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renal transplantation pregnant

Carl Chrobak, Jan Adam Sidler, Alix O'Meara, Sabine Schaedelin, Balthasar L Hug
AIMS OF THE STUDY: We aimed to assess a potential association of iron status with mortality and morbidity of inpatients with systemic inflammation. METHODS: This was a single centre prospective observational study. From April 2014 to October 2014, all consecutive medical inpatients aged >=18 years with a C-reactive protein value >5 mg/l on hospital admission were eligible for the study. We excluded pregnant women and patients with terminal renal insufficiency or past allogeneic stem cell transplantation...
April 19, 2017: Swiss Medical Weekly
Tarek Mahmoud, Khalida Mujaibel, Hosam Attia, Zakaria Zakaria, Jude Yagan, Osama Gheith, Medhat Abdel Halim, Prasad Nair, Torki Al-Otaibi
Triplet and higher-order multiple pregnancies can carry increased fetal and maternal complications. Reports of triplet pregnancies after kidney transplant are scarce and have been associated with perinatal complications. Presence of diabetes in such cases worsens both fetal and maternal outcomes. Here, we present a triplet pregnancy in a kidney transplant recipient with diabetes. We also reviewed the literature for causes, prevalence, and outcomes in association with chronic kidney disease, kidney transplant, and diabetes mellitus...
February 2017: Experimental and Clinical Transplantation
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
Philip Webster, Liz Lightstone, Dianne B McKay, Michelle A Josephson
Chronic kidney disease (CKD) affects up to 6% of women of childbearing age in high income countries, and is estimated to affect 3% of pregnant women. Advanced renal dysfunction, proteinuria, hypertension, and poorly controlled underlying primary renal disease are all significant risks for adverse maternal, fetal, and renal outcomes. In order to achieve the best outcomes, it is therefore of paramount importance that these pregnancies are planned, where possible, to allow the opportunity to counsel women and their partners in advance and to optimize these risks...
February 13, 2017: Kidney International
Anna Cyganek, Filip Andrzej Dabrowski, Bronislawa Pietrzak, Zoulikha Jabiry-Zieniewicz, Barbara Grzechocinska, Anna Madej, Miroslaw Wielgos
OBJECTIVES: Delayed motherhood is associated with an increasing number of comorbidities such as glomerulonephritis, systemic lupus erythematosus, and diabetic nephropathy. Women after renal transplant belong to the group of patients who require a highly individualized approach to treatment and diagnosis. The aim of the study was to validate the commonly used diagnostic criteria for preeclampsia which seem to be irrelevant in patients with chronic renal insufficiency. MATERIAL AND METHODS: The course of pregnancy and delivery were retrospectively analyzed in 48 renal transplant patients...
2016: Ginekologia Polska
Tommaso Cai, Bela Koves, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary treatment. The purpose of this review is to outline and evaluate the most recent literature on the management of ABU. RECENT FINDINGS: The role of ABU management has been evaluated in several patient subgroups: healthy patients without identified risk factors, pregnant women, postmenopausal women, women with recurrent UTI, patients with diabetes, elderly institutionalized patients, patients with renal transplants, patients with indwelling catheters and prior to surgery...
March 2017: Current Opinion in Urology
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
December 17, 2016: Lancet
Eisuke Fujimoto, Shuichiro Yamanaka, Sho Kurihara, Susumu Tajiri, Luna Izuhara, Yuichi Katsuoka, Shinya Yokote, Kei Matsumoto, Eiji Kobayashi, Hirotaka James Okano, Tatsuya Chikaraishi, Takashi Yokoo
BACKGROUND: Rapid advancements have been made in alternative treatments for renal diseases. Our goal for renal regeneration is to establish a kidney graft derived from human embryonic tissues. In this study, we investigated the effects of host renal failure on the structure and activity of transplanted embryonic kidney and bladder, and found that diuretics effectively induced urine production in the transplanted kidney. METHODS: Uremic conditions were reproduced using a 5/6 renal infarction rat model...
September 30, 2016: Clinical and Experimental Nephrology
Yasue Omori, Keiko Yanagisawa, Asako Sato, Yasuko Uchigata
BACKGROUND: There are no reports of very long follow-up studies of pregnant women with type 2 diabetes after delivery. Here we describe cases of Japanese women whom we treated for 20 to 50 years after deliveries to investigate the relationship between blood glucose control and diabetic complications. METHODS: In Japan, the prevalence of type 1 diabetes is very low, and we have very few long-term follow-up cases with type 1 diabetes. Therefore, we chose to describe subjects with type 2 diabetes only...
September 26, 2016: Diabetes/metabolism Research and Reviews
Avi Ben-Haroush, Ronit Abir, Onit Sapir, Roni Garor, Benjamin Fisch
BACKGROUND: In vitro maturation of immature oocytes is an important technology for selected clinical indications. We previously described a pregnant woman with a history of renal transplantation who underwent oocyte aspiration during cesarean section (CS) for fertility preservation and future surrogacy. CASE: A 27-year-old pregnant woman was diagnosed with neck rhabdomyosarcoma at 37 weeks' gestation. CS was performed with direct aspiration of small follicles from one ovary and oophorectomy of the other...
September 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
Joanna Kabat-Koperska, Agnieszka Kolasa-Wołosiuk, Irena Baranowska-Bosiacka, Krzysztof Safranow, Danuta Kosik-Bogacka, Izabela Gutowska, Anna Pilutin, Edyta Gołembiewska, Karolina Kędzierska, Kazimierz Ciechanowski
Pregnancy puts a significant additional strain on kidneys. The aim of our study was to investigate the impact of immunosuppressive drugs on changes in native kidneys in female Wistar rats after exposure during pregnancy. The study was conducted on 32 dams, subjected to immunosuppressive regimens commonly used in the therapy of human kidney transplant recipients (cyclosporine A, mycophenolate mofetil and prednisone; tacrolimus, mycophenolate mofetil and prednisone; cyclosporine A, everolimus and prednisone)...
November 2016: Apoptosis: An International Journal on Programmed Cell Death
A Madej, B Pietrzak, N Mazanowska, T Songin, B Kociszewska-Najman, A Cyganek, Z Jabiry-Zieniewicz, M Wielgos
BACKGROUND: Pregnancies in transplant recipients involve risks for both grafts and the fetus, and need to be carefully managed. Hypertension is the most frequent complications in pregnant transplant recipients, especially in renal transplant recipients. Strict control of blood pressure is essential for a favorable obstetric outcome and long-term graft survival. The aim of the study was to evaluate the influence of hypertension on obstetric outcome and graft function in pregnant renal transplant recipients (RTR) or liver transplant recipients (LTR) in comparison with healthy pregnant women...
June 2016: Transplantation Proceedings
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
Vicente Soriano, Benjamin Young, Norah Terrault
The International Conference on Viral Hepatitis 2016 brought exciting news on the treatment of viral hepatitis. The conference was mainly focused on the most recent estimates of burden for HBV and HCV; the current gaps and prospects for regional and global HCV eradication; the use of HCV treatment as prevention; and the management of difficult-to-cure hepatitis C patients, including individuals who fail on direct-acting antivirals, people who inject drugs, and those with decompensated cirrhosis or renal insufficiency...
April 2016: AIDS Reviews
Yuko Fukasawa, Yasuo Makino, Masaki Ogawa, Keiko Uchida, Hideo Matsui
OBJECTIVE: This study is designed to evaluate which factors would relate to deterioration of renal function (DRF) after delivery in pregnant women with chronic kidney disease (CKD). MATERIALS AND METHODS: This study included 156 singleton pregnancies of 139 women with CKD at our institution from 2001 to 2010. DRF was defined as the shift of CKD stage into another more severe stage. The relevant variables were compared between women who had DRF (n = 39) and the controls (n = 117)...
April 2016: Taiwanese Journal of Obstetrics & Gynecology
Duygu Eren Dağlar, Gözde Öngüt, Dilek Çolak, Aykut Özkul, Derya Mutlu, Ayşın Zeytinoğlu, Kenan Midilli, Selma Gökahmetoğlu, Filiz Günseren, Dilara Öğünç, Meral Gültekin
Cytomegalovirus (CMV), a common virus found all around the world, usually causes asymptomatic infections in immunocompetent hosts, however it may lead to serious complications in immunodeficient patients and in the fetus. CMV is divided into four genotypes according to the polymorphisms in UL55 gene that encodes for envelope glycoprotein B. Nucleotide polymorphisms of CMV gB gene can affect the cell tropism of the virus and host immune response and believed to have important changes in the pathogenesis of CMV...
January 2016: Mikrobiyoloji Bülteni
Sokratis Stoumpos, Susan H McNeill, Morag Gorrie, Patrick B Mark, Janet E Brennand, Colin C Geddes, Christopher J Deighan
Female renal transplant recipients of childbearing age may ask what the outcomes are for pregnancy and whether pregnancy will affect graft function. We analyzed obstetric and transplant outcomes among renal transplant recipients in our center who have been pregnant between 1973 and 2013. A case-cohort study was performed identifying 83 pairs of pregnant and non-pregnant controls matched for sex, age, transplant vintage, and creatinine. There were 138 pregnancies reported from 89 renal transplant recipients...
June 2016: Clinical Transplantation
C Rose, J Gill, N Zalunardo, O Johnston, A Mehrotra, J S Gill
The optimal timing of pregnancy after kidney transplantation remains uncertain. We determined the risk of allograft failure among women who became pregnant within the first 3 posttransplant years. Among 21 814 women aged 15-45 years who received a first kidney-only transplant between 1990 and 2010 captured in the United States Renal Data System, n = 729 pregnancies were identified using Medicare claims. The probability of allograft failure from any cause including death (ACGL) at 1, 3, and 5 years after pregnancy was 9...
August 2016: American Journal of Transplantation
Heather L Kutzler, Xiaoyi Ye, Caroline Rochon, Spencer T Martin
Pregnancy in solid organ transplant recipients carries numerous risks to the mother such as increased risk of rejection, gestational diabetes mellitus, and preeclampsia. The developing fetus is subjected to risks such as birth defects, preterm delivery, and low birth weight. Typically, these risks can be managed through intensive, multidisciplinary prenatal care and a proper immunosuppressive regimen. In the setting of rejection, however, little data are available to suggest safe and effective treatment of acute cellular rejection, antibody-mediated rejection, or mixed rejection episodes in the pregnant solid organ transplant recipient...
April 2016: Pharmacotherapy
Dávid Ágoston Kovács, László Szabó, Katalin Jenei, Roland Fedor, Gergely Zádori, Lajos Zsom, Krisztina Kabai, Anita Záhonyi, László Asztalos, Balázs Nemes
Women with renal disease, besides many dysfunctions, face increasing infertility and high-risk pregnancy due to uremia and changes of the hormonal functions. After renal transplantation, sexual dysfunction improves, providing the possibility of successful pregnancy for women of childbearing age. However, kidney transplanted patients are high-risk pregnant patients with increased maternal and fetal risks, and the graft also may be compromised during pregnancy; most studies report on several successive deliveries due to multidisciplinary team management...
December 2015: Interventional Medicine & Applied Science
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