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outcomes of renal transplantation

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https://www.readbyqxmd.com/read/29240784/effects-of-calcium-channel-blockers-comparing-to-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-in-patients-with-hypertension-and-chronic-kidney-disease-stage-3-to-5-and-dialysis-a-systematic-review-and-meta-analysis
#1
Yen-Chung Lin, Jheng-Wei Lin, Mai-Szu Wu, Kuan-Chou Chen, Chiung-Chi Peng, Yi-No Kang
BACKGROUND: Calcium channel blocker (CCB) or two renin angiotensin aldosterone system blockades (RAAS), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are major potent and prevalently used as initial antihypertensive agents for mild to moderate hypertension, but no uniform agreement as to which antihypertensive drugs should be given for initial therapy, especially among chronic kidney disease (CKD) patients. DESIGN: A systematic review and meta-analysis comparing CCBs and the two RAAS blockades for hypertensive patients with CKD stage 3 to 5D...
2017: PloS One
https://www.readbyqxmd.com/read/29236239/abdominal-aorta-and-pelvic-artery-calcifications-on-plain-radiographs-may-predict-mortality-in-chronic-kidney-disease-hemodialysis-and-renal-transplantation
#2
Sinee Disthabanchong, Kotcharat Vipattawat, Bunyong Phakdeekitcharoen, Chagriya Kitiyakara, Vasant Sumethkul
PURPOSE: Vascular calcification is common in chronic kidney disease (CKD) and predicts poor patient outcomes. While computed tomography is the gold standard for evaluation of vascular calcification, plain radiograph offers a simpler and less costly alternative. The calcification of abdominal aorta, iliac and femoral arteries has been evaluated by plain radiograph, but the data on their outcome predictabilities are still limited. The present study investigated the role of abdominal aortic calcification (AAC) and pelvic arterial calcification (PAC) in predicting overall morality in non-dialysis CKD stages 2-5 (CKD 2-5), maintenance hemodialysis (HD) and long-term kidney transplant (KT) patients...
December 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29234197/echocardiographic-and-electrocardiographic-predictors-of-adverse-outcomes-in-spontaneous-bacterial-peritonitis
#3
Mahek Shah, Soumya Patnaik, Obiora Maludum, Shantanu Patil, Toni Anne De Venecia, Vincent M Figueredo
Background: Patients with cirrhosis who develop Spontaneous Bacterial Peritonitis (SBP) suffer from cirrhotic cardiomyopathy which is characterized by impaired contractility in response to stress despite a relatively normal resting cardiac output. We hypothesized that electrocardiographic and echocardiographic information would help prognosticate patients developing SBP in addition to existing scoring systems. Methods: Cirrhotic patients admitted to Einstein Medical Center from 01/01/2005 to 6/30/2012 for SBP, and did not receive a transplant within one year, were included...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29228920/comparison-of-outcomes-between-emergent-start-and-planned-start-peritoneal-dialysis-in-incident-esrd-patients-a-prospective-observational-study
#4
Wen-Yi Li, Yi-Cheng Wang, Shang-Jyh Hwang, Shih-Hua Lin, Kwan-Dun Wu, Yung-Ming Chen
BACKGROUND: The clinical consequences of starting chronic peritoneal dialysis (PD) after emergent dialysis via a temporary hemodialysis (HD) catheter has rarely been evaluated within a full spectrum of treated end-stage renal disease (ESRD). We investigated the longer-term outcomes of patients undergoing emergent-start PD in comparison with that of other practices of PD or HD in a prospective cohort of new-onset ESRD. METHODS: This was a 2-year prospective observational study...
December 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29226570/campath-calcineurin-inhibitor-reduction-and-chronic-allograft-nephropathy-the-3c-study-results-of-a-randomized-controlled-clinical-trial
#5
Richard Haynes, Lisa Blackwell, Natalie Staplin, William G Herrington, Jonathan Emberson, Parminder K Judge, Benjamin C Storey, Martin J Landray, Paul N Harden, Colin Baigent, Peter Friend
Calcineurin inhibitors (CNI e.g. tacrolimus) reduce short-term kidney transplant failure, but chronic nephrotoxicity may contribute to late transplant loss. Elective conversion to inhibitors of the mammalian target of rapamycin pathway (mTOR e.g. sirolimus) might avoid long-term CNI renal damage and improve outcomes. The 3C Study was a pragmatic randomized controlled trial comprising sequential randomizations between alemtuzumab and basiliximab induction therapy (at the time of surgery) and between tacrolimus and sirolimus maintenance therapy at 6-months post-transplant...
December 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29226427/case-report-treatment-of-light-chain-amyloidosis-with-daratumumab-monotherapy-in-two-patients
#6
Charlotte Gran, Gösta Gahrton, Evren Alici, Hareth Nahi
Immunoglobulin light-chain amyloidosis (AL) affects multiple organs, most prominently the kidney and the heart. Renal and cardiac impairment are both associated with poor prognosis.(1) Typical treatment regimens for AL include proteasome inhibitors, alkylating agents, and steroids as well as autologous stem cell transplantation (ASCT) for younger, fit patients. Complete response after treatment is associated with a better outcome and can be measured by free light chain (FLC) reduction.(2, 3) Monoclonal antibodies such as daratumumab (Dara, human IgG1 anti-CD38) have shown promising efficacy for the treatment of relapsed and refractory multiple myeloma...
December 11, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29226122/does-mineralocorticoid-receptor-antagonism-prevent-calcineurin-inhibitor-induced-nephrotoxicity
#7
REVIEW
Line Aas Mortensen, Claus Bistrup, Helle Charlotte Thiesson
Calcineurin inhibitors have markedly reduced acute rejection rates in renal transplantation, thus significantly improved short-term outcome. The beneficial effects are, however, tampered by acute and chronic nephrotoxicity leading to interstitial fibrosis and tubular atrophy, which impairs long-term allograft survival. The mineralocorticoid hormone aldosterone induces fibrosis in numerous organs, including the kidney. Evidence from animal models suggests a beneficial effect of aldosterone antagonism in reducing calcineurin inhibitor-induced nephrotoxicity...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29224797/kidney-transplant-with-and-without-native-nephrectomy-for-polycystic-kidney-disease-results-of-the-national-inpatient-sample-and-the-rationale-for-a-2-staged-procedure
#8
Raymond A Jean, Mehida Alexandre, Peter S Yoo
BACKGROUND: Polycystic kidney disease (PKD) is one of the most common causes of end-stage renal disease requiring hemodialysis or transplantation. In patients requiring transplant, there are several indications for native nephrectomy, including recurrent cyst infection, bleeding, or to provide room for the graft. There is disagreement about whether it is advisable to perform kidney transplant alone (KT), or to perform kidney transplant with simultaneous native nephrectomy (KTN). We compared postoperative outcomes of KTN and KT in a large national cohort...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29224020/association-between-glcci1-promoter-polymorphism-rs37972-and-post-transplant-hypertension-in-renal-transplant-recipients
#9
Aki Mafune Hamada, Izumi Yamamoto, Yasuyuki Nakada, Akimitsu Kobayashi, Yusuke Koike, Jun Miki, Hiroki Yamada, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Hiroyasu Yamamoto, Mitsuyoshi Urashima, Takashi Yokoo
BACKGROUND/AIMS: Post-transplant hypertension is highly prevalent in renal transplant recipients and is a risk factor for graft loss, cardiovascular disease and death. Glucocorticoid is used to prevent rejection, but simultaneously increases the risk of post-transplant hypertension. The glucocorticoid-induced transcript 1 (GLCCI1) promoter polymorphism (rs37972) has been reported to be associated with response to glucocorticoid therapy in asthma. We therefore examined the association between GLCCI1 promoter polymorphism and post-transplant hypertension in renal transplant recipients...
December 8, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29223859/outcome-of-pediatric-renal-transplantation-in-urological-versus-non-urological-causes-of-end-stage-renal-disease-does-it-matter
#10
Ahmed Aly Hussein, Ahmed Ismail Shoukry, Fatina Fadel, Hani Abdel-Raouf Morsi, Hussein Aly Hussein, Mostafa Sheba, Nada El-Khateeb, Waseem Abou-El Ela, Mohamed El-Sheemy, Kareem Daw, Ahmed Shouman, Amr Lotfy, Hisham Badawy, Mohamed Eissa
INTRODUCTION: Causes for end stage renal disease (ESRD) in children can be categorized into urological causes or non-urological causes. We sought to compare the outcomes of urological and non-urological causes of ESRD in children. METHODS: Patients were divided into two groups: urological causes of ESRD versus non-urological causes of ESRD. All patients and donors had at least 6 months of follow-up. The main outcomes included the effect on complications and renal function...
November 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29223620/impact-of-obesity-on-modality-longevity-residual-kidney-function-peritonitis-and-survival-among-incident-peritoneal-dialysis-patients
#11
Yoshitsugu Obi, Elani Streja, Rajnish Mehrotra, Matthew B Rivara, Connie M Rhee, Melissa Soohoo, Daniel L Gillen, Wei-Ling Lau, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: The prevalence of severe obesity, often considered a contraindication to peritoneal dialysis (PD), has increased over time. However, mortality has decreased more rapidly in the PD population than the hemodialysis (HD) population in the United States. The association between obesity and clinical outcomes among patients with end-stage kidney disease remains unclear in the current era. STUDY DESIGN: Historical cohort study. SETTING & PARTICIPANTS: 15,573 incident PD patients from a large US dialysis organization (2007-2011)...
December 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29218968/the-psychiatry-integrated-nurse-practitioner-role-in-hemodialysis-an-opportunity-to-provide-nurse-practitioner-care-between-the-interface-of-psychiatry-and-hemodialysis
#12
Brock Cooper, Kien Dang, Ann Jones, Alison Thomas
The mental health of patients living with end-stage kidney disease (ESKD) is an important aspect of their care. According to national survey data, depressive disorders affect about 9% of the North American population (Kessler, Chiu, Demler, Merikangas, & Walters, 2005). A review of psychological distress and depression across the spectrum of chronic kidney disease indicates that the prevalence of depression in ESKD is reported to be about four times that of the general population and it is associated with adverse outcomes including low quality-of-life ratings, graft failure, and death after renal transplantation (Zalai, Szeifert, & Novak, 2012)...
January 2017: CANNT Journal, Journal ACITN
https://www.readbyqxmd.com/read/29217776/melphalan-140mg-m2-or-200mg-m2-for-autologous-transplantation-in-myeloma-results-from-the-collaboration-to-collect-autologous-transplant-outcomes-in-lymphoma-and-myeloma-calm-study-a-report-by-the-ebmt-chronic-malignancies-working-party
#13
Holger W Auner, Simona Iacobelli, Giulia Sbianchi, Cora Knol-Bout, Didier Blaise, Nigel H Russell, Jane F Apperley, David Pohlreich, Paul Browne, Guido Kobbe, Cecilia Isaksson, Stig Lenhoff, Christoph Scheid, Cyrille Touzeau, Esa Jantunen, Achilles Anagnostopoulos, Ibrahim Yakoub-Agha, Alina Tanase, Nicolaas Schaap, Wieslaw Wiktor-Jedrzejczak, Marta Krejci, Stefan O Schönland, Curly Morris, Laurent Garderet, Nicolaus Kröger
Melphalan at a dose of 200mg/m2 is standard conditioning prior to autologous haematopoietic stem cell transplantation for multiple myeloma, but a dose of 140mg/m2 is often used in clinical practice in patients perceived to be at risk of excess toxicity. To determine if melphalan 200 and melphalan 140 are equally effective and tolerable in clinically relevant patient subgroups we analysed 1964 first single autologous transplantation episodes using a series of Cox proportional-hazards models. Overall survival, progression-free survival, cumulative incidence of relapse, non-relapse mortality, haematopoietic recovery and second primary malignancy rates were not significantly different between the melphalan 140 (n=245) and melphalan 200 (n=1719) groups...
December 7, 2017: Haematologica
https://www.readbyqxmd.com/read/29215537/simultaneous-pancreas-and-kidney-transplantation-is-associated-with-inferior-long-term-outcomes-in-african-americans
#14
Joseph T Brooks, Rong Liu, Madeleine Oliver, Anthony DeLeonibus, Jingning Mei, Donald White, Eric Siskind, Jorge Ortiz
OBJECTIVES: Simultaneous pancreas and kidney transplant (SPK) is the most effective treatment for patients with type 1 diabetes mellitus and renal failure. However, the effect of ethnicity on SPK outcomes is not well understood. METHODS: We studied the influence of recipient ethnicity on SPK using the United Network for Organ Sharing database. A retrospective review of 20,196 SPK patients from 1989 to 2014 was performed. The recipients were divided into 4 groups: 15,833 whites (78...
December 5, 2017: Pancreas
https://www.readbyqxmd.com/read/29215520/preeclampsia-and-long-term-renal-function-in-women-who-underwent-kidney-transplantation
#15
Valerie Vannevel, Kathleen Claes, David Baud, Yvan Vial, Delaviz Golshayan, Eugene W Yoon, Ryan Hodges, Anne Le Nepveu, Peter G Kerr, Claire Kennedy, Mary Higgins, Elisabeth Resch, Philipp Klaritsch, Tim Van Mieghem
OBJECTIVE: Preeclampsia often complicates pregnancies after maternal kidney transplantation. We aimed to assess whether preeclampsia is associated with kidney function decline either during the pregnancy or in the long term. METHODS: We performed an international multicenter retrospective cohort study. Renal function at conception, pregnancy outcomes, and short- and long-term graft outcomes were collected for women who were pregnant after renal transplantation and had transplant and obstetric care at the participating centers...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29214126/pharmacologic-complement-inhibition-in-clinical-transplantation
#16
REVIEW
Vasishta S Tatapudi, Robert A Montgomery
Purpose of Review: Over the past two decades, significant strides made in our understanding of the etiology of antibody-mediated rejection (AMR) in transplantation have put the complement system in the spotlight. Here, we review recent progress made in the field of pharmacologic complement inhibition in clinical transplantation and aim to understand the impact of this therapeutic approach on outcomes in transplant recipients. Recent Findings: Encouraged by the success of agents targeting the complement cascade in disorders of unrestrained complement activation like paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), investigators are testing the safety and efficacy of pharmacologic complement blockade in mitigating allograft injury in conditions ranging from AMR to recurrent post-transplant aHUS, C3 glomerulopathies and antiphospholipid anti-body syndrome (APS)...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29212466/exploring-the-use-of-tablet-computer-based-electronic-data-capture-system-to-assess-patient-reported-measures-among-patients-with-chronic-kidney-disease-a-pilot-study
#17
Dorothy Wong, Shen Cao, Heather Ford, Candice Richardson, Dmitri Belenko, Evan Tang, Luca Ugenti, Eleanor Warsmann, Amanda Sissons, Yalinie Kulandaivelu, Nathaniel Edwards, Marta Novak, Madeline Li, Istvan Mucsi
BACKGROUND: Collecting patient reported outcome measures (PROMs) via computer-based electronic data capture system may improve feasibility and facilitate implementation in clinical care. We report our initial experience about the acceptability of touch-screen tablet computer-based, self-administered questionnaires among patients with chronic kidney disease (CKD), including stage 5 CKD treated with renal replacement therapies (RRT) (either dialysis or transplant). METHODS: We enrolled a convenience sample of patients with stage 4 and 5 CKD (including patients on dialysis or after kidney transplant) in a single-centre, cross-sectional pilot study...
December 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29208248/kidney-diseases-associated-with-alternative-complement-pathway-dysregulation-and-potential-treatment-options
#18
REVIEW
Prateek Sanghera, Mythili Ghanta, Fatih Ozay, Venkatesh K Ariyamuthu, Bekir Tanriover
Atypical hemolytic uremic syndrome and C3 glomerulopathy (dense deposit disease and C3 glomerulonephritis) are characterized as inappropriate activation of the alternative complement pathway. Genetic mutations affecting the alternative complement pathway regulating proteins (complement factor H, I, membrane cofactor protein and complement factor H-related proteins) and triggers (such as infection, surgery, pregnancy and autoimmune disease flares) result in the clinical manifestation of these diseases. A decade ago, prognosis of these disease states was quite poor, with most patients developing end-stage renal disease...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29208204/durable-renal-response-after-combination-of-bortezomib-corticosteroids-rituximab-and-plasmapheresis-for-late-antibody-mediated-renal-transplant-rejection%C3%A2
#19
Yanli Ding, Jean Francis, Amitabh Gautam, Linda Pelletier, Vaishali Sanchorawala, Karen Quillen
Late occurrence of antibody-mediated rejection (AMR), defined as occurring 6 months after transplantation, is associated with poor renal allograft survival, compared to early acute AMR and acute cellular rejection. The proteasome inhibitor bortezomib has multiple immunomodulatory effects on plasma cells, the source of donor-specific HLA antibodies which mediate AMR. MATERIALS AND METHODS: Consecutive patients who presented with biopsy-proven AMR and donor-specific anti-HLA antibodies (DSA) at a single institution between July 2011 and February 2015 were included...
December 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29207754/clinicopathological-characteristics-and-outcomes-of-diffuse-crescentic-glomerulonephritis-a-single-center-experience-from-southern-india
#20
Shankar Prasad Nagaraju, Sindhura Lakshmi Koulmane Laxminarayana, Srinivas Kosuru, Rajeevalochana Parthasarathy, Ravindra Prabhu Attur, Dharshan Rangaswamy, Uday Venkat Matteti, Vasudeva Guddattu
Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
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