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Renal transplant obesity

Elaine Hillesheim, Valéria Laguna Salomão Ambrósio, Inalda Facincani
Introduction: Chronic kidney disease in children often determines poor nutritional status. Although renal transplantation (RTx) resolves endocrine and metabolic disorders, growth continues to be suboptimal and excessive weight gain may result in obesity. Objectives: Evaluating the development of height and body mass index in renal transplanted children and adolescents and identifying associated factors with final nutritional status. Methods: We reviewed the medical records of 17 patients with regular follow-ups up to 24 months after RTx...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
R Thuret, F Kleinclauss, N Terrier, G Karam, M O Timsit
OBJECTIVES: To describe kidney transplantation surgical techniques and to propose strategies in high-risk recipients. MATERIAL AND METHODS: Relevant publications were identified through Medline ( and Embase ( database using the following keywords, alone or in association, "renal transplantation; peripheral arterial disease; obesity; third and fourth transplantation; robotic-assisted kidney transplant; anticoagulant therapy; dual kidney transplant"...
October 6, 2016: Progrès en Urologie
Daniele Camboni, Matthaeus Zerdzitzki, Stephan Hirt, René Tandler, Michael Weyand, Christof Schmid
OBJECTIVES: A silicone interface at skin level of left ventricular assist device (LVAD) may reduce the risk of driveline (DL) exit site infections when compared with other materials (e.g. velour). The purpose of this study was to evaluate the rate of DL exit site infection according to the presence of silicone or velour at the exit site with the redesigned INCOR, facilitating the positioning of silicone at the exit site. METHODS: The rate of DL exit site infection and overall survival were compared between the two groups (silicone group, n = 16/velour group, n = 24) with 1-year follow-up postimplantation...
October 4, 2016: Interactive Cardiovascular and Thoracic Surgery
Suzanne M Boyle, Yimei Li, F P Wilson, Joel D Glickman, Harold I Feldman
♦ Background: Total body water (V) is an imprecise metric for normalization of dialytic urea clearance (Kt). This poses a risk of early mortality/technique failure (TF). We examined differences in the distribution of peritoneal Kt/V when V was calculated with actual weight (AW), ideal weight (IW), and adjusted weight (ADW). We also examined the associations of these Kt/V measurements, Kt/body surface area (BSA), and non-normalized Kt with mortality and TF. ♦ Methods: This is a retrospective cohort study of 534 incident peritoneal dialysis (PD) patients from the Dialysis Morbidity and Mortality Study Wave 2 linked with United States Renal Data System through 2010...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Pierre Delanaye, Toralf Melsom, Natalie Ebert, Sten-Erik Bäck, Christophe Mariat, Etienne Cavalier, Jonas Björk, Anders Christensson, Ulf Nyman, Esteban Porrini, Giuseppe Remuzzi, Piero Ruggenenti, Elke Schaeffner, Inga Soveri, Gunnar Sterner, Bjørn Odvar Eriksen, Flavio Gaspari
A reliable assessment of glomerular filtration rate (GFR) is of paramount importance in clinical practice as well as epidemiological and clinical research settings. It is recommended by Kidney Disease: Improving Global Outcomes guidelines in specific populations (anorectic, cirrhotic, obese, renal and non-renal transplant patients) where estimation equations are unreliable. Measured GFR is the only valuable test to confirm or confute the status of chronic kidney disease (CKD), to evaluate the slope of renal function decay over time, to assess the suitability of living kidney donors and for dosing of potentially toxic medication with a narrow therapeutic index...
October 2016: Clinical Kidney Journal
Young Kim, Alex L Chang, Koffi Wima, Audrey E Ertel, Tayyab S Diwan, Daniel E Abbott, Shimul A Shah
BACKGROUND: A growing number of renal transplant recipients have a body mass index ≥40. While previous studies have shown that patient and graft survival are significantly decreased in renal transplant recipients with body mass indexes ≥40, less is known about perioperative outcomes and resource utilization in morbidly obese patients. We aimed to analyze the effects of morbid obesity on these parameters in renal transplant. METHODS: Using a linkage between the Scientific Registry of Transplant Recipients and the databases of the University HealthSystem Consortium, we identified 29,728 adult renal transplant recipients and divided them into 2 cohorts based on body mass index (<40 vs ≥40 kg/m(2))...
August 26, 2016: Surgery
D A Axelrod, M A Schnitzler, H Xiao, A S Naik, D L Segev, V R Dharnidharka, D C Brennan, K L Lentine
Kidney transplantation has become more resource intensive as recipient complexity has increased and average donor quality has diminished over time. A national retrospective cohort study was performed to assess the impact of kidney donor and recipient characteristics on transplant center cost (exclusive of organ acquisition) and Medicare reimbursement. Data from the national transplant registry, University HealthSystem Consortium hospital costs, and Medicare payments for deceased donor (N = 53 862) and living donor (N = 36 715) transplants from 2002 to 2013 were linked and analyzed using multivariate linear regression modeling...
August 27, 2016: American Journal of Transplantation
Tara O'Brien, Donna Hathaway
OBJECTIVE: To establish the current state of knowledge regarding physical activity interventions for adult kidney transplant recipients. DATA SOURCES: A comprehensive literature search was conducted for the years 2009 to 2015 using 5 electronic databases: PubMed, CINAHL, Cochrane Library, Ovid, and ScienceDirect. DATA EXTRACTION: Of the 110 articles identified, only 6 met inclusion requirements. These studies were conducted between 2009 and 2015 and found that weight gain was reported most often within the first year of transplantation and that kidney transplant recipients desired early interventions to help them become more physically active...
August 22, 2016: Progress in Transplantation
Michael R Charlton
Longterm outcomes in liver transplant recipients has undergone a dramatic transition, driven by three factors: i. efficacy of immunosuppression, ii. declining impact of viral hepatitis with surge in obesity and alcohol -related liver diseases, and iii. shortage of donor organs with subsequent recipient frailty at the time of transplantation. Graft function in general and rejection specifically are uncommon determinants of longterm outcomes. The most common causes of mortality in liver transplant recipients are cardiovascular disease, renal failure and malignancies, all of which are contributed to by immunosuppression and the metabolic syndrome...
August 12, 2016: Liver Transplantation
K Letachowicz, M Boratyńska, M Obremska, D Kamińska, A Goździk, O Mazanowska, M Klinger
OBJECTIVE: Left ventricular hypertrophy (LVH) is a risk factor for premature cardiovascular morbidity and mortality in chronic kidney disease. The aim of the study was to determine echocardiographic evaluation morphology and function of the left ventricle in older renal transplantation patients. MATERIAL AND METHODS: We retrospectively analyzed clinical data of renal transplant recipients who underwent routine echocardiography. We compared the data from 38 patients who were older than 65 years with 49 patients who were a mean age of 47...
June 2016: Transplantation Proceedings
Z Wołyniec, A Dębska-Ślizień, W Wołyniec, B Rutkowski
BACKGROUND: The epidemic of obesity has led to dilemmas facing all nephrologists who care for patients with chronic kidney disease and who must make decisions regarding whether or not the patient can undergo transplantation. The aim of the study was to assess the outcome of transplantation among obese compared to nonobese recipients. To minimize donor variability and bias, paired kidney analysis was applied. MATERIALS AND METHODS: Patients with a body mass index >30 who received transplants in our unit between January 2000 and December 2010 were selected...
June 2016: Transplantation Proceedings
Raluca Pais, A Sidney Barritt, Yvon Calmus, Olivier Scatton, Thomas Runge, Pascal Lebray, Thierry Poynard, Vlad Ratziu, Filomena Conti
Because of global epidemics of obesity and type 2 diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing both in Europe and the United States, becoming one of the most frequent causes of chronic liver disease and predictably, one of the leading causes of liver transplantation both for end-stage liver disease and hepatocellular carcinoma. For most transplant teams around the world this will raise many challenges in terms of pre- and post-transplant management. Here we review the multifaceted impact of NAFLD on liver transplantation and will discuss: (1) NAFLD as a frequent cause of cryptogenic cirrhosis, end-stage chronic liver disease, and hepatocellular carcinoma; (2) prevalence of NAFLD as an indication for liver transplantation both in Europe and the United States; (3) the impact of NAFLD on the donor pool; (4) the access of NAFLD patients to liver transplantation and their management on the waiting list in regard to metabolic, renal and vascular comorbidities; (5) the prevalence and consequences of post-transplant metabolic syndrome, recurrent and de novo NAFLD; (6) the alternative management and therapeutic options to improve the long-term outcomes with particular emphasis on the correction and control of metabolic comorbidities...
July 30, 2016: Journal of Hepatology
Hoon Yu, Hyosang Kim, Chung Hee Baek, Seung Don Baek, Soomin Jeung, Duck Jong Han, Su-Kil Park
BACKGROUND: New-onset diabetes mellitus after transplantation (NODAT) is a serious complication following renal transplantation. The aim of this study was to identify the risk factors for the development of NODAT in Korean transplant patients. METHODS: Recipients who underwent living donor kidney transplantation between January 2009 and April 2012 at Asan Medical Center were reviewed. Diagnosis of NODAT was defined according to the American Diabetes Association criteria...
2016: BMC Nephrology
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...
July 29, 2016: Clinical Nephrology
Maurizio Postorino, Elena Mancini, Graziella D'Arrigo, Carmela Marino, Antonio Vilasi, Giovanni Tripepi, Silvano Gallus, Alessandra Lugo, Antonio Santoro, Carmine Zoccali
BACKGROUND: In the USA, the increase in the prevalence of obesity in the general population has been accompanied by a marked increase in the prevalence and incidence of obesity in the dialysis population. However, secular trends of body mass index (BMI) have not been investigated in European renal registries. METHODS: We investigated the secular trend of BMI across 18 years (1994-2011) in two haemodialysis (HD) registries (Calabria in southern Italy and Emilia in northern Italy) on a total of 16 201 prevalent HD patients and in a series of 3559 incident HD patients...
October 2016: Nephrology, Dialysis, Transplantation
Juan M Mejía-Vilet, Bertha M Córdova-Sánchez, José M Arreola-Guerra, Josefina Alberú, Luis E Morales-Buenrostro
BACKGROUND Due to the shortage of organs for transplantation, there has been increased interest in developing living-donor kidney transplantation (LDKT) programs. MATERIAL AND METHODS A total of 668 potential living kidney donors (PLKD) for 496 intended recipients were evaluated in a LDKT program between 2010 and 2014. Causes for PLKD exclusion were recorded, as well as patient survival. RESULTS After evaluation, 250 (37.4%) PLKD were considered suitable for kidney donation, 331 (49.6%) were excluded for medical reasons, and 87 (13...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Velibor Tasic, Aleksandra Janchevska, Nora Emini, Emilija Sahpazova, Zoran Gucev, Momir Polenakovic
The knowledge about the progression of chronic kidney disease is an important issue for every pediatric nephrologist and pediatrician in order to implement appropriate measures to prevent wasting of renal function and the final consequence - end stage renal disease with the need for the dialysis and transplantation. Therefore it is important to know, treat or ameliorate the standard risk factors such as hypertension, proteinuria, anemia, hyperparathyroidism etc. In this review devoted to the World Kidney Day 2016 we will pay attention to the low birth parameters, obesity, hyperuricemia and smoking which emerged as particularly important risk factors for children and adolescent with chronic kidney disease...
2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Sarah S Jackson, Surbhi Leekha, Lisa Pineles, Laurence S Magder, Kerri A Thom, Yuan Wang, Anthony D Harris
OBJECTIVE To identify comorbid conditions associated with surgical site infection (SSI) among patients undergoing renal transplantation and improve existing risk adjustment methodology used by the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN). PATIENTS Patients (≥18 years) who underwent renal transplantation at University of Maryland Medical Center January 1, 2010-December 31, 2011. METHODS Trained infection preventionists reviewed medical records to identify surgical site infections that developed within 30 days after transplantation, using NHSN criteria...
October 2016: Infection Control and Hospital Epidemiology
Mira T Keddis, Hatem Amer, Nikolay Voskoboev, Walter K Kremers, Andrew D Rule, John C Lieske
BACKGROUND AND OBJECTIVES: eGFR equations have been evaluated in kidney transplant recipients with variable performance. We assessed the performance of the Modification of Diet in Renal Disease equation and the Chronic Kidney Disease Epidemiology Collaboration equations on the basis of creatinine, cystatin C, and both (eGFR creatinine-cystatin C) compared with measured GFR by iothalamate clearance and evaluated their non-GFR determinants and associations across 15 cardiovascular risk factors...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Hargovind Trivedi, Aruna Vanikar, Himanshu Patel, Kamal Kanodia, Vivek Kute, Lovelesh Nigam, Kamlesh Suthar, Umang Thakkar, Harsh Sutariya, Shruti Gandhi
BACKGROUND: Globally there is an increase in incidence of chronic kidney diseases (CKDs). Diabetes mellitus (DM), hypertension and stone diseases are the major risk factors for CKD. We organized kidney disease screening camps in a semi-urban population of Gujarat, India on the occasion of World Kidney Day (WKD). METHODS: Voluntary participants from six towns were screened. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease formula and CKD was defined as an eGFR <60 mL/min/1...
June 2016: Clinical Kidney Journal
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