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Renal transplant obesity

Maria Irene Bellini, Kostas Koutroutsos, Jack Galliford, Paul E Herbert
Background: The prevalence of overweight and obese kidney transplant recipients (KTR) has risen in parallel to the obesity epidemic that has affected the general population over the last two decades. At present, there is an ongoing debate regarding the suitability for transplantation of obese patients. Methods: Data were prospectively collected on consecutive single organ KTR transplanted between January 2014 and March 2016. The patients were stratified according to their body mass index (BMI) using the World Health Organization classification...
December 2017: Transplantation Direct
Akanksha Bhatnagar, Ulrich Pein, Silke Markau, Karl Weigand, Paolo Fornara, Matthias Girndt, Eric Seibert
BACKGROUND/AIMS: We compare conventional office blood pressure measurements with automated SPRINT-study type readings in kidney transplant recipients in order to determine the impact of the white coat effect in a prospective observational study. METHODS: Adult patients with a functional renal transplant not dependent on dialysis were eligible. Readings were taken in the office in presence of the physician with an oscillometric method. Afterwards, readings were repeated with the patients resting alone in a quiet examination room with an automated blood pressure monitor...
March 6, 2018: Kidney & Blood Pressure Research
Damla Ateş, Fatma Cebeci
Obesity, which has become an increasing problem worldwide, poses a risk for kidney transplant recipients both before and after surgery. In this literature review, we studied the effects of obesity before and after kidney transplant. There are numerous studies and different opinions on the effects of obesity on graft function before and after transplant. Obesity prolongs surgery time and the ischemic process. A large cohort study of 11 836 recipients noted a close association between body mass index and delayed renal transplant and delayed graft function...
March 2018: Experimental and Clinical Transplantation
Zubaidah Nor Hanipah, Suriya Punchai, Stacy A Brethauer, Philip R Schauer, Ali Aminian
INTRODUCTION: While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution. METHODS: Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6...
March 9, 2018: Obesity Surgery
Michele Molinari, Chethan Puttarajappa, Martin Wijkstrom, Armando Ganoza, Roberto Lopez, Amit Tevar
BACKGROUND: Recent studies have reported a significant decrease in wound problems and hospital stay in obese patients undergoing renal transplantation by robotic-assisted minimally invasive techniques with no difference in graft function. OBJECTIVE: Due to the lack of cost-benefit studies on the use of robotic-assisted renal transplantation versus open surgical procedure, the primary aim of our study is to develop a Markov model to analyze the cost-benefit of robotic surgery versus open traditional surgery in obese patients in need of a renal transplant...
March 8, 2018: JMIR Research Protocols
Bruna Bellincanta Nicoletto, Elis Forcellini Pedrollo, Larissa Salomoni Carpes, Natália Gomes Coloretti, Thaiana Cirino Krolikowski, Gabriela Corrêa Souza, Luiz Felipe Santos Gonçalves, Roberto Ceratti Manfro, Luis Henrique Canani
BACKGROUND: The adipokine progranulin has metabolic proprieties, playing a role in obesity and insulin resistance. Its levels seems to be dependent of renal function, since higher progranulin concentration is observed in patients with end-stage kidney disease. However, the effect of kidney transplantation on progranulin remains unknown. OBJECTIVE: To assess the serum progranulin levels in kidney transplant recipients before and after kidney transplantation. METHODS: Forty-six prospective kidney transplant recipients were included in this longitudinal study...
2018: PloS One
V Aguilera, T Di Maira, I Conde, V Fornés-Ferrer, C Vinaixa, C Pallarés, A Carvalho-Gomes, A Cubells, M García, A Rubín, S Benlloch, L Gonzalez-Dieguez, J M Molina, L Puchades, X López-Labrador, M Prieto, M Berenguer
The association between cytomegalovirus (CMV) reactivation and cardiovascular risk has been reported in solid organ transplant populations; however, it has yet to be assessed in liver transplantation (LT). We aim to evaluate whether CMV reactivation is associated with cardiovascular events (CVE) in HCV-LT patients. Methods: LT patients (2010 and 2014) due to HCV cirrhosis were included. Clinically significant CMV (CS-CMV) was defined as viral load (VL)>5000 copies/mL, need of therapy or CMV disease. Baseline variables and end-point measures (CVE, survival, severe recurrent hepatitis C, de novo tumors and diabetes) were collected...
March 1, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Ian A Thomas, Jeffrey J Gaynor, Tameka Joseph, Nestor De La Cruz-Munoz, Junichiro Sageshima, Warren Kupin, Linda J Chen, Gaetano Ciancio, George W Burke, Adela D Mattiazzi, David Roth, Giselle Guerra
Body mass index(BMI)>35-40kg/m2 is often a contraindication, while Roux-en-Y gastric bypass(RYGB) is performed to enable kidney transplantation. This single-center retrospective study evaluated pre- and post-transplant outcomes of 31 morbidly obese end-stage-renal-disease patients having RYGB before kidney transplantation between July,2009-June,2014. Fourteen RYGB patients were subsequently transplanted. Nineteen recipients not having GB with a BMI>36kg/m2 at transplantation were used as historical controls...
February 28, 2018: Clinical Transplantation
Avesh J Thuluvath, Po-Hung Chen, Paul J Thuluvath, Sergey Kantsevoy, Yulia Savva
BACKGROUND: Nonalcoholic steatohepatitis (NASH) cirrhosis is a common indication for liver transplantation (LT) in the U.S. There is a paucity of data on retransplantation (re-LT) in those who were initially transplanted for NASH. METHODS: We queried the UNOS data sets from 2002-2016 to analyze the outcomes of adults with NASH (n=128) and compared them to groups that received re-LT for cryptogenic cirrhosis (CC, n=189), alcoholic cirrhosis (AC, n=300) or autoimmune hepatitis cirrhosis (AIH-C, n=118) after excluding multiple-organ re-LT and individuals with HCC...
February 20, 2018: Transplantation
Carmine Zoccali, Graziella D'arrigo, Daniela Leonardis, Patrizia Pizzini, Maurizio Postorino, Giovanni Tripepi, Francesca Mallamaci, Jan van den Brand, Arjan van Zuilen, Jack Wetzels, Michiel L Bots, Peter Blankestijn
Background: Neuropeptide Y (NPY) is a sympathetic neurotransmitter that has been implicated in various disorders including obesity, gastrointestinal and cardiovascular diseases. Methods: We investigated the relationship between circulating NPY and the progression of the glomerular filtration rate (GFR) and proteinuria and the risk for a combined renal endpoint (>30% GFR loss, dialysis/transplantation) in two European chronic kidney disease (CKD) cohorts including follow-up of 753 and 576 patients for 36 and 57 months, respectively...
January 23, 2018: Nephrology, Dialysis, Transplantation
O M McCloskey, A E Courtney, J A McCaughan, P Devine
No abstract text is available yet for this article.
January 10, 2018: QJM: Monthly Journal of the Association of Physicians
Franck Bruyère, Nicolas Doumerc
PURPOSE OF REVIEW: Kidney transplantation is the preferred modality for the treatment of patients with end-stage renal disease. Robot-assisted kidney transplantation (RAKT) has been in use since 2002 to reduce morbidity in open kidney transplantation. The aim of this review is to highlight the most relevant publications on this challenging surgical topic. RECENT FINDINGS: Recent publications suggest that minimally invasive techniques in kidney transplantation, including RAKT, have shown promising results particularly with regard to complications and recovery, reducing postoperative pain and analgesic requirement with a better cosmetic result...
January 4, 2018: Current Opinion in Urology
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
Marilena Gregorini, Eleonora Francesca Pattonieri, Gianluca Fasoli, Mauro Valente, Edoardo La Porta, Michele Canevari, Fulvia Erasmi, Teresa Rampino
This review is intended to be a guide for the physician to evaluate and prepare a donor / recipient couple for living kidney transplantation. Although it is intended to be exhaustive, it will not be able to respond at all possible and different cases, but it may apply at most of them. Renal transplantation is considered the choice treatment for patients with chronic renal failure and if the kidney transplant is performed pre-emptive it is associated with better organ and patient survival. The main aim of the program is to evaluate the risks of donor and recipient and to ensure the donor safety and well-being...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Nicolas Simon, Valérie Coiteux, Bénédicte Bruno, Sophie Taque, Amandine Charbonnier, Laetitia Souchet, Laure Vincent, Ibrahim Yakoub-Agha, Yves Chalandon
In September 2016 in Lille, France, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 7th Allogeneic Stem Cell Transplantation Clinical Practices Harmonization Workshop Series. Our work group focused on chemotherapy drug dose adaptation for hematopoietic stem cell transplantation patients presenting a comorbidity. The purpose of this workshop was to provide recommendations on chemotherapy drug dose adaptation for patient populations receiving hematopoietic stem cell transplantation who also had the following comorbidities: obesity, chronic kidney disease and hepatopathy...
December 2017: Bulletin du Cancer
Cécile Couchoud, Clémence Béchade, Abdelkader Bemrah, Jean-Christophe Delarozière, Guillaume Jean
Background: Few studies have analysed the impact of chronic respiratory disease (CRD) on outcomes in dialysis. We therefore sought to describe patients with CRD and end-stage renal disease and their outcomes after dialysis start, compared with patients without CRD, focusing especially on causes of death, access to renal transplantation and causes of hospital admissions. Methods: The study included 52 797 adults aged 18 years and older who began dialysis from 2008 to 2013 and are recorded in the French national REIN registry...
December 1, 2017: Nephrology, Dialysis, Transplantation
Ihsan Yildız, Yavuz Savas Koca
BACKGROUND The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL AND METHODS Twenty-four patients who underwent renal transplantation in 2015-2017 were retrospectively examined...
November 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
A De Giorgi, A Storari, S Forcellini, F Manfredini, N Lamberti, P Todeschini, G La Manna, R Manfredini, F Fabbian
OBJECTIVE: Kidney transplant recipients (KTRs) are bound to develop cardiovascular disease (CVD), and obesity represents a well-known risk factor for CVD. It has been reported that the metabolic syndrome (MetS) is a frequent finding in KTRs, and MetS could develop even if body mass index (BMI) is only mildly increased. We compared the impact of BMI and MetS on the development of major clinical events (MCEs) in a cohort of 107 KTRs during a follow-up of 63 ± 31 months. PATIENTS AND METHODS: Clinical characteristics were recorded at the time of enrollment and patients were classified on the basis of MCEs development...
October 2017: European Review for Medical and Pharmacological Sciences
Philippe Chauveau, Michel Aparicio, Vincenzo Bellizzi, Katrina Campbell, Xu Hong, Lina Johansson, Anne Kolko, Pablo Molina, Siren Sezer, Christoph Wanner, Pieter M Ter Wee, Daniel Teta, Denis Fouque, Juan J Carrero
Traditional dietary management of chronic kidney disease (CKD) focuses on the quantity within the diet of energy and protein, and the restriction of single micronutrients, with little mention of dietary quality. Dietary patterns that are more plant-based, lower in meat (including processed meat), sodium and refined sugar, and have a higher content of grains and fibres are now included in multiple clinical guidelines for chronic disease prevention. The Mediterranean diet (MD) has been associated with reduced cardiovascular disease incidence in both observational and interventional studies...
July 2, 2017: Nephrology, Dialysis, Transplantation
Marcia Regina Gianotti Franco, Fernando Antonio Basile Colugnati, Abdul Rashid Qureshi, José Carolino Divino-Filho, Natália Maria Da Silva Fernandes
INTRODUCTION: Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. METHODS: Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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