scholarly journals Temporal trends, center-level variation, and the impact of prevalent state obesity rates on acceptance of obese living kidney donors

2017 ◽  
Vol 18 (3) ◽  
pp. 642-649 ◽  
Author(s):  
Abhijit S. Naik ◽  
Diane M. Cibrik ◽  
Ankit Sakhuja ◽  
Milagros Samaniego ◽  
Yee Lu ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Level Variation ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
The Impact

The Impact of Accepting Living Kidney Donors With Mild Hypertension or Proteinuria on Transplantation Rates

2006 ◽  
Vol 47 (2) ◽  
pp. 317-323 ◽  
Author(s):  
Martin Karpinski ◽  
Greg Knoll ◽  
Adam Cohn ◽  
Robert Yang ◽  
Amit Garg ◽  
...  
Keyword(s):  
Mild Hypertension ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
The Impact

scholarly journals The impact of the donors' and recipients' medical complications on living kidney donors' mental health

2016 ◽  
Vol 29 (5) ◽  
pp. 589-602 ◽  
Author(s):  
Lotte Timmerman ◽  
Mirjam Laging ◽  
Reinier Timman ◽  
Willij C. Zuidema ◽  
Denise K. Beck ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Complications ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
The Impact

scholarly journals Long-term impact of baseline serum uric acid levels on living kidney donors: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kosuke Tanaka ◽  
Shigeyoshi Yamanaga ◽  
Yuji Hidaka ◽  
Sho Nishida ◽  
Kohei Kinoshita ◽  
...  
Keyword(s):  
Uric Acid ◽  
Adverse Events ◽  
Donor Selection ◽  
Kidney Donors ◽  
Baseline Serum ◽  
Living Kidney Donors ◽  
Preoperative Serum ◽  
The Impact

Abstract Background Preoperative characteristics of living kidney donors are commonly considered during donor selection and postoperative follow-up. However, the impact of preoperative uric acid (UA) levels is poorly documented. The aim of this study was to evaluate the association between preoperative serum UA levels and post-donation long-term events and renal function. Methods This was a single-center retrospective analysis of 183 living kidney donors. The donors were divided into high (≥5.5 mg/dl) and low (< 5.5 mg/dl) UA groups. We analyzed the relationship between preoperative UA levels and postoperative estimated glomerular filtration rate (eGFR), as well as adverse events (cardiovascular events and additional prescriptions for hypertension, gout, dyslipidemia, and diabetes mellitus), over 5 years after donation. Results In total, 44 donors experienced 52 adverse events over 5 years. The incidence of adverse events within 5 years was significantly higher in the high UA group than in the low UA group (50% vs. 24%, p = 0.003); this was true even after the exclusion of hyperuricemia-related events (p = 0.047). UA emerged as an independent risk factor for adverse events (p = 0.012). Donors with higher UA levels had lower eGFRs after donation, whereas body mass index, hemoglobin A1c, blood pressure, and low-density lipoprotein cholesterol did not have any impact on the eGFR. Conclusions The findings suggest that preoperative UA levels should be considered during donor selection and postoperative follow-up.

scholarly journals Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1834 ◽  
Author(s):  
Charat Thongprayoon ◽  
Javier A. Neyra ◽  
Panupong Hansrivijit ◽  
Juan Medaura ◽  
Napat Leeaphorn ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Kidney Transplant ◽  
Mean Difference ◽  
Kidney Donation ◽  
Kidney Transplant Recipients ◽  
Lower Serum ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Study Results ◽  
The Impact

α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of klotho on outcomes among kidney transplant (KTx) recipients and kidney donors remain unclear. A literature search was conducted using MEDLINE, EMBASE, and Cochrane Database from inception through October 2019 to identify studies evaluating serum klotho levels and impacts of klotho on outcomes among KTx recipients and kidney donors. Study results were pooled and analyzed utilizing a random-effects model. Ten cohort studies with a total of 431 KTx recipients and 5 cohort studies with a total of 108 living kidney donors and were identified. After KTx, recipients had a significant increase in serum klotho levels (at 4 to 13 months post-KTx) with a mean difference (MD) of 243.11 pg/mL (three studies; 95% CI 67.41 to 418.81 pg/mL). Although KTx recipients had a lower serum klotho level with a MD of = −234.50 pg/mL (five studies; 95% CI −444.84 to −24.16 pg/mL) compared to healthy unmatched volunteers, one study demonstrated comparable klotho levels between KTx recipients and eGFR-matched controls. Among kidney donors, there was a significant decrease in serum klotho levels post-nephrectomy (day 3 to day 5) with a mean difference (MD) of −232.24 pg/mL (three studies; 95% CI –299.41 to −165.07 pg/mL). At one year following kidney donation, serum klotho levels remained lower than baseline before nephrectomy with a MD of = −110.80 pg/mL (two studies; 95% CI 166.35 to 55.24 pg/mL). Compared to healthy volunteers, living kidney donors had lower serum klotho levels with a MD of = −92.41 pg/mL (two studies; 95% CI −180.53 to −4.29 pg/mL). There is a significant reduction in serum klotho levels after living kidney donation and an increase in serum klotho levels after KTx. Future prospective studies are needed to assess the impact of changes in klotho on clinical outcomes in KTx recipients and living kidney donors.

scholarly journals 121. Temporal Trends in Urine Culture Rates in the U.S. Acute Care Hospitals During 2012–2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S74-S74
Author(s):  
Sophia Kazakova ◽  
Natalie McCarthy ◽  
James Baggs ◽  
Kelly M Hatfield ◽  
Hannah Wolford ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Acute Care ◽  
Urine Culture ◽  
Temporal Trends ◽  
Acute Care Hospitals ◽  
Level Variation ◽  
Hospital Level ◽  
Hospital Variation ◽  
Teaching Status ◽  
The Impact

Abstract Background Decreasing inappropriate urine cultures in hospitalized patients has been a target of diagnostic stewardship to improve infection surveillance and antimicrobial use. The impact of such efforts has been largely unstudied. This study assessed temporal trends in urine culture rates in a cohort of acute care hospitals (ACHs) between 2012 and 2017. Hospital Level Variation in Admission Urine Culture Rates Hospital Level Variation in Post-admission Urine Culture Rates Methods We used microbiology data from ACHs participating in the Premier Healthcare Database and Cerner Health Facts to measure monthly urine culture rates. All cultures from the urinary tract collected on or before day 3 were defined as admission cultures (AC) and those collected on day 4 or later as post-admission cultures (PAC). Temporal trends in AC and PAC rates were estimated using general estimating equation models adjusting for hospital-level clustering, hospital size, teaching status, urban/rural designation, discharge month, and region. Results During the study period, ACHs had 20.8 million discharges and performed 4,946,717 urine cultures, of which 21% were PAC. In 2012 and 2017, the unadjusted AC rates were 18.7 and 18.4 per 100 discharges; the unadjusted PAC rates were 11.5 and 8.5 per 1,000 patient days (PD) respectively. The median annual hospital-level AC rate was 17.2 with inter-hospital variation ranging from 12.7 (quartile 1) to 24.1 (quartile 3) per 100 discharges, Figure 1. Similarly, the PAC rates varied among the ACHs with a median of 7.1 and inter-hospital variation ranging from 4.6 (quartile 1) to 10.5 (quartile 3) per 1,000 PDs, Figure 2. In multivariable analysis, no temporal trends in AC rates were detected (rate ratio (RR) 1.01; 95% confidence interval (CI): 0.99–1.02). However, PAC rates decreased 6.3% annually (RR 0.937; 95% CI: 0.93–0.95). Factors significantly associated (p&lt; 0.02) with PAC rates were discharge month, teaching status, bed size, and region. For AC, significant associations (p&lt; 0.0001) were discharge month and region. Conclusion Between 2012 and 2017, the rate of AC remained unchanged, but PAC rates decreased significantly. Factors driving this trend are unknown, but potential explanations include changes in culturing practices and/or decreases in hospital-onset urinary tract infections. Understanding factors related to the decrease and the impact on patient outcomes warrants further study. Disclosures All Authors: No reported disclosures

The Impact of the Israeli Transplantation Law on the Socio-Demographic Profile of Living Kidney Donors

2015 ◽  
Vol 15 (4) ◽  
pp. 1076-1080 ◽  
Author(s):  
H. Boas ◽  
E. Mor ◽  
R. Michowitz ◽  
B. Rozen-Zvi ◽  
R. Rahamimov
Keyword(s):  
Kidney Donors ◽  
Demographic Profile ◽  
Living Kidney Donors ◽  
Transplantation Law ◽  
The Impact

scholarly journals Long-Term Impact of Baseline Serum Uric Acid Levels On Living Kidney Donors: A Retrospective Study

2021 ◽  
Author(s):  
Kosuke Tanaka ◽  
Shigeyoshi Yamanaga ◽  
Yuji Hidaka ◽  
Sho Nishida ◽  
Kohei Kinoshita ◽  
...  
Keyword(s):  
Uric Acid ◽  
Adverse Events ◽  
Donor Selection ◽  
Kidney Donors ◽  
Baseline Serum ◽  
Living Kidney Donors ◽  
Preoperative Serum ◽  
The Impact

Abstract Background: Preoperative characteristics of living kidney donors are commonly considered during donor selection and postoperative follow-up. However, the impact of preoperative uric acid (UA) levels is poorly documented. The aim of this study was to evaluate the association between preoperative serum UA levels and post-donation long-term events and renal function.Methods: This was a single-center retrospective analysis of 183 living kidney donors. The donors were divided into high (≥5.5 mg/dl) and low (<5.5 mg/dl) UA groups. We analyzed the relationship between preoperative UA levels and postoperative estimated glomerular filtration rate (eGFR), as well as adverse events (cardiovascular events and additional prescriptions for hypertension, gout, dyslipidemia, and diabetes mellitus), over 5 years after donation. Results: In total, 44 donors experienced 52 adverse events over 5 years. The incidence of adverse events within 5 years was significantly higher in the high UA group than in the low UA group (50% vs. 24%, p = 0.003); this was true even after the exclusion of hyperuricemia-related events (p = 0.047). UA emerged as an independent risk factor for adverse events (p = 0.012). Donors with higher UA levels had lower eGFRs after donation, whereas body mass index, hemoglobin A1c, blood pressure, and low-density lipoprotein cholesterol did not have any impact on the eGFR.Conclusions: The findings suggest that preoperative UA levels should be considered during donor selection and postoperative follow-up.

The Impact of the Israeli Transplant Law on Living Kidney Donors

2012 ◽  
Vol 94 (10S) ◽  
pp. 1091
Author(s):  
H. Boaz ◽  
R. Michowiz ◽  
E. Mor ◽  
R. Rahamimov
Keyword(s):  
Kidney Donors ◽  
Living Kidney Donors ◽  
The Impact

scholarly journals Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors

2019 ◽  
Vol 12 (5) ◽  
pp. 748-755 ◽  
Author(s):  
Ana González-Rinne ◽  
Sergio Luis-Lima ◽  
Beatriz Escamilla ◽  
Natalia Negrín-Mena ◽  
Ana Ramírez ◽  
...  
Keyword(s):  
Cystatin C ◽  
Estimated Gfr ◽  
Kidney Donors ◽  
Reliable Determination ◽  
Living Kidney Donors ◽  
The Impact ◽  
Iohexol Plasma Clearance ◽  
Measured Gfr ◽  
Selection Of

AbstractBackgroundReliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.MethodsWe evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.ResultsNinety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.ConclusionThe misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.

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