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Renal transplant obesity

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https://www.readbyqxmd.com/read/28742255/weight-management-strategies-for-those-with-chronic-kidney-disease-a-consensus-report-from-the-asia-pacific-society-of-nephrology-and-australia-and-new-zealand-society-of-nephrology-2016-renal-dietitians-meeting
#1
Kelly Lambert, Jo Beer, Ruth Dumont, Katie Hewitt, Karen Manley, Anthony Meade, Karen Salamon, Katrina Campbell
AIM: Develop a consensus report to guide dietetic management of overweight or obese individuals with Chronic Kidney Disease (CKD). METHODS: Six statements relating weight management in CKD guided a comprehensive review of the literature. A summary of the evidence was then presented at the renal nutrition meeting of the 2016 Asia Pacific Society of Nephrology and Australia and New Zealand Society of Nephrology. Majority agreement was defined as group agreement on a statement of between 50-74%, and consensus was considered ≥ 75% agreement...
July 25, 2017: Nephrology
https://www.readbyqxmd.com/read/28732093/attitudes-among-transplant-professionals-regarding-shifting-paradigms-in-eligibility-criteria-for-live-kidney-donation
#2
Jeffrey A Lafranca, Emerentia Q W Spoon, Jacqueline van de Wetering, Jan N M IJzermans, Frank J M F Dor
BACKGROUND: The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. METHODS: An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts...
2017: PloS One
https://www.readbyqxmd.com/read/28684646/association-between-reperfusion-renal-allograft-biopsy-findings-and-transplant-outcomes
#3
Sumit Mohan, Eric Campenot, Mariana C Chiles, Dominick Santoriello, Eric Bland, R John Crew, Paul Rosenstiel, Geoffrey Dube, Ibrahim Batal, Jai Radhakrishnan, P Rodrigo Sandoval, James Guarrera, M Barry Stokes, Vivette D'Agati, David J Cohen, Lloyd E Ratner, Glen Markowitz
Biopsy findings at the time of procurement of deceased donor kidneys remain the most common reason cited for kidney discard. To determine the value of renal allograft histology in predicting outcomes, we evaluated the significance of histologic findings, read by experienced renal pathologists, in 975 postreperfusion biopsy specimens collected from 2005 to 2009 after living donor (n=427) or deceased donor (n=548) renal transplant. We evaluated specimens for the degree of glomerulosclerosis, interstitial fibrosis and tubular atrophy, and vascular disease; specimens with a score of 0 or 1 (scale, 0-3) for each parameter were considered optimal...
July 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28678923/cardiac-amyloidosis-and-its-new-clinical-phenotype-heart-failure-with-preserved-ejection-fraction
#4
Evandro Tinoco Mesquita, Antonio José Lagoeiro Jorge, Celso Vale Souza, Thais Ribeiro de Andrade
Heart failure with preserved ejection fraction (HFpEF) is now an emerging cardiovascular epidemic, being identified as the main phenotype observed in clinical practice. It is more associated with female gender, advanced age and comorbidities such as hypertension, diabetes, obesity and chronic kidney disease. Amyloidosis is a clinical disorder characterized by the deposition of aggregates of insoluble fibrils originating from proteins that exhibit anomalous folding. Recently, pictures of senile amyloidosis have been described in patients with HFpEF, demonstrating the need for clinical cardiologists to investigate this etiology in suspect cases...
June 29, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28622834/morbid-obesity-and-functional-status-as-predictors-of-surgical-complication-after-renal-transplantation
#5
Tara M Veasey, James N Fleming, Sara E Strout, Ryan Miller, Nicole A Pilch, Holly B Meadows, Caitlin R Mardis, Benjamin A Mardis, Sunil Shenvi, John McGillicuddy, Kenneth D Chavin, Prabhakar Baliga, David J Taber
BACKGROUND: This study evaluated the impact of body mass index (BMI) and patient functional status on the risk for surgical complications after kidney transplant. METHODS: This retrospective cohort study of adult kidney transplant recipients grouped patients by baseline Karnofsky status (low function ≤ 70%) and further stratified by morbid obesity (BMI ≥ 35 kg/m(2)) to assess surgical complication risk. RESULTS: 736 patients were included with surgical complications occurring in 25%...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28553631/left-ventricular-hypertrophy-in-pediatric-hypertension-a-mini-review
#6
REVIEW
Robert P Woroniecki, Andrew Kahnauth, Laurie E Panesar, Katarina Supe-Markovina
Adults with arterial hypertension (HTN) have stroke, myocardial infarction, end-stage renal disease (ESRD), or die at higher rates than those without. In children, HTN leads to target organ damage, which includes kidney, brain, eye, blood vessels, and heart, which precedes "hard outcomes" observed in adults. Left ventricular hypertrophy (LVH) or an anatomic and pathologic increase in left ventricular mass (LVM) in response to the HTN is a pediatric surrogate marker for HTN-induced morbidity and mortality in adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28500419/bariatric-surgery-as-a-bridge-to-renal-transplantation-in-patients-with-end-stage-renal-disease
#7
Shadi Al-Bahri, Tannous K Fakhry, John Paul Gonzalvo, Michel M Murr
BACKGROUND: Obesity is a relative contraindication to organ transplantation. Preliminary reports suggest that bariatric surgery may be used as a bridge to transplantation in patients who are not eligible for transplantation because of morbid obesity. SETTING: The Bariatric Center at Tampa General Hospital, University of South Florida, Tampa, Florida. METHODS: We reviewed the outcomes of 16 consecutive patients on hemodialysis for end-stage renal disease (ESRD) who underwent bariatric surgery from 1998 to 2016...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28493926/obesity-and-access-to-kidney-transplantation-in-patients-starting-dialysis-a-prospective-cohort-study
#8
Mathilde Lassalle, Léopold K Fezeu, Cécile Couchoud, Thierry Hannedouche, Ziad A Massy, Sébastien Czernichow
BACKGROUND: Obesity has been linked to poor access to medical care. Although scientific evidence suggest that kidney transplantation improves survival and quality of life in obese patients with end-stage renal disease (ESRD), few data exist on the impact of obesity on access to kidney transplantation in this population. OBJECTIVES: We aimed to characterize the relationships between body mass index (BMI) at the start of dialysis, changes in BMI after the start of dialysis, and either access to kidney transplantation or overall mortality in dialysis or transplantation among ESRD patients...
2017: PloS One
https://www.readbyqxmd.com/read/28457383/kidney-transplantation-in-alstr%C3%A3-m-syndrome-case-report
#9
L Poli, G Arroyo, M Garofalo, E Choppin de Janvry, G Intini, A Saracino, R Pretagostini, F Della Pietra, P B Berloco
The Alström syndrome is a rare genetic disorder, inherited in an autosomal recessive manner. It has recently been classified as a ciliopathic disorder. Alström syndrome is a multiorgan pathology characterized by cone-rod dystrophy, hearing loss, childhood truncal obesity, insulin resistance and hyperinsulinemia, type 2 diabetes mellitus, dyslipidemia, short stature in adulthood, hypothyroidism, hypogonadism, dilated or restrictive cardiomyopathy, and progressive pulmonary, hepatic, and renal dysfunction. End-stage renal disease can occur as early as the late teens and is the leading cause of death...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457364/bariatric-surgery-to-target-obesity-in-the-renal-transplant-population-preliminary-experience-in-a-single-center
#10
P G Gazzetta, M Bissolati, A Saibene, C G A Ghidini, G Guarneri, F Giannone, O Adamenko, A Secchi, R Rosati, C Socci
During the last century, obesity has become a global epidemic. The effect of obesity on renal transplantation may occur in perioperative complications and impairment of organ function. Obese patients have metabolic derangements that can be exacerbated after transplantation and obesity directly impacts most transplantation outcomes. These recipients are more likely to develop adverse graft events, such as delayed graft function and early graft loss. Furthermore, obesity is synergic to some immunosuppressive agents in triggering diabetes and hypertension...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28439568/bariatric-surgery-and-kidney-related-outcomes
#11
Alex R Chang, Morgan E Grams, Sankar D Navaneethan
The prevalence of severe obesity in both the general and the chronic kidney disease (CKD) populations continues to rise, with more than one-fifth of CKD patients in the United States having a body mass index of ≥35 kg/m(2). Severe obesity has significant renal consequences, including increased risk of end-stage renal disease (ESRD) and nephrolithiasis. Bariatric surgery represents an effective method for achieving sustained weight loss, and evidence from randomized controlled trials suggests that bariatric surgery is also effective in improving blood pressure, reducing hyperglycemia, and even inducing diabetes remission...
March 2017: KI Reports
https://www.readbyqxmd.com/read/28411866/addressing-the-challenges-of-sleeve-gastrectomy-in-end-stage-renal-disease-analysis-of-100-consecutive-renal-failure-patients
#12
Young Kim, Junzi Shi, Christopher M Freeman, Andrew D Jung, Vikrom K Dhar, Shimul A Shah, E Steve Woodle, Tayyab S Diwan
BACKGROUND: While previous studies have demonstrated short-term efficacy of laparoscopic sleeve gastrectomy in candidates awaiting renal transplantation, the combination of morbid obesity and end-stage renal disease presents unique challenges to perioperative care. We demonstrate how increasing experience and the development of postoperative care guidelines can improve outcomes in this high-risk population. METHODS: Single-center medical records were reviewed for renal transplantation candidates undergoing laparoscopic sleeve gastrectomy between 2011 and 2015 by a single surgeon...
April 12, 2017: Surgery
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#13
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28366701/altering-the-approach-open-minimally-invasive-renal-transplant-in-obese-patients-through-the-anterior-rectus-sheath
#14
Stephen H Phillips, Sharon K Hill, Lorie D Lipscomb, Joseph B Africa
OBJECTIVE: To retrospectively analyze the wound issues for obese renal transplant patients, as well as post-transplant outcomes including graft and patient survival, hypothesizing improvement over the standard approach. As the obese population has expanded, minimally invasive renal transplant techniques have attempted to improve the issues of complications related to wounds and hernias. The anterior rectus sheath approach, which facilitates a minimal incision, has been adopted at our center for all renal transplants, including obese patients...
March 31, 2017: Urology
https://www.readbyqxmd.com/read/28352024/anesthetic-management-of-two-cases-of-bardet-biedl-syndrome-for-renal-transplantation
#15
Kalpana S Vora, Manisha P Modi, Bina P Butala, Veena R Shah
Bardet-Biedl syndrome (BBS) is a multisystem autosomal recessive disorder with clinical and genetic heterogeneity. It is a type of ciliopathy characterized by retinal dystrophy, central obesity, polydactyly, cognitive impairment, and gonadal and renal dysgenesis. It has been suggested that the involved proteins attach to the basal body of ciliated cells making this a disorder of ciliary dysfunction. We report two cases of typical BBS in a 17-year-old female and 29-year-old male patient, who presented for live-related renal transplant...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28352021/prevalence-of-the-metabolic-syndrome-in-kidney-transplant-recipients-a-single-center-study
#16
Maryam Hami, M Ghorban Sabbagh, A Sefidgaran, M J Mojahedi
Metabolic syndrome (MS) is characterized by a combination of cardiovascular (CV) risk factors (hypertension, dyslipidemia, obesity, and alterations in glucose homeostasis). Insulin resistance is suggested to be the common pathogenic background. This syndrome is also a risk factor for diabetes and chronic kidney disease. In renal transplant recipients, MS has been shown to be an independent risk factor for chronic allograft dysfunction, graft failure, new-onset diabetes, and CV disease. We performed a cross-sectional study on 106 stable renal transplant recipients to detect MS between January 2013 and August 2013...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28342282/pharmacokinetic-and-pharmacogenetic-analysis-of-immunosuppressive-agents-after-laparoscopic-sleeve-gastrectomy
#17
Tayyab S Diwan, Alicia B Lichvar, Abbie D Leino, Alexander A Vinks, Uwe Christians, Adele R Shields, Michael A Cardi, Tsuyoshi Fukuda, Tomoyuki Mizuno, Tiffany Kaiser, E Steve Woodle, Rita R Alloway
BACKGROUND: Severe obesity has been shown to limit access to renal transplantation in patients with end-stage renal disease (ESRD). Laparoscopic sleeve gastrectomy (LSG) has been performed in the ESRD population to assist in achieving waitlist and transplant eligibility. Little is known about how LSG impacts the bioequivalence of tacrolimus products and immunosuppression pharmacokinetics. METHODS: This was a prospective, open-label, single-dose, crossover, two-period pharmacokinetic (PK) study...
June 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#18
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. In all, 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T cells were measured using an interferon-γ Elispot assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28282006/a-nationwide-analysis-of-kidney-autotransplantation
#19
MULTICENTER STUDY
Zhobin Moghadamyeghaneh, Mark H Hanna, Reza Fazlalizadeh, Yoshitsugu Obi, Clarence E Foster, Michael J Stamos, Hirohito Ichii
There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28262264/the-incidence-of-new-onset-diabetes-after-transplantation-and-related-factors-single-center-experience
#20
Ayse Sinangil, Vedat Celik, Soykan Barlas, Yener Koc, Taner Basturk, Tamer Sakaci, Emin Baris Akin, Tevfik Ecder
AIM: New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors. METHODS: All patients' data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded...
March 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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