CLINICAL ASPECTS OF RENAL TRANSPLANTATION

Vestnik ◽  
2021 ◽  
pp. 136-142
Author(s):  
Б.Г. Султанова ◽  
И.Б. Мансурова ◽  
С.Б. Бодесова ◽  
Н.С. Джуманов ◽  
Ш.А. Сарсенова ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Interdisciplinary Approach ◽  
Clinical Aspects ◽  
Graft Dysfunction ◽  
Donor Kidney ◽  
Donor Evaluation

В статье приведен литературный обзор, посвященный современным проблемам в трансплантологии почек. Нерешенными проблемами остаются оценка донора, низкая приверженность пациентов иммуносупрессивной терапии и развитие дисфункции трансплантата. Развивающиеся осложнения после трансплантации и иммуносупрессивной терапии требуют междисциплинарного подхода в лечении и наблюдении реципиентов донорской почки. Также необходимо широкое развитие трупного донорства для снижения числа потенциальных пациентов с хронической болезнью почек. The article presents a literature review of contemporary problems in kidney transplantation. Donor evaluation, low adherence of patients to immunosuppressive therapy and the development of graft dysfunction remain as unresolved problems. Developing complications after transplantation and immunosuppressive therapy require an interdisciplinary approach in the treatment and monitoring of recipients of donor kidney. It is also indispensable to the development of cadaveric donation to reduce the number of potential patients with chronic kidney disease.

scholarly journals Autonomic Cardiovascular Alterations in Chronic Kidney Disease: Effects of Dialysis, Kidney Transplantation, and Renal Denervation

2021 ◽  
Vol 23 (2) ◽  
Author(s):  
Fosca Quarti-Trevano ◽  
Gino Seravalle ◽  
Raffaella Dell’Oro ◽  
Giuseppe Mancia ◽  
Guido Grassi
Keyword(s):  
Chronic Kidney Disease ◽  
Nervous System ◽  
Kidney Transplantation ◽  
Autonomic Nervous System ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Renal Denervation ◽  
Clinical Severity ◽  
Plasma Norepinephrine ◽  
Autonomic Nervous

Abstract Purpose of Review To review the results of studies of the effects of dialysis and kidney transplantation on the autonomic nervous system alterations that occur in chronic kidney disease. Recent Findings Vagal control of the heart mediated by arterial baroreceptors is altered early in the course of the renal disease. Sympathetic activation occurs, with increases in resting heart rate, venous plasma norepinephrine levels, muscle sympathetic nerve traffic, and other indirect indices of adrenergic drive. The magnitude of the changes reflects the clinical severity of the kidney disease. Both the sympathetic and parasympathetic alterations have a reflex origin, depending on the impairment in baroreflex and cardiopulmonary reflex control of the cardiovascular system. These alterations are partially reversed during acute hemodialysis, but the responses are variable depending on the specific type of dialytic treatment that is employed. Renal transplantation improves reflex cardiovascular control, resulting in sympathoinhibition following renal transplantation if the native kidneys are removed. Sympathoinhibitory effects have been also reported in renal failure patients after bilateral renal denervation. Summary Assessment of autonomic nervous system responses to dialysis and renal transplantation provides information of clinical interest, given the evidence that autonomic alterations are involved in the development and progression of cardiovascular complications, as well as in the prognosis of chronic kidney disease.

scholarly journals Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation

2019 ◽  
Vol 20 (14) ◽  
pp. 3413 ◽  
Author(s):  
Mineaki Kitamura ◽  
Yasushi Mochizuki ◽  
Yasuyoshi Miyata ◽  
Yoko Obata ◽  
Kensuke Mitsunari ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Periodontal Disease ◽  
Immunosuppressive Therapy ◽  
Kidney Allograft ◽  
Periodontal Tissues ◽  
Pathological Conditions ◽  
Allograft Function ◽  
The Impact

Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.

Clinical Case Studies in Renal Transplantation

2013 ◽  
Vol 12 (2) ◽  
pp. 75-75
Keyword(s):  
Risk Assessment ◽  
Chronic Kidney Disease ◽  
Pulmonary Hypertension ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Case Studies ◽  
Clinical Case ◽  
Hemodynamic Evaluation ◽  
Clinical Case Studies

The case studies below are referred to in the articles “Pulmonary Hypertension in Patients with Chronic Kidney Disease: Noninvasive Strategies for Patient Phenotyping and Risk Assessment” by Amresh Raina, MD, and “Hemodynamic Evaluation of Pulmonary Hypertension in Chronic Kidney Disease” by Ryan Tedford, MD, and Paul Forfia, MD, on the following pages.

Kidney transplantation fails to provide adequate growth in children with chronic kidney disease born small for gestational age

2016 ◽  
Vol 32 (3) ◽  
pp. 511-519 ◽  
Author(s):  
Doris Franke ◽  
Rena Steffens ◽  
Lena Thomas ◽  
Leo Pavičić ◽  
Thurid Ahlenstiel ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Gestational Age ◽  
Small For Gestational Age

Roxadustat Improves Erythropoietin Antibody-Mediated Pure Red Cell Aplasia in a Patient with Hemodialysis

2021 ◽  
pp. 1-4
Author(s):  
Sijia Li ◽  
Xueqin Chen ◽  
Penghua Hu ◽  
Suijing Wu ◽  
Jianchao Ma ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Recombinant Human Erythropoietin ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Common Complication ◽  
Normal Range ◽  
Red Cell Aplasia ◽  
Human Erythropoietin

Anemia is a common complication of chronic kidney disease (CKD). Recombinant human erythropoietin (rHu-EPO) is used extensively in patients with CKD. However, anti-erythropoietin (anti-EPO) antibody has been reported during rHu-EPO treatment, which causes pure red cell aplasia (PRCA). We presented a case of 75-year-old man, who underwent hemodialysis for 2 years. He developed PRCA during rHu-EPO treatment. The rHu-EPO was immediately discontinued, and the patient was given roxadustat treatment. After 6 months of roxadustat treatment, the anti-EPO antibody was disappeared, and hemoglobin recovered normal range. The results suggest that roxadustat can be used to treat patients with anti-EPO antibody-mediated PRCA without immunosuppressive therapy.

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