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esw and kidney

Sami Uğuz, Zafer Demirer, Bulent Uysal, Bilal Firat Alp, Ercan Malkoc, Ali Guragac, Turker Turker, Ferhat Ateş, Kenan Karademir, Ayhan Ozcan, Ibrahim Yildirim, Ahmet Korkmaz, Ahmet Guven
OBJECTIVES: Extracorporeal shock wave (ESW) lithotripsy is the preferred treatment modality for uncomplicated kidney stones. More recently free oxygen radical production following ESW application has been considered to be crucial in shock wave-induced renal damage. It has been shown that ozone therapy (OT) has ameliorative and preventive effects against various pathological conditions due to increased nitro-oxidative stress. In current study, we aimed to evaluate the efficacy of OT against ESW-induced renal injury...
July 2016: Renal Failure
J Andrade-Sierra, E Rojas-Campos, E Cardona-Muñoz, L A Evangelista-Carrillo, B Gómez-Navarro, E González-Espinoza, O Lugo-Lopez, J I Cerrillos-Gutiérrez, M Medina-Pérez, B Jalomo-Martínez, J J Nieves-Hernández, M Sandoval, J R Abundis-Jiménez, J N Ramírez-Robles, M A Villanueva-Pérez, F Monteón-Ramos, A M Cueto-Manzano
BACKGROUND: Early steroid withdrawal (ESW) can improve lipid and hemodynamic profiles without severe acute rejection (AR) events in renal transplant patients. Our objective was to evaluate the effects of ESW on the frequency and severity of AR. METHODS: A randomized, open-label, controlled clinical trial was performed on renal transplant recipients with a follow-up of 12 months. In the ESW group, patients were selected for corticosteroid treatment withdrawal on the fifth day post transplantation...
January 2016: Transplantation Proceedings
B Chopra, K K Sureshkumar
BACKGROUND: This study aimed to analyze the impact of chronic steroid maintenance (CSM) vs early steroid withdrawal (ESW) in kidney transplant recipients (KTRs) stratified by the level of human leukocyte antigen (HLA) mismatch. METHODS: Adult KTRs between 2001 and 2011 who received antibody induction followed by calcineurin inhibitor (CNI)/mycophenolate mofetil (MMF) maintenance with or without steroid were identified from the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) database...
December 2015: Transplantation Proceedings
Kalathil K Sureshkumar, Richard J Marcus, Bhavna Chopra
AIM: To evaluate whether there is a threshold sensitization level beyond which benefits of chronic steroid maintenance (CSM) emerge. METHODS: Using Organ Procurement and Transplant Network/United Network of Organ Sharing database, we compared the adjusted graft and patient survivals for CSM vs early steroid withdrawal (ESW) among patients who underwent deceased-donor kidney (DDK) transplantation from 2000 to 2008 who were stratified by peak-panel reactive antibody (peak-PRA) titers (0%-30%, 31%-60% and > 60%)...
September 24, 2015: World Journal of Transplantation
Ercan Malkoc, Bilal Fırat Alp, Zafer Demirer, Ali Guragac, Furkan Dursun, Ferhat Ates, Ibrahim Yildirim, Ramazan Yuksel, Bulent Uysal, Turgut Topal, Yasemin Gulcan Kurt, Ayhan Ozcan, Ahmet Guven
OBJECTIVES: Extracorporeal shock wave lithotripsy (ESW) induces renal damage by excessive production of free oxygen radicals. Free Oxygen radicals cause cellular injury by inducing nicks in DNA. The enzyme poly(adenosine diphosphate-ribose) polymerase (PARP) involved in the process of repair of DNA in damaged cells. However, its activation in damaged cells can lead to adenosine triphosphate depletion and death. Thus, we designed a study to evaluate the efficacy of 3-aminobenzamide (3-AB), a PARP inhibitor, against extracorporeal shock wave induced renal injury...
November 2014: Renal Failure
Jorge Andrade-Sierra, Enrique Rojas-Campos, Ernesto Cardona-Muñoz, Luis A Evangelista-Carrillo, Abel Puentes-Camacho, Orlando Lugo-López, Benjamín Gómez, Carlos Valdespino, Ignacio Cerrillos, Miguel Medina-Pérez, Basilio Jalomo, Juan J Nieves, Mario Sandoval, Francisco Ramos-Solano, Francisco Monteón-Ramos, Alfonso M Cueto-Manzano
BACKGROUND: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. MATERIAL AND METHOD: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil...
2014: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Christin C Rogers, Natalya Asipenko, Timothy Horwedel, Shiva Gautam, Alexander S Goldfarb-Rumyantzev, Martha Pavlakis, Scott R Johnson, Seth J Karp, Amy Evenson, Khalid Khwaja, Douglas W Hanto, Didier A Mandelbrot
BACKGROUND: Modern immunosuppression and rabbit antithymocyte globulin (rATG) have facilitated the success of early steroid withdrawal (ESW) protocols. Little data exist on optimal rATG dosing in ESW protocols. METHODS: Rejection at 12 months in era 1 (four doses of rATG, 1.25 mg/kg) vs. era 2 (three doses of rATG, 1.25 mg/kg) was the primary endpoint. Secondary endpoints included patient and graft survival, renal function and infectious complications. Factors associated with rejection at 1 year were identified...
2013: American Journal of Nephrology
F Burkhalter, T Oettl, B Descoeudres, A Bachmann, L Guerke, M J Mihatsch, M Dickenmann, J Steiger
Immunosuppressive maintenance therapy after kidney transplantation leads to various undesired side effects such as calcineurin inhibitor (CNI)-associated nephrotoxicity or elevated cardiovascular risk due to posttransplantation diabetes and hypertension. These effects show negative impacts on long-term allograft function as well as patient morbidity and mortality. Therefore, we used an immunosuppressive regimen with early corticosteroid withdrawal (ESW), maintenance therapy containing tacrolimus, sirolimus (SRL), and mycophenolate sodium for 3 months followed by a prospective randomized trial comparing a CNI free versus a low-dose CNI therapy...
December 2012: Transplantation Proceedings
H Iwamoto, K Hama, O Konno, T Yokoyama, Y Kihara, Y Jojima, Y Nakamura, H Takeuchi, M Shimazu
BACKGROUND: Beneficial effects of protocols using minimal steroid exposure have been recently reported. The purpose of this study was to evaluate the outcomes of kidney transplantation recipients who received immunosuppression protocols with early steroid withdrawal (ESW) at our center. METHODS: We retrospectively studied 84 kidney transplant recipients who had received ESW immunosuppressive protocols at our center from March 2005 to December 2010. The immunosuppressive regimen was a combination of calcineurin inhibitors (tacrolimus/cyclosporine), methylprednisolone, which was tapered and discontinued within 2 months, mycophenolate mofetil, and basiliximab (postoperative days 0 and 4)...
January 2012: Transplantation Proceedings
Spencer T Martin, Keri L Roberts, Sayeed K Malek, Stefan G Tullius, Nidyanandh Vadivel, Sacha De Serres, Monica Grafals, Abdelaziz Elsanjak, Beth Anne Filkins, Anil Chandraker, Steven Gabardi
STUDY OBJECTIVE: To compare the safety and efficacy of rabbit antithymocyte globulin (r-ATG) with basiliximab in renal transplant recipients for whom an early steroid withdrawal (ESW) regimen was planned. DESIGN: Single-center, retrospective, cohort study. SETTING: Tertiary care medical center, including inpatient hospital stays and outpatient nephrology clinics. PATIENTS: Ninety-nine consecutive adult recipients of living- or deceased-donor renal transplants between January 1, 2004, and December 31, 2007, in whom ESW was planned and who received either r-ATG or basiliximab; patients receiving an extended-criteria kidney donation or a donation after cardiac death were excluded...
June 2011: Pharmacotherapy
Alexandre B Libório, Talita R Mendoza, Ronaldo M Esmeraldo, Maria Luiza M B Oliveira, Fernando J V Nogueira Paes, Geraldo B Silva Junior, Elizabeth F Daher
BACKGROUND: The present study intends to investigate the effects of anti-IL2 receptors (anti-IL2R) vs. lymphocyte-depleting agents in the early steroid withdrawal (ESW) scheme. METHODS: This is a retrospective cohort of 167 consecutive adult renal transplant recipients. Immunosuppression was based on tacrolimus and mycophenolate mofetil. Antibody induction therapy was carried out with lymphocyte-depleting agent (thymoglobulin) or anti-IL2R (Basiliximab or Daclizumab)...
November 2011: International Immunopharmacology
Muhammad A Mujtaba, Tim E Taber, William C Goggins, Muhammad S Yaqub, Dennis P Mishler, Martin L Milgrom, Jonathan A Fridell, Andrew Lobashevsky, John A Powelson, Asif A Sharfuddin
BACKGROUND AND OBJECTIVES: Kidney re-transplantation (KRT) candidates are considered at high risk for graft failure. Most of these patients are kept on a chronic steroid maintenance (CSM) regimen. The safety of early steroid withdrawal (ESW) remains unanswered in KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study was aimed at comparing the outcomes of ESW and CSM in KRT. Retrospective analysis of 113 KRT patients (ESW, n=59; CSM, n=54) was performed...
February 2011: Clinical Journal of the American Society of Nephrology: CJASN
Márcio Carvalho, Luiz Gonzaga de Freitas Filho, Maurício Carvalho, Djalma José Fagundes, Valdemar Ortiz
PURPOSE: To access the effect of repeated extracorporeal shock wave (ESW) on urinary biochemical markers METHODS: 20 rats were assigned for ESW (Direx Tripter X1(R) - 14 KV) to one of two groups: G1 (n=10) one ESW; G2 (n=10) two ESWs within a 14-day interval. Within the twenty-four hour period before and after the application of shock waves, the animals were placed in metabolic cages for 24 hour urine collection. The ph, creatinine, sodium, potassium, chlorides, calcium, magnesium, phosphorus, oxalates, alkaline phosphatase and citrates were measured...
November 2009: Acta Cirúrgica Brasileira
Sofia Mariotto, Alessandra Carcereri de Prati, Elisabetta Cavalieri, Ernesto Amelio, Ernst Marlinghaus, Hisanori Suzuki
Shock waves (SW), defined as a sequence of single sonic pulses characterised by high peak pressure (100 MPa), a fast rise in pressure (< 10 ns) and a short lifecycle (10 micros), are conveyed by an appropriate generator to a specific target area at an energy density ranging from 0.03 to 0.11 mJ/mm(2). Extracorporeal SW (ESW) therapy was first used on patients in 1980 to break up kidney stones. During the last ten years, this technique has been successfully employed in orthopaedic diseases such as pseudoarthosis, tendinitis, calcarea of the shoulder, epicondylitis, plantar fasciitis and several inflammatory tendon diseases...
2009: Current Medicinal Chemistry
Vicente M Kira, Djalma J Fagundes, Cesar O P Bandeira, Oskar Kaufman, Anna T N Fagundes, Valdemar Ortiz
OBJECTIVE: To assess the effect of repeated extracorporeal shock waves (ESW) on the apoptosis of renal parenchyma in normal and diabetic rats by the caspase-3 expression. MATERIALS AND METHODS: 80 rats were assigned for ESW (Direx Tripter X1(R) - 14 KVA) to one of three groups with 50% rats with diabetes (A) and 50% normal (B) in each: G1 (n = 40): no ESW; G2 (n = 20): one ESW; G3 (n = 20): two ESWin an interval of 14 days. The animals were sacrificed 3 days after the ESW and samples of the renal parenchyma were histologically prepared, stained by the caspase-3 cleavage immunohistochemical method, and the apoptotic index (ApIn) was calculated by computer program Image Pro-Plus V 4,5,1 Media Cybernetics ( ApIn = number of apoptotic cells in the microscopic section / total cells in the microscopic section)...
January 2008: International Braz J Urol: Official Journal of the Brazilian Society of Urology
M S Anil Kumar, S Khan, K Ranganna, G Malat, N Sustento-Reodica, W C Meyers
Generally chronic steroid therapy is standard care for African American (AA) kidney recipients because of their higher incidence of rejections and lower long-term graft survival. This prospective study evaluated the long-term safety and efficacy of early steroid withdrawal (ESW) in AA recipients. A total of 206 recipients were studied; 103 AA and 103 non-AA recipients monitored by serial surveillance biopsies from 1 to 60 months posttransplantation to evaluate subclinical acute rejections (SCAR) and chronic allograft injury (CAI)...
March 2008: American Journal of Transplantation
Xu Zeng, Jose M El-Amm, Mona D Doshi, Atul Singh, Katherina Morawski, Elizabeth Cincotta, Julian E Losanoff, Miguel S West, Scott A Gruber
BACKGROUND: There is a paucity of data regarding the use of early corticosteroid withdrawal (ESW) in African-American renal allograft recipients, and very few reports with >or=1 year follow-up in all patients. METHODS: We examined the outcomes of 57 African-American renal allograft recipients with minimum follow-up 12 months who did not receive maintenance steroids after day 4 posttransplant. All patients received thymoglobulin induction, mycophenolate mofetil, and initial tacrolimus (n = 48) or sirolimus (n = 9)...
October 2007: Surgery
Vicente Massaji Kira, Djalma José Fagundes, César Orlando Peralta Bandeira, Anna Tereza Negrini Fagundes, Valdemar Ortiz
PURPOSE: To assess the effect of repeated extracorporeal shock waves (ESW) on renal parenchyma of normal and diabetic rats. METHODS: 40 normal rats (A) and 40 diabetic rats (B) were assigned for ESW (Direx Tripter X1 - 14 KVA) as follow: A1/B1 and A3/B3 no ESW; A2/B2 one ESW (2,000 SW); A4/B4 two ESW (4,000 SW) in an elapsed 14 days. All the animals were sacrificed 3 days after the ESW and samples of renal parenchyma were histological prepared, stained by H&E. For each animal the frequency of hemorrhage focus (HF) in the subcapsular, interstitial and glomerulus area was calculated (percentage) on 20 randomly histological sections...
July 2007: Acta Cirúrgica Brasileira
James J Jaber, Paul J Feustel, Ossama Elbahloul, Alexander D Conti, Michael H Gallichio, David J Conti
BACKGROUND: Maintenance steroid therapy is associated with significant morbidity and mortality in renal transplant recipients. Elimination of the many long-term side effects of corticosteroids, including those that impinge on cardiovascular risk, remains a laudable goal in designing immunosuppressive protocols. However, concern persists that prednisone-free maintenance immunotherapy in kidney transplant recipients will result in an increase incidence of acute rejections, renal dysfunction and ultimate graft loss...
January 2007: Clinical Transplantation
A Haririan, D H Sillix, K Morawski, J M El-Amm, J Garnick, M D Doshi, M S West, S A Gruber
There are limited data on the results of early steroid withdrawal (ESW) in African-American (AA) renal allograft recipients. We examined short-term transplant outcomes in a retrospective, non-concurrent cohort study of 40 AAs who did not (ESW group), and 33 who did [steroid maintenance (SM) group] receive maintenance steroids after day 4 post-transplant. Patients received thymoglobulin (ATG) induction, mycophenolate mofetil, and tacrolimus or sirolimus. Data were analyzed using survival analysis methods and regression models...
October 2006: American Journal of Transplantation
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