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Renal transplant obesity

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https://www.readbyqxmd.com/read/27901336/robotic-kidney-transplantation-current-status-and-future-perspectives
#1
Angelo Territo, Alex Mottrie, Ronney Abaza, Craig Rogers, Mani Menon, Mahendra Bhandari, Rajesh Ahlawat, Alberto Breda
INTRODUCTION: For the treatment of patients with end-stage renal disease, kidney transplantation is preferred to renal replacement modalities such as hemodialysis and peritoneal dialysis. Although open surgery remains the gold standard, minimally invasive approaches have recently been applied in transplant kidney surgery. Despite growing enthusiasm and potential benefits of robotic kidney transplant, many aspects of this novel technique remain controversial. Aim of this study was to analyze the current status and future developments in robotic-assisted surgery for kidney transplantation...
November 30, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27851743/effect-of-the-obesity-epidemic-on-kidney-transplantation-obesity-is-independent-of-diabetes-as-a-risk-factor-for-adverse-renal-transplant-outcomes
#2
Jennifer M Kwan, Zahraa Hajjiri, Ahmed Metwally, Patricia W Finn, David L Perkins
BACKGROUND: Obesity is a growing epidemic in most developed countries including the United States resulting in an increased number of obese patients with end-stage renal disease. A previous study has shown that obese patients with end-stage renal disease have a survival benefit with transplantation compared with dialysis. However, due to serious comorbidities, many centers place restrictions on the selection of obese patients for transplantation. Further, due to obese patients having an increased risk of diabetes, it is unclear whether obesity can be an independent risk, independent of diabetes for increasing adverse renal transplant outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27818369/french-law-what-about-a-reasoned-reimbursement-of-serum-vitamin-d-assays
#3
Jean-Claude Souberbielle, Claude Laurent Benhamou, Bernard Cortet, Mickael Rousière, Christian Roux, Vered Abitbol, Cédric Annweiler, Maurice Audran, Justine Bacchetta, Pierre Bataille, Olivier Beauchet, Rémi Bardet, Alexandra Benachi, Francis Berenbaum, Hubert Blain, Françoise Borson-Chazot, Véronique Breuil, Karine Briot, Philippe Brunet, Jean-Claude Carel, Philippe Caron, Olivier Chabre, Philippe Chanson, Roland Chapurlat, Pierre Cochat, Régis Coutant, Sophie Christin-Maitre, Martine Cohen-Solal, Christian Combe, Catherine Cormier, Marie Courbebaisse, Grégory Debrus, Brigitte Delemer, Georges Deschenes, Marc Duquenne, Guillaume Duval, Patrice Fardellone, Denis Fouque, Gérard Friedlander, Jean-Bernard Gauvain, Lionel Groussin, Pascal Guggenbuhl, Pascal Houillier, Thierry Hannedouche, William Jacot, Rose-Marie Javier, Guillaume Jean, Claude Jeandel, Dominique Joly, Peter Kamenicky, Bertrand Knebelmann, Marie-Hélène Lafage-Proust, Yves LeBouc, Erick Legrand, Florence Levy-Weil, Agnès Linglart, Laurent Machet, Emmanuel Maheu, Eric Mallet, Christian Marcelli, Pierre Marès, Christophe Mariat, Gérard Maruani, Yves Maugars, France Montagnon, Bruno Moulin, Philippe Orcel, Henri Partouche, Virginie Personne, Charles Pierrot-Deseilligny, Michel Polak, Claire Pouteil-Noble, Dominique Prié, Agathe Raynaud-Simon, Yves Rolland, Jean-Louis Sadoul, Bernard Salle, Corinne Sault, Anne-Marie Schott, Isabelle Sermet-Gaudelus, Martin Soubrier, Ivan Tack, Eric Thervet, Isabelle Tostivint, Philippe Touraine, Florence Tremollières, Pablo Urena-Torres, Jean-Paul Viard, Jean-Louis Wemeau, Georges Weryha, Norbert Winer, Jacques Young, Thierry Thomas
The number of serum 25-hydroxyvitamin D (25OHD) assays has increased tenfold in France in less than 10 years, sometimes for invalidated reasons. In 2013, the French National Authority for Health (Haute autorité de santé, or HAS) limited the indications for serum 25OHD measurements to rickets/osteomalacia, older adults with recurrent falls, monitoring of kidney transplant in adults, and surgical treatment of obesity in adults. Our aim here was to note that other indications for serum 25OHD measurements are supported by previous literature and by a number of national and international recommendations, in particular the following: any situation of bone fragility, any chronic renal failure <45 mL/min/1...
November 4, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/27805534/weight-gain-after-kidney-transplant
#4
Nilgün Aksoy
OBJECTIVES: Weight gain and obesity are frequent problems for renal transplant patients. The purpose of this review is to show why weight gain is experienced by patients after kidney transplant and the significance of prevention. MATERIALS AND METHODS: To investigate this topic, PubMed and Ulakbim databases were searched with the following key words: renal transplant and transplantation, weight gain, and obesity. RESULTS: Weight gain frequently appears in the first year after transplant, and it is reported to be a common problem for patients within the first 6 months...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27737391/development-of-height-and-body-mass-index-after-pediatric-kidney-transplantation-experience-of-the-nephrology-pediatric-service-at-hcfmrp-usp-2005-2014
#5
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
https://www.readbyqxmd.com/read/27720627/-challenges-in-renal-transplantation
#6
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 (http://www.ncbi.nlm.nih.gov/) and Embase (http://www.embase.com/) 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
https://www.readbyqxmd.com/read/27702831/reduction-of-incor%C3%A2-driveline-infection-rate-with-silicone-at-the-driveline-exit-site
#7
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
https://www.readbyqxmd.com/read/27680757/association-of-alternative-approaches-to-normalizing-peritoneal-dialysis-clearance-with-mortality-and-technique-failure-a-retrospective-analysis-using-the-united-states-renal-data-system-dialysis-morbidity-and-mortality-study-wave-2
#8
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
https://www.readbyqxmd.com/read/27679716/iohexol-plasma-clearance-for-measuring-glomerular-filtration-rate-in-clinical-practice-and-research-a-review-part-2-why-to-measure-glomerular-filtration-rate-with-iohexol
#9
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
https://www.readbyqxmd.com/read/27574775/the-impact-of-morbid-obesity-on-resource-utilization-after-renal-transplantation
#10
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))...
December 2016: Surgery
https://www.readbyqxmd.com/read/27565133/the-changing-financial-landscape-of-renal-transplant-practice-a-national-cohort-analysis
#11
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
https://www.readbyqxmd.com/read/27555071/an-integrative-literature-review-of-physical-activity-recommendations-for-adult-renal-transplant-recipients
#12
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
https://www.readbyqxmd.com/read/27514705/strategies-to-improve-patient-and-graft-survival-in-the-next-ten-years
#13
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
https://www.readbyqxmd.com/read/27496463/prevalence-of-left-ventricular-hypertrophy-and-left-ventricular-dysfunction-in-older-renal-transplant-recipients
#14
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
https://www.readbyqxmd.com/read/27496432/impact-of-obesity-on-renal-graft-function-analysis-of-kidney-grafts-from-the-same-donor
#15
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
https://www.readbyqxmd.com/read/27486010/nafld-and-liver-transplantation-current-burden-and-expected-challenges
#16
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
https://www.readbyqxmd.com/read/27473469/risk-factors-for-new-onset-diabetes-mellitus-after-living-donor-kidney-transplantation-in-korea-a-retrospective-single-center-study
#17
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
https://www.readbyqxmd.com/read/27469152/promotion-of-kidney-care-in-countries-with-limited-resources-how-does-the-national-kidney-foundation-of-south-africa-fare
#18
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...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27466462/body-mass-index-trend-in-haemodialysis-patients-the-shift-of-nutritional-disorders-in-two-italian-regions
#19
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
https://www.readbyqxmd.com/read/27443824/facing-the-metabolic-syndrome-epidemic-in-living-kidney-donor-programs
#20
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
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