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https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#1
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28437758/balance-impairment-in-kidney-transplant-recipients-without-concurrent-peripheral-neuropathy
#2
T Zanotto, S Gobbo, V Bullo, B Vendramin, F Duregon, L Cugusi, A Di Blasio, L Furian, C Silvestre, D Neunhaeuserer, M Zaccaria, M Bergamin, A Ermolao
Kidney transplant recipients (KTRs) present with compromised functional capacity, low levels of physical activity, muscle atrophy, and peripheral nerve dysfunction that may result in high postural instability. This study aimed to compare the static balance control of 19 KTRs with 19 healthy adults (HA). All participants completed the Romberg test on a stabilometric platform with eyes open (EO), eyes closed (EC) and during a dual task (DT) condition. Centre of pressure (COP) measures (COP velocity (COPv) and sway area (SA)), as well as position-based outcomes such as anterior-posterior (AP) and medio-lateral (ML) ranges of COP displacements were recorded...
April 15, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28396733/current-trends-in-european-renal-epidemiology
#3
James Heaf
The incidence of end-stage renal disease (ESRD) continues to vary substantially between the countries in Europe that contribute data to the ERA-EDTA Registry. Differences can be attributed to socioeconomic factors and prophylaxis programs for patients with chronic kidney disease (CKD) and may also express real differences in CKD incidence. Recently, age-adjusted ESRD incidence has begun to fall in many countries, probably related to improved prophylaxis. However, absolute rates may increase, partly due to socioeconomic advances in countries with a low gross domestic product and partly due to continuing increases in the proportion of elderly patients...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28383177/low-socioeconomic-status-adversely-effects-dialysis-survival-in-australia
#4
Rathika Krishnasamy, Nicholas A Gray
BACKGROUND: Low socioeconomic status (SES) is associated with increased incidence of end stage kidney disease and in the USA poorer dialysis survival. All Australians have access to a universal health care system. METHODS: The study included all non-indigenous adult Australians registered with the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) who commenced dialysis between 2003 and 2013. SES at dialysis start was classified into quartiles of advantaged through to disadvantaged using Australian Bureau of Statistics socio-economic indexes for areas...
April 6, 2017: Nephrology
https://www.readbyqxmd.com/read/28331061/an-intracellular-matrix-metalloproteinase-2-isoform-induces-tubular-regulated-necrosis-implications-for-acute-kidney-injury
#5
Carla S Ceron, Celine Baligand, Sunil K Joshi, Shaynah Wanga, Patrick M Cowley, Joy P Walker, Sang Heon Song, Rajeev Mahimkar, Anthony J Baker, Robert L Raffai, Zhen J Wang, David H Lovett
Acute kidney injury (AKI) causes severe morbidity, mortality, and chronic kidney disease (CKD). Mortality is particularly marked in the elderly and with pre-existing CKD. Oxidative stress is a common theme in models of AKI induced by ischemia/reperfusion (I/R) injury. We recently characterized an intracellular isoform of matrix metalloproteinase-2 (MMP-2) induced by oxidative stress-mediated activation of an alternate promoter in the first intron of the MMP-2 gene. This generates an N-terminal truncated MMP-2 isoform (NTT-MMP-2) that is intracellular and associated with mitochondria...
March 22, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28320767/comparing-outcomes-between-antibody-induction-therapies-in-kidney-transplantation
#6
Neel Koyawala, Jeffrey H Silber, Paul R Rosenbaum, Wei Wang, Alexander S Hill, Joseph G Reiter, Bijan A Niknam, Orit Even-Shoshan, Roy D Bloom, Deirdre Sawinski, Susanna Nazarian, Jennifer Trofe-Clark, Mary Ann Lim, Jesse D Schold, Peter P Reese
Kidney transplant recipients often receive antibody induction. Previous studies of induction therapy were often limited by short follow-up and/or absence of information about complications. After linking Organ Procurement and Transplantation Network data with Medicare claims, we compared outcomes between three induction therapies for kidney recipients. Using novel matching techniques developed on the basis of 15 clinical and demographic characteristics, we generated 1:1 pairs of alemtuzumab-rabbit antithymocyte globulin (rATG) (5330 pairs) and basiliximab-rATG (9378 pairs) recipients...
March 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28216502/-treatment-of-ureteral-fistula-and-stricture-following-renal-transplantation-with-boari-flap
#7
Peng Jin, Jinliang Xie, Jingeng Dun, Xiang Ding, Cheng Zhou, Xiangrong Zhu, Lielin Wu, Bo Yang, Gang Zhang
To estimate the incidence rate of ureteral fistula and stricture after kidney transplantation, and to evaluate the effect of bladder flap (Boari flap) on ureteral complication of the transplanted kidney. 
 Methods: The clinical data and risk factors from 270 recipients of renal transplantation, who came from the Centre of Organ Transplantation, Xiangya Hospital, Central South University from January 2010 to January 2015, were retrospectively analyzed. The surgical management included Boari flap for ureteral reconstruction, neoureterocystostomy and endoscopic therapy with double-J (DJ) stent placement...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28201960/hypoglycemia-and-glucocorticoid-free-immunosuppression-are-related-with-low-dehydroepiandrosterone-sulfate-level
#8
Martina Zahradnicka, Frantisek Saudek, Kvetoslav Lipar, Jelena Skibova
BACKGROUND: Low dehydroepiandrosterone sulfate (DHEAS) levels and a high cortisol/DHEAS ratio are associated with higher mortality in elderly, dialyzed, and immunocompromised patients. The role of these hormones in patients with hypoglycemia unawareness (hypo) or in pancreas or islet recipients treated by glucocorticoid-free immunosuppressive regimen (IS) has not been studied. OBJECTIVE: The aim of this study was to determine the effects of IS and of recurrent hypoglycemia on DHEAS and adrenocorticotropic hormone (ACTH) levels in patients with type-1 diabetes (T1DM)...
February 13, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28161264/ten-years-trends-in-renal-replacement-therapy-for-end-stage-renal-disease-in-mainland-france-lessons-from-the-french-renal-epidemiology-and-information-network-rein-registry
#9
Cécile Vigneau, Anne Kolko, Bénédicte Stengel, Christian Jacquelinet, Paul Landais, Philippe Rieu, Sahar Bayat, Cécile Couchoud
BACKGROUND: The incidence rate of renal replacement therapy (RRT) for end-stage renal disease (ESRD) is decreasing in several countries, but not in France. We studied the RRT trends in mainland France from 2005 to 2014 to understand the reasons for this discrepancy and determine the effects of ESRD management changes. METHODS: Data were extracted from the French Renal Epidemiology and Information Network registry. Time trends of RRT incidence and prevalence rates, patients' clinical and treatment characteristics were analysed using the Joinpoint regression program and annual percentage changes...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28095796/a-severe-case-of-visceral-leishmaniasis-and-liposomal-amphotericin-b-treatment-failure-in-an-immunosuppressed-patient-15%C3%A2-years-after-exposure
#10
Anna Eichenberger, Annina E Buechi, Andreas Neumayr, Chistroph Hatz, Andri Rauch, Marc Huguenot, Eva Diamantis-Karamitopoulou, Cornelia Staehelin
BACKGROUND: Visceral leishmaniasis (VL) is a protozoan disease, which is responsible for 200.000-400.000 yearly infections worldwide. If left untreated, the fatality rate can be as high as 100% within 2 years. 90% of cases occur in just six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. It is thus a disease rarely seen by physicians in Europe or North America. We report on the fatal case of VL in an 80-year-old immunosuppressed patient who presented with a latency of over 15 years after having visited an endemic region...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#11
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#12
REVIEW
María José Pérez-Sáez, Núria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
April 2017: Transplantation
https://www.readbyqxmd.com/read/27966109/renal-ultrasound-and-doppler-sonography-in-hypertension-an-update
#13
Maria Boddi
Ultrasound (US) allows the non-invasive evaluation of morphological changes of kidney structure (by means of B-Mode) and patterns of renal and extrarenal vascularization (by means of color-Doppler and contrast-enhanced US). In hypertensive subjects it offers a relevant contribution to the diagnosis of early renal damage, acute or chronic nephropathies and nephrovascular disease. However, morphological changes are often detected late and non-specific and in recent years evidence has increased regarding the clinical relevance of renal resistive index (RRI) for the study of vascular and renal parenchymal renal abnormalities...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27938472/post-transplant-immune-activation-innocent-bystander-or-insidious-culprit-of-post-transplant-accelerated-atherosclerosis
#14
Didier Ducloux, Jamal Bamoulid, Thomas Crepin, Jean-Michel Rebibou, Cecile Courivaud, Philippe Saas
Cardiovascular disease is a major cause of morbidity, disability, and mortality in kidney transplant patients. Cumulative reports indicate that the excessive risk of cardiovascular events is not entirely explained by the increased prevalence of traditional cardiovascular risk factors. Atherosclerosis is a chronic inflammatory disease and it has been postulated that post-transplant immune disturbances may explain the gap between the predicted and observed risks of cardiovascular events. However, whereas concordant data suggest that innate immunity contributes to the posttransplant accelerated atherosclerosis, only few arguments plead for a role of adaptive immunity...
October 27, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27830521/surgical-treatment-of-secondary-hyperparathyroidism-in-elderly-patients-an-institutional-experience
#15
Andrea Polistena, Alessandro Sanguinetti, Roberta Lucchini, Segio Galasse, Stefano Avenia, Massimo Monacelli, Louis Banka Johnson, Bengt Jeppsson, Nicola Avenia
BACKGROUND: Secondary hyperparathyroidism in elderly fragile patients presents clinical difficulties due to severity of symptoms and related comorbidity. The optimal surgical approach for this group of patients is still debated. AIM: The aim of the study was to define the optimal technique of parathyroidectomy in elderly patients with secondary hyperparathyroidism. METHODS: Retrospective analysis in a series of 253 patients including 35 elderly individuals at a single institution was carried out...
February 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27753146/the-pharmacokinetics-and-pharmacodynamics-of-mycophenolate-mofetil-in-younger-and-elderly-renal-transplant-recipients
#16
Jiang-Tao Tang, Brenda C de Winter, Dennis A Hesselink, Ferdi Sombogaard, Lan-Lan Wang, Teun van Gelder
AIMS: Elderly transplant recipients have a lower incidence of acute rejection, and a higher risk to die from infectious complications. A potential cause may be differences in the pharmacokinetics (PK) or pharmacodynamics (PD) of the immunosuppressive drugs they are taking. This study was designed to comprehensively evaluate the influence of age on the PK and PD of mycophenolic acid (MPA). METHODS: In this study the PK and PD of MPA was studied in 26 elderly and 54 younger renal transplant recipients treated with mycophenolate mofetil and tacrolimus...
April 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27748703/dual-kidney-transplantation-is-it-worth-it
#17
REVIEW
Renaud Snanoudj, Marc-Olivier Timsit, Marion Rabant, Claire Tinel, Hélène Lazareth, Lionel Lamhaut, Frank Martinez, Christophe Legendre
Use of expanded criteria donor (ECD) kidneys, which are associated with a reduced graft survival rate, has become widely adopted in elderly recipients in an old-to-old allocation system. However, the results are frequently unsatisfactory, and a high proportion of these ECD kidneys are discarded. Dual kidney transplantation (DKT) is an underused way to expand the pool of ECD kidneys and to rapidly transplant elderly patients with satisfactory results because of the transplantation of double the nephronic mass...
March 2017: Transplantation
https://www.readbyqxmd.com/read/27740520/%C3%A2-simultaneous-liver-and-kidney-transplantation-in-elderly-patients-outcomes-and-validation-of-a-clinical-risk-score-for-patient-selection
#18
COMPARATIVE STUDY
Kristopher P Croome, David D Lee, Justin M Burns, Dana K Perry, Justin H Nguyen, Andrew P Keaveny, Hani M Wadei, C Burcin Taner
 Introduction and aim. Many transplant programs have expanded eligibility to include patients previously ineligible because of advanced age. Outcomes of simultaneous liver-kidney transplantation (SLK) in recipients with advanced age are not known. MATERIAL AND METHODS: Data from patients undergoing transplantation between 2002 and 2015 were obtained from the UNOS Standard Analysis and Research file. RESULTS: SLK recipients aged ≥ 65 years (N = 677), SLK recipients aged < 65 years (N = 4517), and recipients of liver transplant alone(LTA) aged ≥ 65 years(N = 8495) were compared...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27729570/stretching-the-limits-of-renal-transplantation-in-elderly-recipients-of-grafts-from-elderly-deceased-donors
#19
COMPARATIVE STUDY
Hessel Peters-Sengers, Stefan P Berger, Martin B A Heemskerk, Doaa Al Arashi, Jaap J Homan van der Heide, Aline C Hemke, Ineke J M Ten Berge, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Maarten H Christiaans, L W Ernest van Heurn, Johan W de Fijter, Frederike J Bemelman
An increasing number of elderly patients (≥65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (≥18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27726196/evaluation-of-mdrd4-ckd-epi-bis-1-and-modified-cockcroft-gault-equations-to-estimate-glomerular-filtration-rate-in-the-elderly-renal-transplanted-recipients
#20
Elias David-Neto, Ana Heloisa Kamada Triboni, Fernanda Ramos, Fabiana Agena, Nelson Zocoler Galante, Marcelo Altona, Francine Brambate Carvalhinho Lemos, Marcelo Tatit Sapienza, William Carlos Nahas
Equations to estimate glomerular filtration rate (eGFR) were developed in patients using the variables age, body weight, and serum creatinine, which may be different in the elderly. Elderly renal transplant patients (EG; n=70; mean age 65 ± 4 y) who measured plasma (51) Cr-EDTA-Clearance (mGFR) had mGFR compared to eGFR obtained by the Cockcroft-Gault corrected by body surface area (CG-BSA), the modification of diet in renal disease (MDRD-4), the Berlin Initiative Study (BIS-1), and the chronic kidney disease epidemiology collaboration (CKD-EPI)...
December 2016: Clinical Transplantation
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