PON1) has been inversely associated with cardiovascular outcomes. We now report the association of changes in PON1 with changes in left ventricular volume and left ventricular mass after kidney transplantation.Design: Patients on dialysis were assessed at baseline and 12 months after kidney transplantation (n = 38). A comparison group of patients on dialysis who were not expected to receive a transplant in the next 24 months were studied (n = 43) to determine if the change of PON1 with kidney transplantation achieved a significance greater than that due to biologic variation. Left ventricular volume and mass were determined by cardiac magnetic resonance imaging. PON1 was measured by arylesterase activity and by mass.Results: PON1 mass and activity were not different between the groups at baseline. Both PON1 mass and activity were increased post-kidney transplantation (p &lt; 0.0001 for change). The change in PON1 mass (p = 0.0062) and PON1 arylesterase activity (p = 0.0254) were inversely correlated with the change in NT-proBNP for patients receiving a kidney transplant. However, only the change in the PON1 mass, and not the change in PON1 arylesterase, was inversely correlated with the change in left ventricular volume (ml/m2.7) (p = 0.0146 and 0.0114 for diastolic and systolic, respectively) and with the change in hemoglobin (p = 0.0042).Conclusion: Both PON1 mass and arylesterase activity are increased by kidney transplantation. The increase in PON1 mass is consistent with a novel relationship to the increase in hemoglobin and decrease in left ventricular volume and NT-proBNP seen when kidney function is restored.

scholarly journals Sex differences in uric acid levels in kidney transplant recipients and their donors: a preliminary retrospective cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Mineaki Kitamura ◽  
Yasushi Mochizuki ◽  
Tsuyoshi Matsuda ◽  
Yuta Mukae ◽  
Hiromi Nakanishi ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Kidney Transplantation ◽  
Linear Regression ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Renal Prognosis ◽  
The Mean

Abstract Background Higher serum uric acid (UA) levels are associated with poorer renal prognosis. In kidney transplantation, both donors and recipients are diagnosed as having chronic kidney diseases (CKD) based on renal function; however, their UA levels slightly vary. Elucidating the differences in UA would help improve kidney prognosis, especially for recipients. Therefore, we investigated UA levels in kidney transplant recipients by comparing them to those in their donors. Methods In this retrospective cross-sectional survey, background information and blood examination results were collected from the donors just before donation and after transplantation in the donors and recipients. Associations between UA and sex estimated glomerular filtration rate (eGFR), and body mass index (BMI) were evaluated. Data were assessed by the Wilcoxon rank-sum test for continuous variables and the chi-squared test for categorical variables; multiple linear regression analyses were performed to determine which factors were associated with renal function before and after transplantation. Results Participant characteristics were as follows. The mean donor age (n = 45, 16 men and 29 women) was 55 ± 11 years, and the mean recipient age (n = 45, 25 men and 20 women) was 46 ± 16 years. Sex-related differences (UA levels in men were predominant) existed in the UA of donors before (P < 0.001) and after donation (P < 0.001). Conversely, there were no significant sex-related differences in the UA of recipients (P = 0.51); the mean standardized eGFRs were similar in donors and recipients after transplantation. Multivariate linear regression analysis showed donor UA only correlated with donor sex before donation (P = 0.008). After donation, donor UA was associated with donor sex (P = 0.006), eGFR (P < 0.001), and BMI (P = 0.02). Notably, the UA of recipients after transplantation was only associated with eGFR (P = 0.003). Conclusions Sex has less impact on UA in recipients than in donors. UA has a greater impact on renal prognosis in women than men, even at the same UA level. Therefore, attention should be given to UA levels in female recipients. These findings can be useful for determining patient prognosis following kidney transplantation in both donors and recipients.

scholarly journals Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients

2020 ◽  
Vol 30 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Kari Gire Dahl ◽  
Marit Helen Andersen ◽  
Kristin Hjorthaug Urstad ◽  
Ragnhild S. Falk ◽  
Eivind Engebretsen ◽  
...  
Keyword(s):  
Health Care ◽  
Kidney Transplantation ◽  
Health Literacy ◽  
Kidney Transplant ◽  
Health Care Providers ◽  
Vulnerable Groups ◽  
Care Providers ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

Background: A kidney transplantation requires complex self-care skills and adequate follow-up from health-care providers. Identifying strengths and limitations in different aspects of health literacy (HL) and associated variables are central to being able to improve health care. The objective of this study was to identify core variables associated with independent domains of HL 8 weeks following a kidney transplantation. Methods: A single-center cross-sectional study was conducted, wherein 159 kidney transplant recipients answered the Health Literacy Questionnaire (HLQ). Multivariable linear regression with backward elimination was used to investigate variables possibly associated with the 9 domains of HL. Results: The transplant recipients had the lowest scores in “appraisal of health information” and “navigating the healthcare system.” The highest scores were found in “feeling understood and supported by health-care providers” and “ability to actively engage with health-care provider.” General perceived self-efficacy, transplant-specific knowledge, and general health were the driving variables in several of the HL domains. Conclusions: The HLQ provides a more complex picture of strengths and limitations related to HL, as well as important knowledge about vulnerable groups following a kidney transplantation. The study offers an important supplement to the field of HL in kidney transplant care.

scholarly journals Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 413
Author(s):  
Theerawut Klangjareonchai ◽  
Natsuki Eguchi ◽  
Ekamol Tantisattamo ◽  
Antoney J. Ferrey ◽  
Uttam Reddy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Pharmacological Intervention ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kidney Allograft ◽  
Post Transplant ◽  
Glucose Management

Hyperglycemia after kidney transplantation is common in both diabetic and non-diabetic patients. Both pretransplant and post-transplant diabetes mellitus are associated with increased kidney allograft failure and mortality. Glucose management may be challenging for kidney transplant recipients. The pathophysiology and pattern of hyperglycemia in patients following kidney transplantation is different from those with type 2 diabetes mellitus. In patients with pre-existing and post-transplant diabetes mellitus, there is limited data on the management of hyperglycemia after kidney transplantation. The following article discusses the nomenclature and diagnosis of pre- and post-transplant diabetes mellitus, the impact of transplant-related hyperglycemia on patient and kidney allograft outcomes, risk factors and potential pathogenic mechanisms of hyperglycemia after kidney transplantation, glucose management before and after transplantation, and modalities for prevention of post-transplant diabetes mellitus.

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