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chronical kidney decease

Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Magnolia Cardona-Morrell, Amanda Chapman, Robin M Turner, Ebony Lewis, Blanca Gallego-Luxan, Michael Parr, Ken Hillman
AIM: To investigate associations between clinical parameters - beyond the evident physiological deterioration and limitations of medical treatment - with in-hospital death for patients receiving Rapid Response System (RRS) attendances. METHODS: Retrospective case-control analysis of clinical parameters for 328 patients aged 60 years and above at their last RRS call during admission to a single teaching hospital in the 2012-2013 calendar years. Generalised estimating equation modelling was used to compare the deceased with a randomly selected sample of those who had RRS calls and survived admission (controls), matched by age group, sex, and hospital ward...
December 2016: Resuscitation
A T Silva, L B Soares, F R L Magajewski
BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem and is expressed by increasing amounts of patients on renal replacement therapy (RRT), with significant economic and social impacts. The aim of this work was to analyze socioeconomic and mortality aspects of CKD patients in Santa Catarina (SC), Brazil. METHODS: This was an ecologic study with the population of SC's CKD patients, who used RRT or underwent renal transplantation (RT) from 2012 to 2013...
September 2016: Transplantation Proceedings
Ana Maria Cusumano, Guillermo Javier Rosa-Diez, Maria Carlota Gonzalez-Bedat
In 2015, 634387 million people (9% of the world's population) resided in Latin America (LA), with half of those populating Brazil and Mexico. The LA Dialysis and Transplant Registry was initiated in 1991, with the aim of collecting data on renal replacement therapy (RRT) from the 20 LA-affiliated countries. Since then, the Registry has revealed a trend of increasing prevalence and incidence of end-stage kidney disease on RRT, which is ongoing and is correlated with gross national income, life expectancy at birth, and percentage of population that is older than 65 years...
September 6, 2016: World Journal of Nephrology
Ioannis Papayannis, P Patel
Kidney transplantation from hepatitis C virus (HCV)-positive donors to HCV-positive recipients has always been controversial regarding the safety and the outcomes. In the posttransplant period, treatment of hepatitis C with interferon-based regimens could lead to serious side effects. A patient with chronic hepatitis C and nephropathy, on dialysis, underwent renal transplantation from an HCV-positive donor and received direct-acting antiviral (DAA) drugs thereafter. His renal and liver functions, as well as the hepatitis C viral load, were evaluated at predetermined intervals throughout and after his treatment...
September 2016: Progress in Transplantation
Hellevi Ruokonen, Karita Nylund, Jussi Furuholm, Jukka H Meurman, Timo Sorsa, Karoliina Kotaniemi, Fernanda Ortiz, Anna Maria Heikkinen
OBJECTIVES: We investigated factors related to the mortality of patients with chronic kidney disease to find out whether oral disease inflammatory burden or different diagnosis of chronic kidney disease could be associated with mortality. MATERIAL AND METHODS: This prospective cohort study comprised 144 adults at the predialysis stage. Clinical oral and radiological examination was made during the years 2000 - 2005. The patients were then followed up until August 2015 (complete follow-up time 157 months)...
August 13, 2016: Journal of Periodontology
Solenne Tillet, Sébastien Giraud, Thomas Kerforne, Thibaut Saint-Yves, Sandrine Joffrion, Jean-Michel Goujon, Jerôme Cau, Gérard Mauco, Maurice Petitou, Thierry Hauet
Coagulation is an important pathway in the pathophysiology of ischemia-reperfusion injuries. In particular, deceased after circulatory death (DCD) donors undergo a no-flow period, a strong activator of coagulation. Hence, therapies influencing the coagulation cascade must be developed. We evaluated the effect of a new highly specific and effective anti-Xa/IIa molecule, with an integrated innovative antidote site (EP217609), in a porcine preclinical model mimicking injuries observed in DCD donor kidney transplantation...
July 25, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
Luis E Morales-Buenrostro
Latin America is a region made up of 33 countries that share many characteristics with each other. Since the first kidney transplant in Argentina in 1957, most of the Latin American countries have had a continuous increase in renal transplant activity, accounting for an increase in the total number of kidney transplants over time. In the last years, several advances have been made in the area of renal transplantation in Latin America: There are transplantation activities in almost all countries, the kidney transplantation rate from deceased donors has steadily increased, and almost all the countries have an appropriate legislation for transplantation activity...
2016: Clinical Nephrology
B Krüger, B Döhler, G Opelz, H Mundt, B K Krämer, C Süsal
OBJECTIVE: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) are important predictors of graft and patient survival in renal transplant recipients. Pulse pressure (PP) has been associated with cardiovascular and renal morbidity and mortality in the general population and patients with chronic kidney disease (CKD). DESIGN AND METHOD: Adult recipients of first deceased donor kidney grafts transplanted between 1995 and 2014 were included into the analysis for graft and patient survival if the patient had both a functioning graft and a known blood pressure reading at year 1...
September 2016: Journal of Hypertension
Aida Hamzić-Mehmedbašić, Senija Rašić, Merima Balavac, Damir Rebić, Marina Delić-Šarac, Azra Durak-Nalbantić
INTRODUCTION: Data regarding prognostic factors of post-discharge mortality and adverse renal function outcome in acute kidney injury (AKI) hospital survivors are scarce and controversial. OBJECTIVES: We aimed to identify predictors of post-discharge mortality and adverse renal function outcome in AKI hospital survivors. PATIENTS AND METHODS: The study group consisted of 84 AKI hospital survivors admitted to the tertiary medical center during 2-year period...
2016: Journal of Renal Injury Prevention
Anthony M Meyers
INTRODUCTION: An often-quoted remark is to present problems as challenges, which invariably end up in the "in-box", eventually to be swept under the carpet. The chronic kidney disease burden in the South African black population poses a challenging crisis requiring immediate intervention even in a country with limited resources. Aims, materials, and methods: The National Kidney Foundation of South Africa (NKFSA) reports on 3 major projects. The schools project is aimed at prevention, early diagnosis, and appropriate management of chronic kidney disease (CKD) on a national basis...
2016: Clinical Nephrology
Rashad S Barsoum
Geographical, ecological, and genetic factors result in many similarities among the six main countries of the African Sahara, including the epidemiology of kidney disease. With an average incidence of 182 and prevalence of 522 patients with end-stage kidney disease (ESKD) per million population, North Africa (NA) spends $650 million on dialysis and transplantation despite an estimated annual loss of 600,000 life years. The health burden of ESKD is not limited to its directly-related morbidity and mortality but affects even more significantly other body systems, particularly the cardiovascular system...
2016: Clinical Nephrology
Georgi Abraham, Madhusudan Vijayan, Natarajan Gopalakrishnan, Sunil Shroff, Joseph Amalorpavanathan, Anand Yuvaraj, Sanjeev Nair, Saravanan Sundarrajan
Renal replacement therapy (RRT) resources are scarce in India, with wide urban-rural and interstate disparities. The burden of end-stage renal disease is expected to increase further due to increasing prevalence of risk factors like diabetes mellitus. Renal transplantation, the best RRT modality, is increasing in popularity, due to improvements made in public education, the deceased donor transplantation (DDT) programme and the availability of free and affordable transplant services in government hospitals and certain non-governmental philanthropic organizations...
June 24, 2016: World Journal of Transplantation
Tiziana Cena, Claudio Musetti, Marco Quaglia, Corrado Magnani, Piero Stratta, Vincenzo Bagnardi, Vincenzo Cantaluppi
The aim of this study was to evaluate the association between cancer occurrence and risk of graft failure in kidney transplant recipients. From November 1998 to November 2013, 672 adult patients received their first kidney transplant from a deceased donor and had a minimum follow-up of 6 months. During a median follow-up of 4.7 years (3523 patient-years), 47 patients developed a nonmelanoma skin cancer (NMSC) and 40 a noncutaneous malignancy (NCM). A total of 59 graft failures were observed. The failure rate was 6 per 100 patient-year (pt-yr) after NCM versus 1...
October 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
N Ichimaru, Y Obi, S Nakazawa, K Yamanaka, Y Kakuta, T Abe, J-Y Kaimori, R Imamura, N Nonomura, T Moriyama, S Takahara
BACKGROUND: Post-transplant anemia (PTA) is a risk factor for mortality and graft loss in kidney transplant patients. METHODS: In all, 172 patients were included in this study. PTA was defined as hemoglobin <13.0 g/dL in men and 12.0 g/dL in women. The primary outcome of interest was the renal outcome, defined as a 50% increase in serum levels of creatinine, a return to chronic dialysis, and subsequent kidney transplantation (KTx). The secondary outcome was a composite of the primary outcome and death...
April 2016: Transplantation Proceedings
Sabiha M Hussain, Richard J Marcus, Tina Y Ko, Khaled Nashar, Ngoc L Thai, Kalathil K Sureshkumar
OBJECTIVES: This study explored the safety of early steroid withdrawal in recipients of expanded criteria deceased-donor kidney transplants. MATERIALS AND METHODS: Using the Organ Procurement and Transplant Network-United Network of Organ Sharing database, we identified patients who underwent expanded criteria deceased-donor kidney transplant between January 2000 and December 2008 after receiving induction with rabbit-antithymocyte globulin (n = 3717), alemtuzumab (n = 763), or interleukin 2 blocking agent (n = 2600) followed by calcineurin inhibitor and mycophenolate mofetil-based maintenance with and without steroid therapy...
June 2016: Experimental and Clinical Transplantation
Rosângela Maria Gomes, Augusto Afonso Guerra Júnior, Lívia Lovato Pires de Lemos, Juliana de Oliveira Costa, Alessandra Maciel Almeida, Juliana Alvares, Charles Simão Filho, Mariângela Leal Cherchiglia, Eli Iola Gurgel Andrade, Brian Godman, Francisco Assis Acurcio
BACKGROUND: Cyclosporine and tacrolimus are well established immunosuppressants; however little is known about long term survival rates. The project aim was to compare 10-year graft survival and associated factors among kidney transplant patients within the Brazilian Public Health System (SUS) prescribed either immunosuppressant. METHODS: Analyze a national cohort of kidney transplant recipients within SUS. Graft loss defined by death or dialysis for more than three months...
July 2016: Expert Review of Clinical Pharmacology
E Diaz-Chavez, A Orozco-Mosqueda, J M Soel-Encalada, D A Aleman-Suarez, E E Perez-Granados, J C Gontes-Godinez, L Rodriguez-Zuñiga, M A Ayala-Garcia
BACKGROUND: We present the first results of our program, which is characterized by its acceptance of any candidate with chronic renal failure. Therefore, we serve all patients, regardless of their social security and socioeconomic status. METHODS: We conducted a retrospective, descriptive, cross-sectional study describing the characteristics of patients who received kidney transplants in the period from 2008 to 2015. Descriptive statistics were used to evaluate our findings...
March 2016: Transplantation Proceedings
Laurens J Ceulemans, Faouzi Braza, Diethard Monbaliu, Ina Jochmans, Gert De Hertogh, Johannie Du Plessis, Marie-Paule Emonds, Hiroaki Kitade, Masaru Kawai, Ying Li, Zhao Xiangdong, Takaaki Koshiba, Ben Sprangers, Sophie Brouard, Mark Waer, Jacques Pirenne
Intestinal transplantation (ITx) remains challenged by frequent/severe rejections and immunosuppression-related complications (infections/malignancies/drug-toxicity). We developed in the lab the Leuven Immunomodulatory Protocol (LIP) and translated it to the clinics. LIP consists in experimentally-proven maneuvers, destined to promote T-regulatory (Tregs)-dependent graft-protective mechanisms: Donor-Specific-Blood-Transfusion (DSBT); avoiding high-dose steroids/calcineurin-inhibitors; minimizing reperfusion-injury and endotoxin-translocation...
April 1, 2016: American Journal of Transplantation
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