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chronic allograft nephropathy

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https://www.readbyqxmd.com/read/28710896/renal-allograft-histology-at-10-years-after-transplantation-in-the-tacrolimus-era-evidence-of-pervasive-chronic-injury
#1
Mark D Stegall, Lynn D Cornell, Walter D Park, Byron H Smith, Fernando G Cosio
Improving long-term renal allograft survival remains an important unmet need. To assess the extent of histologic injury at 10 years after transplantation in functioning grafts, we studied 575 consecutive adult solitary renal transplants performed between 2002 and 2005-77% from living donors and 92% maintained on tacrolimus-based immunosuppression. Ten-year graft survival was 59% and death-censored graft survival was 74%. Surveillance allograft biopsies were assessed at implantation, 5 years and 10 years from 145 patients that reached 10 years...
July 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28706180/serum-uric-acid-and-arterial-function-after-renal-transplantation
#2
Frederic Bauer, Nikolaos Pagonas, Felix S Seibert, Walter Zidek, Richard Viebahn, Nina Babel, Timm H Westhoff
BACKGROUND Hyperuricemia is associated with an increased risk of cardiovascular disease and chronic allograft nephropathy after renal transplantation. It has recently been demonstrated that treatment of asymptomatic hyperuricemia is associated with improved patient and graft survival; although, the underlying mechanisms remain elusive. The present study investigated the association of serum uric acid (SUA) and systemic arterial function after renal transplantation. MATERIAL AND METHODS In a cross-sectional study, arterial function was analyzed in 54 renal transplant recipients by means of pulse wave analysis...
July 14, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#4
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28676864/innate-immune-response-in-kidney-ischemia-reperfusion-injury-potential-target-for-therapy
#5
REVIEW
Aleksandra Kezić, Natasa Stajic, Friedrich Thaiss
Acute kidney injury caused by ischemia and subsequent reperfusion is associated with a high rate of mortality and morbidity. Ischemia/reperfusion injury in kidney transplantation causes delayed graft function and is associated with more frequent episodes of acute rejection and progression to chronic allograft nephropathy. Alloantigen-independent inflammation is an important process, participating in pathogenesis of injurious response, caused by ischemia and reperfusion. This innate immune response is characterized by the activity of classical cells belonging to the immune system, such as neutrophils, macrophages, dendritic cells, lymphocytes, and also tubular epithelial cells and endothelial cells...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28670579/assessment-of-circulating-protein-signatures-for-kidney-transplantation-in-pediatric-recipients
#6
Tara K Sigdel, Minnie M Sarwal
Identification and use of non-invasive biomarkers for kidney transplantation monitoring is an unmet need. A total of 121 biobanked sera collected from 111 unique kidney transplant (KT) patients (children and adolescent) and 10 age-matched healthy normal controls were used to profile serum proteins using semi-quantitative proteomics. The proteomics data were analyzed to identify panels of serum proteins that were specific to various transplant injuries, which included acute rejection (AR), BK virus nephropathy (BKVN), and chronic allograft nephropathy (CAN)...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28664821/de-novo-iga-nephropathy-in-a-renal-allograft
#7
Amir Shabaka, Isabel Pérez-Flores, José Antonio Cortés, Ana Isabel Sánchez-Fructuoso
Posttransplant glomerulonephritis is a complication of kidney transplant that can impair graft function and long-term graft survival. De novo immunoglobulin A disease in kidney allografts appears to be much less common than the recurrent disease, and in most cases it is diagnosed in protocol biopsies with no clinical evidence of disease or in association with other renal transplant pathologies such as chronic rejection. We present a case of de novo immunoglobulin A nephropathy presenting with overt proteinuria, microscopic hematuria, and progressive deterioration of renal function 30 months after renal transplant...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28664159/rediscovering-beta-2-microglobulin-as-a-biomarker-across-the-spectrum-of-kidney-diseases
#8
REVIEW
Christos P Argyropoulos, Shan Shan Chen, Yue-Harn Ng, Maria-Eleni Roumelioti, Kamran Shaffi, Pooja P Singh, Antonios H Tzamaloukas
There is currently an unmet need for better biomarkers across the spectrum of renal diseases. In this paper, we revisit the role of beta-2 microglobulin (β2M) as a biomarker in patients with chronic kidney disease and end-stage renal disease. Prior to reviewing the numerous clinical studies in the area, we describe the basic biology of β2M, focusing in particular on its role in maintaining the serum albumin levels and reclaiming the albumin in tubular fluid through the actions of the neonatal Fc receptor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28651015/acute-rejection-after-kidney-transplantation-promotes-graft-fibrosis-with-elevated-adenosine-level-in-rat
#9
Mingliang Li, Yingbo Dai, Jun Lei, Jin Tang, Yihong Zhou, Bing Xia, Yang Xia, Guangming Yin
AIMS: Chronic allograft nephropathy is a worldwide issue with the major feature of progressive allograft fibrosis, eventually ending with graft loss. Adenosine has been demonstrated to play an important role in process of fibrosis. Our study aimed to investigate the relationship between adenosine and fibrosis in renal allograft acute rejection in rat. MATERIALS AND METHODS: Wistar rats and SD rats were selected as experimental animals. Our study designed two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28647211/tubuloreticular-inclusions-in-peritubular-capillaries-of-renal-allografts
#10
Jee Youn Lee, Seung Hwan Song, Yu Seun Kim, Beom Jin Lim, Soon Il Kim, Myoung Soo Kim, Hyeon Joo Jeong
BACKGROUND: Tubuloreticular inclusions (TRIs) are anastomosing networks of microtubules that are frequently found in autoimmune diseases and viral infections. In renal allografts, TRIs have been reported in glomerular endothelial cells in association with viral infections and donor specific antibodies (DSAs), but their presence in peritubular capillaries has not been explored. METHODS: We collected seven cases with TRIs out of 148 consecutive renal allograft biopsies taken from Dec...
June 6, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28586044/noninvasive-detection-of-acute-renal-allograft-rejection-by-measurement-of-soluble-tim-3-in-urine
#11
Dajin Chen, Wenhan Peng, Hong Jiang, Hao Yang, Jianyong Wu, Huiping Wang, Jianghua Chen
The purpose of the present study was to assess whether urinary soluble T-cell immunoglobulin and mucin domain-containing protein 3 (sTim-3) could be adopted as a novel non‑invasive biomarker for acute rejection (AR) following renal transplantation. A total of 156 patients were enrolled between January 2006 and December 2009, comprising 49 patients with biopsy‑proven AR, 58 patients with stable grafts and no abnormal histological findings (NO‑AR), 10 patients with subclinical rejection (SCR) in protocol biopsies, 10 patients with acute tubular necrosis (ATN) and 29 patients with chronic allograft nephropathy (CAN)...
July 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28585910/cxc-chemokine-receptor-type-4-antagonism-ameliorated-allograft-fibrosis-in-rat-kidney-transplant-model
#12
Xun-Feng Zou, Jian-Hua Gu, Zi-Lin Cui, Yi-Wei Lu, Chuan Gu
OBJECTIVES: In this study, we evaluated the effects of CXC chemokine receptor type 4 and stromal cell-derived factor 1 signaling in the progression of chronic allograft nephropathy in a rat model. MATERIALS AND METHODS: Experimental rats were divided into 3 groups: Lewis-to-Lewis isograft transplant (group A), Fisher 344 rat-to-Lewis allograft transplant with immunosuppressant cyclosporine (group B), and Fisher 344 rat-to-Lewis allograft transplant treated with cyclosporine and the CXC chemokine receptor type 4 antagonist AMD3100 (1 mg/kg/d) (group C)...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28566603/febuxostat-for-the-prevention-of-recurrent-2-8-dihydroxyadenine-nephropathy-due-to-adenine-phosphoribosyltransferase-deficiency-following-kidney-transplantation
#13
Koji Nanmoku, Akira Kurosawa, Takahiro Shinzato, Toshihiro Shimizu, Takaaki Kimura, Takashi Yagisawa
Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disorder that results in irreversible renal damage due to 2,8-dihydroxyadenine (DHA) nephropathy. A 28-year-old man underwent living-related kidney transplantation for chronic kidney disease of unknown etiology. Numerous spherical brownish crystals observed in his urinary sediment on postoperative day 3 and were observed within the tubular lumen of renal allograft biopsy specimens on postoperative day 7. After a genetic diagnosis, febuxostat treatment was started on postoperative day 7, with the dosage gradually increased to 80 mg/day until complete the disappearance of 2,8-DHA crystals...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28559850/innovative-perspective-gadolinium-free-magnetic-resonance-imaging-in-long-term-follow-up-after-kidney-transplantation
#14
REVIEW
Mick J M van Eijs, Arjan D van Zuilen, Anneloes de Boer, Martijn Froeling, Tri Q Nguyen, Jaap A Joles, Tim Leiner, Marianne C Verhaar
Since the mid-1980s magnetic resonance imaging (MRI) has been investigated as a non- or minimally invasive tool to probe kidney allograft function. Despite this long-standing interest, MRI still plays a subordinate role in daily practice of transplantation nephrology. With the introduction of new functional MRI techniques, administration of exogenous gadolinium-based contrast agents has often become unnecessary and true non-invasive assessment of allograft function has become possible. This raises the question why application of MRI in the follow-up of kidney transplantation remains restricted, despite promising results...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28536123/randomized-controlled-trial-of-mineralocorticoid-receptor-blockade-in-children-with-chronic-kidney-allograft-nephropathy
#15
Mara Medeiros, Luis Velásquez-Jones, Ana M Hernández, Guillermo Ramón-García, Saúl Valverde, Yolanda Fuentes, Arindal Vargas, Mauricio Patiño, Rosalba Pérez-Villalva, Juan Antonio Ortega-Trejo, Jonatan Barrera-Chimal, Norma A Bobadilla
BACKGROUND AND OBJECTIVES: We showed that mineralocorticoid receptor blockade (MRB) prevented acute and chronic cyclosporine nephropathy (CsA-Nx) in the rat. The aim of this translational study was to investigate the effect of long-term eplerenone administration on renal allograft function in children with biopsy-proven chronic allograft nephropathy (CAN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Renal transplant children <18 years, biopsy-proven CAN, and a GFR>40 ml/min per 1...
May 23, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28535528/chronic-allograft-injury-an-overview-of-pathogenesis-and-treatment-strategies
#16
Hector M Madariaga, Leonardo V Riella
Chronic allograft injury (CAI) remains one of the biggest challenges in transplantation as it directly affects the long-term allograft survival, an area in which the scientific and transplantation communities have struggled to improve outcomes. Therefore, understanding the mechanisms of CAI is paramount to implement preventive measures and novel therapeutic options. In this review, we will address the latest evidence on CAI, potential etiologies and risk factors including non-adherence, antibody-mediated rejection, recurrence of glomerular disease, BK nephropathy, and calcineurin nephrotoxicity...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28461839/predictive-factors-of-abnormal-circadian-blood-pressure-profile-in-recipients-of-kidney-transplantation
#17
Camelia Achim, Anca Zgura, Mihai Voiculescu
Arterial hypertension (HT) plays an important role and is a major factor in the occurrence and progression of chronic graft nephropathy. We evaluated 24-hour blood pressure (BP) profile in kidney transplant patients to identify factors predictive of abnormal circadian BP profile. BP was measured over a period of 24 hours using a noninvasive automatic device (EC-3H / ABPM) in 40 renal transplant patients (mean age = 37.2±12.2 years, M = 30, mean serum creatinine = 2.0±1.4 mg/dl). They were under the triple immunosuppressive therapy (CsA / Ts + Aza / MMF + PDN)...
June 2016: Mædica
https://www.readbyqxmd.com/read/28460546/an-update-on-chemical-pharmacotherapy-options-for-the-prevention-of-kidney-transplant-rejection-with-a-focus-on-costimulation-blockade
#18
Florian Kälble, Matthias Schaier, Sebastian Schäfer, Caner Süsal, Martin Zeier, Claudia Sommerer, Christian Morath
The introduction of calcineurin inhibitors (CNI) has greatly improved graft survival in the past three decades. However, long-term graft survival is still limited due to chronic allograft injury and side-effects of immunosuppressive medication. Areas covered: The present overview gives an update on pharmacotherapeutic strategies after kidney transplantation. The main focus is on CNI-sparing regimens using co-stimulatory blockade and on new substances on the horizone. Expert opinion: CNI sparing regimens are well-established...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28457399/polyomavirus-nephropathy-ten-year-experience
#19
J S Costa, E Ferreira, R Leal, N Bota, C Romãozinho, V Sousa, C Marinho, L Santos, F Macário, R Alves, J Pratas, M Campos, A Figueiredo
BACKGROUND: Polyomavirus nephropathy (BKVN) is an important cause of chronic allograft dysfunction (CAD). Recipient determinants (male sex, white race, and older age), deceased donation, high-dose immunosuppression, diabetes, delayed graft function (DGF), cytomegalovirus infection, and acute rejection (AR) are risk factors. Reducing immunosuppression is the best strategy in BKVN. The objective of our study was to evaluate CAD progression after therapeutic strategies in BKVN and risk factors for graft loss (GL)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28371308/bk-virus-nephropathy-histological-evolution-by-sequential-pathology
#20
B J Nankivell, J Renthawa, R N Sharma, K Kable, P J O'Connell, J R Chapman
Reactivation of BK virus in renal allografts causes a destructive chronic infection. This single-center retrospective cohort study describes the evolution of BK virus allograft nephropathy (BKVAN) from 63 kidneys (from 61 patients) using sequential histopathology (454 biopsies, averaging 7.8 ± 2.6 per kidney) followed for 60.1 mo. Uninfected protocol biopsies formulated time-matched control Banff scores (n = 975). Interstitial inflammation occurred in 73% at diagnosis, correlating with viral histopathology (r = 0...
August 2017: American Journal of Transplantation
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