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Renal failure and heart transplant

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https://www.readbyqxmd.com/read/29731073/pretransplantation-cystatin-c-but-not-creatinine-predicts-30-day-cardiovascular-events-and-mortality-in-liver-transplant-recipients-with-normal-serum-creatinine-levels
#1
H-M Kwon, Y-J Moon, K-W Jung, I-G Jun, J-G Song, G-S Hwang
BACKGROUND: The connection between renal dysfunction and cardiovascular dysfunction has been consistently shown. In patients with liver cirrhosis, renal dysfunction shows a tight correlation with prognosis after liver transplantation (LT); therefore, precise renal assessment is mandatory. Cystatin C, a sensitive biomarker for assessing renal function, has shown superiority in detecting mild renal dysfunction compared to classical biomarker creatinine. In this study, we aimed to compare cystatin C and creatinine in predicting 30-day major cardiovascular events (MACE) and all-cause mortality in LT recipients with normal serum creatinine levels...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29725637/cystatin-c-predicts-renal-recovery-earlier-than-creatinine-among-patients-with-acute-kidney-injury
#2
Kamel A Gharaibeh, Abdurrahman M Hamadah, Ziad M El-Zoghby, John C Lieske, Timothy S Larson, Nelson Leung
Introduction: Serum cystatin C increases earlier than creatinine during acute kidney injury. However, whether cystatin C decreases earlier during recovery is unknown. This retrospective study aimed to determine the temporal trend between creatinine and cystatin C in acute kidney injury. Methods: We identified hospitalized patients with nonoliguric acute kidney injury who had serial creatinine and cystatin C values measured between May 2015 and May 2016. Demographic and laboratory data, causes of acute kidney injury, and relevant comorbidity data were collected through chart review...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29702997/recovery-of-renal-function-in-a-heart-transplantation-recipient-with-over-300-days-of-iatrogenic-anuria-a-case-report
#3
Yong-Hua Peng, Xiao-Min Yu, Chen Yan, Lan Luo, Tao-Sheng Li, Jie Xiao
RATIONALE: Anuria is a severe symptom indicating severe kidney damage. Patient recovery from prolonged anuria is rarely reported. PATIENT CONCERNS: A 15-year-old boy received gender- and weight-mismatch heart transplantation (HT) due to dilated cardiomyopathy. He developed severe hypotension, and heart failure 24 hours after surgery, which were relieved by preload reduction treatments. Although, routine examinations did not show any abnormalities in renal function before surgery, anuria occurred 4 days after preload reduction treatments (24-hour urine volume was 23 mL)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29672718/mineralocorticoid-receptor-antagonists-in-kidney-transplantation-time-to-consider
#4
Sophie Girerd, Frédéric Jaisser
Although patient survival is significantly improved by kidney transplantation (KT) in comparison with dialysis, it remains significantly lower than that observed in the general population. Graft function is one of the major determinants of patient survival after KT. Mineralocorticoid receptor antagonists (MRAs) could be of particular interest in this population to improve graft function and treat or prevent cardiovascular (CV) complications. In KT, ischaemia/reperfusion injury is a major factor involved in delayed graft function, which is often associated with inferior long-term graft survival...
April 17, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#5
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
March 21, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29655525/predictive-value-of-liver-damage-for-severe-early-complications-and-survival-after-heart-transplantation-a-retrospective-analysis
#6
Pascal Lebray, Shaida Varnous, Alina Pascale, Philippe Leger, Charles Edouard Luyt, Vlad Ratziu, Mona Munteanu, Salima Ould Amar, Dominique Thabut, Jean Chastre, Alain Pavie, Thierry Poynard, Pascal Leprince
BACKGROUND: Hepatic dysfunction is often associated with advanced heart failure. Its impact on complications following heart transplantation is not well known. We studied the influence of preoperative hepatic dysfunction on the results of heart transplantation with a specific priority access for critical patients. METHODS: Consecutive heart transplantation patients were retrospectively analyzed at listing to detect predictive factors for early complications and survival following heart transplantation...
April 11, 2018: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29622458/usefulness-of-a-clinical-risk-score-to-predict-the-response-to-cardiac-resynchronization-therapy
#7
Rui Providencia, Eloi Marijon, Sergio Barra, Christian Reitan, Alexander Breitenstein, Pascal Defaye, Nikolaos Papageorgiou, Rudolph Duehmke, Stephan Winnik, Richard Ang, Didier Klug, Daniel Gras, Tardu Oezkartal, Oliver R Segal, Jean-Claude Deharo, Christophe Leclercq, Pier D Lambiase, Laurent Fauchier, Pierre Bordachar, Jan Steffel, Nicolas Sadoul, Olivier Piot, Rasmus Borgquist, Sharad Agarwal, Anthony Chow, Serge Boveda
BACKGROUND: Almost 1/3 of heart failure patients fail to respond to cardiac resynchronization therapy (CRT). A simple clinical score to predict who these patients are at the moment of referral or at time of implant may be of importance for early optimization of their management. METHODS: Observational study. A risk score was derived from factors associated to CRT response. The derivation cohort was composed of 1301 patients implanted with a CRT defibrillator in a multi-center French cohort-study...
June 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29605378/de-novo-heart-failure-after-kidney-transplantation-trends-in-incidence-and-outcomes
#8
Colin R Lenihan, Sai Liu, Anita Deswal, Maria E Montez-Rath, Wolfgang C Winkelmayer
BACKGROUND: Heart failure is an important cause of morbidity and mortality following kidney transplantation. Some studies in the general population have shown that the incidence of heart failure has decreased during the past 20 years. However, it is not currently known whether such a trend exists in the kidney transplantation population. STUDY DESIGN: Retrospective observational cohort study. SETTING & PARTICIPANTS: Adult patients included in the US Renal Data System who underwent their first kidney transplantation in the United States between 1998 and 2010 with at least 6 months of continuous Medicare parts A and B coverage before transplantation and no prior evidence for a diagnosis of heart failure before kidney transplantation...
March 29, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29601379/moderate-to-severe-renal-insufficiency-is-associated-with-high-mortality-after-hip-and-knee-replacement
#9
Pyry Jämsä, Esa Jämsen, Heini Huhtala, Antti Eskelinen, Niku Oksala
BACKGROUND: In patients having elective hip or knee replacements, many comorbid conditions, including diabetes, cardiovascular disease, and congestive heart failure, are associated with postoperative mortality. Renal failure and a history of renal transplantation also increase mortality. However, the effect of different stages of chronic kidney disease on patients' prognoses is unclear. QUESTIONS/PURPOSES: (1) What is the risk of postoperative mortality in different stages of chronic kidney disease after elective hip or knee replacement and does the risk increase with mild renal insufficiency? (2) How severe is the risk of death in patients with chronic kidney disease compared with other major medical comorbidities such as diabetes, cardiovascular disease, and congestive heart failure? (3) Are there risk factor combinations associated with especially poor survival? METHODS: Using longitudinally maintained databases, the records of 18,575 patients (median age 69 years, 63% female, median body mass index 29 kg/m) undergoing elective hip and knee replacements from a single center between 2002 and 2011 were analyzed in this retrospective study...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29588066/life-threatening-everolimus-associated-pneumonitis-a-case-report-and-a-review-of-the-literature
#10
F Almeida, S Amorim, A Sarmento, L Santos
INTRODUCTION: Noninfective pneumonitis is a class-related effect within mammalian target of rapamycin (mTOR) inhibitors, including everolimus, and can occasionally be severe. CASE REPORT: A 62-year-old man, medicated with everolimus due to a heart transplantation 17 years previously and with chronic kidney disease, was admitted to the intensive care unit (ICU) with acute respiratory failure, cardiovascular shock, and impaired renal function requiring dialysis. Computed tomography (CT) scan revealed right upper lobe consolidation...
March 24, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29557907/cardiovascular-disease-outcomes-related-to-early-stage-renal-impairment-following-liver-transplantation
#11
Lisa B VanWagner, Samantha Montag, Lihui Zhao, Norrina B Allen, Donald M Lloyd-Jones, Arighno Das, Anton I Skaro, Samuel Hohmann, John J Friedewald, Josh Levitsky
BACKGROUND: In the general population, even mild renal disease is associated with increased cardiovascular (CV) complications. Whether this is true in liver transplant recipients (LTR) is unknown. METHODS: This was a retrospective cohort study of 671 LTR (2002-2012) from a large urban tertiary care center and 37,322 LTR using Vizient hospitalization data linked to the United Network for Organ Sharing. The MDRD4 equation estimated GFR (eGFR). Outcomes were 1-year CV complications (death/hospitalization from myocardial infarction, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism or stroke) and mortality...
March 20, 2018: Transplantation
https://www.readbyqxmd.com/read/29557615/-tolvaptan-in-a-pediatric-cardiorenal-syndrome-what-is-its-role
#12
M Angeles Tejero Hernández, Elena García Martínez, M José Arroyo Marin, Elena Gómez Guzmán
The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29536372/contemporary-drug-treatment-of-hypertension-focus-on-recent-guidelines
#13
REVIEW
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
April 2018: Drugs
https://www.readbyqxmd.com/read/29515582/cd4-t-cell-help-is-mandatory-for-naive-and-memory-donor-specific-antibody-responses-impact-of-therapeutic-immunosuppression
#14
Chien-Chia Chen, Alice Koenig, Carole Saison, Suzan Dahdal, Guillaume Rigault, Thomas Barba, Morgan Taillardet, Dimitri Chartoire, Michel Ovize, Emmanuel Morelon, Thierry Defrance, Olivier Thaunat
Antibody-mediated rejection is currently the leading cause of transplant failure. Prevailing dogma predicts that B cells differentiate into anti-donor-specific antibody (DSA)-producing plasma cells only with the help of CD4+ T cells. Yet, previous studies have shown that dependence on helper T cells decreases when high amounts of protein antigen are recruited to the spleen, two conditions potentially met by organ transplantation. This could explain why a significant proportion of transplant recipients develop DSA despite therapeutic immunosuppression...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29514222/short-term-mechanical-circulatory-support-for-severe-primary-graft-dysfunction-following-orthotopic-heart-transplant
#15
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29513901/do-arteriovenous-fistulas-increase-cardiac-risk
#16
Randall Faull, Nitesh Rao, Matthew Worthley
An effectively functioning arteriovenous fistula is the life line for patients on long-term hemodialysis, and for most an upper limb, native vessel fistula has significant short- and long-term advantages. There are, however, situations where a fistula has deleterious effects, including the relatively uncommon problem of severe heart failure exacerbated in particular by high-flow fistulas. There is also increasing evidence that a fistula can add to the already high burden of cardiovascular risk in patients with advanced kidney disease, including by promoting water and salt retention, and by inducing or worsening left ventricular hypertrophy...
March 7, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29492382/current-state-of-pediatric-cardiac-transplantation
#17
REVIEW
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29478058/visions-in-a-crystal-ball-the-future-of-peritoneal-dialysis
#18
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
2018: Blood Purification
https://www.readbyqxmd.com/read/29465066/prognostic-utility-of-the-n-terminal-prohormone-of-brain-natriuretic-peptide-and-the-modified-model-for-end-stage-liver-disease-in-patients-with-end-stage-heart-failure
#19
Wioletta Szczurek, Bożena Szyguła-Jurkiewicz, Michał Zakliczyński, Bogumiła Król, Mariusz Gąsior, Marian Zembala
INTRODUCTION    The N terminal prohormone of brain natriuretic peptide (NT proBNP) is secreted by cardiomyocytes in response to increased wall stress resulting from pressure and volume overload. The modified Model for End Stage Liver Disease (modMELD) scale reflects the systemic effect of heart failure (HF), which includes end-organ congestion and subsequent hepatic and renal dysfunction. OBJECTIVES    The aim of this study was to assess the prognostic accuracy of NT proBNP and the modMELD score, as well as to compare their usefulness in the risk stratification of patients with end-stage HF awaiting orthotopic heart transplantation (OHT)...
April 30, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29423397/age-is-relative-impact-of-donor-age-on-induced-pluripotent-stem-cell-derived-cell-functionality
#20
REVIEW
Elisabeth Tamara Strässler, Katriina Aalto-Setälä, Mostafa Kiamehr, Ulf Landmesser, Nicolle Kränkel
Induced pluripotent stem cells (iPSCs) avoid many of the restrictions that hamper the application of human embryonic stem cells: limited availability of source material due to legal restrictions in some countries, immunogenic rejection and ethical concerns. Also, the donor's clinical phenotype is often known when working with iPSCs. Therefore, iPSCs seem ideal to tackle the two biggest tasks of regenerative medicine: degenerative diseases with genetic cause (e.g., Duchenne's muscular dystrophy) and organ replacement in age-related diseases (e...
2018: Frontiers in Cardiovascular Medicine
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