Incidence, risk factors, and the impact of allograft pyelonephritis on renal allograft function

2016 ◽  
Vol 18 (5) ◽  
pp. 647-660 ◽  
Author(s):  
R. Singh ◽  
S.E. Geerlings ◽  
H. Peters-Sengers ◽  
M.M. Idu ◽  
C.J. Hodiamont ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Allograft ◽  
Allograft Function ◽  
Incidence Risk ◽  
The Impact

scholarly journals Preservation of epoxyeicosatrienoic acid bioavailability prevents renal allograft dysfunction and cardiovascular alterations in kidney transplant recipients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thomas Duflot ◽  
Charlotte Laurent ◽  
Anne Soudey ◽  
Xavier Fonrose ◽  
Mouad Hamzaoui ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Kidney Transplant ◽  
Plasma Levels ◽  
Renal Allograft ◽  
Transplant Recipients ◽  
Loss Of Function ◽  
Kidney Transplant Recipients ◽  
Allograft Dysfunction ◽  
Allograft Function ◽  
The Impact

AbstractThis study addressed the hypothesis that epoxyeicosatrienoic acids (EETs) synthesized by CYP450 and catabolized by soluble epoxide hydrolase (sEH) are involved in the maintenance of renal allograft function, either directly or through modulation of cardiovascular function. The impact of single nucleotide polymorphisms (SNPs) in the sEH gene EPHX2 and CYP450 on renal and vascular function, plasma levels of EETs and peripheral blood monuclear cell sEH activity was assessed in 79 kidney transplant recipients explored at least one year after transplantation. Additional experiments in a mouse model mimicking the ischemia–reperfusion (I/R) injury suffered by the transplanted kidney evaluated the cardiovascular and renal effects of the sEH inhibitor t-AUCB administered in drinking water (10 mg/l) during 28 days after surgery. There was a long-term protective effect of the sEH SNP rs6558004, which increased EET plasma levels, on renal allograft function and a deleterious effect of K55R, which increased sEH activity. Surprisingly, the loss-of-function CYP2C9*3 was associated with a better renal function without affecting EET levels. R287Q SNP, which decreased sEH activity, was protective against vascular dysfunction while CYP2C8*3 and 2C9*2 loss-of-function SNP, altered endothelial function by reducing flow-induced EET release. In I/R mice, sEH inhibition reduced kidney lesions, prevented cardiac fibrosis and dysfunction as well as preserved endothelial function. The preservation of EET bioavailability may prevent allograft dysfunction and improve cardiovascular disease in kidney transplant recipients. Inhibition of sEH appears thus as a novel therapeutic option but its impact on other epoxyfatty acids should be carefully evaluated.

The impact ofCTLA4andPTPN22genes polymorphisms on long-term renal allograft function and transplant outcomes

Renal Failure ◽  
2013 ◽  
Vol 35 (9) ◽  
pp. 1223-1227 ◽  
Author(s):  
Karolina Kłoda ◽  
Leszek Domanski ◽  
Katarzyna Bobrek-Lesiakowska ◽  
Andrzej Pawlik ◽  
Krzysztof Safranow ◽  
...  
Keyword(s):  
Renal Allograft ◽  
Transplant Outcomes ◽  
Allograft Function ◽  
The Impact

scholarly journals Postoperative Burden of Hospital-Acquired Clostridium difficile Infection

2015 ◽  
Vol 36 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Zaid M. Abdelsattar ◽  
Greta Krapohl ◽  
Layan Alrahmani ◽  
Mousumi Banerjee ◽  
Robert W. Krell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Length Of Stay ◽  
Lower Extremity ◽  
Bowel Resection ◽  
Hospital Acquired Infection ◽  
Incidence Risk ◽  
Multivariable Regression Models ◽  
Hospital Acquired ◽  
The Impact

OBJECTIVEClostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on the incidence, risk factors, and impact of CDI on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings.METHODSWe prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between July 2012 and September 2013. We used multivariable regression models to identify CDI risk factors and to determine the impact of CDI on resource utilization.RESULTSOf 35,363 patients, 179 (0.51%) developed postoperative CDI. The highest rates of CDI occurred after lower-extremity amputation (2.6%), followed by bowel resection or repair (0.9%) and gastric or esophageal operations (0.7%). Gynecologic and endocrine operations had the lowest rates (0.1% and 0%, respectively). By multivariable analyses, older age, chronic immunosuppression, hypoalbuminemia (≤3.5 g/dL), and preoperative sepsis were associated with CDI. Use of prophylactic antibiotics was not independently associated with CDI, neither was sex, body mass index (BMI), surgical priority, weight loss, or comorbid conditions. Three procedure groups had higher odds of postoperative CDI: lower-extremity amputations (adjusted odds ratio [aOR], 3.5; P=.03), gastric or esophageal operations (aOR, 2.1; P=.04), and bowel resection or repair (aOR, 2; P=.04). Postoperative CDI was independently associated with increased length of stay (mean, 13.7 d vs 4.5 d), emergency department presentations (18.9 vs 9.1%) and readmissions (38.9% vs 7.2%, all P<.001).CONCLUSIONSIncidence of postoperative CDI varies by surgical procedure. Postoperative CDI is also associated with higher rates of extended length of stay, emergency room presentations, and readmissions, which places a potentially preventable burden on hospital resources.Infect Control Hosp Epidemiol 2015;36(1): 40–46

The Impact of Functioning Arteriovenous Fistula on Blood Pressure Control and Renal Allograft Function

2018 ◽  
Vol 50 (6) ◽  
pp. 1855-1857 ◽  
Author(s):  
K. Letachowicz ◽  
T. Królicki ◽  
K. Bardowska ◽  
A. Drabik ◽  
K. Zajdel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arteriovenous Fistula ◽  
Blood Pressure Control ◽  
Renal Allograft ◽  
Pressure Control ◽  
Allograft Function ◽  
The Impact

The Impact of Renal Allograft Function on Exposure and Elimination of Mycophenolic Acid (MPA) and Its Metabolite MPA 7-O-glucuronide

2007 ◽  
Vol 84 (3) ◽  
pp. 362-373 ◽  
Author(s):  
Maarten Naesens ◽  
Henriette de Loor ◽  
Yves Vanrenterghem ◽  
Dirk R. J. Kuypers
Keyword(s):  
Mycophenolic Acid ◽  
Renal Allograft ◽  
Allograft Function ◽  
The Impact

scholarly journals Incidence, Risk Factors, and Outcomes of Stroke Following Cardiac Transplantation

Stroke ◽  
2021 ◽  
Author(s):  
Hilmi Alnsasra ◽  
Rabea Asleh ◽  
Neeraj Kumar ◽  
Camden Lopez ◽  
Takumi Toya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hemorrhagic Stroke ◽  
Calcineurin Inhibitor ◽  
Stroke Risk ◽  
Single Institution ◽  
Risk Of Death ◽  
Increased Risk ◽  
Incidence Risk ◽  
The Impact ◽  
Ischemic Events

Background and Purpose: Less is known about the risk factors and outcomes associated with stroke in the current era of increasing heart transplantation (HT) being performed in older patients. The impact of immunosuppression on risk of stroke has not yet been previously studied. We aimed to determine the incidence, risk factors and outcomes of stroke after HT. Methods: We retrospectively analyzed the incidence of ischemic and hemorrhagic strokes and associated outcomes in all consecutive HT recipients transplanted between 1994 and 2016 at a single institution. Results: Of 529 patients who underwent HT, 57 (10.7%) developed stroke, 8.1% had an ischemic events and (2.6%) had a hemorrhagic stroke. Age at HT (adjusted hazard ratio [HR] 1.33; P =0.03) and diabetes (HR, 2.60; P =0.02) were associated with increased risk of ischemic events. Patients with stroke (any type) were more likely to have worse kidney function (HR, 1.81; P =0.02) whereas patients with ischemic events were more likely to undergo combined organ transplantation (HR, 2.01; P =0.05). Cytomegalovirus infection was found to be associated with increased risk of any stroke (HR, 2.09; P =0.02).Conversion from calcineurin inhibitor to sirolimus-based immunosuppression was not found to be associated with a significant change in stroke risk (HR, 1.39; P =0. 45) compared with calcineurin inhibitor maintenance therapy. Stroke of any type and ischemic events were independently associated with increased risk of death (HR, 1.90; P =0.001 and HR, 2.14; P <0.001, respectively). Conclusions: Stroke after HT is associated with increased mortality. Older age at HT, diabetes, renal dysfunction, and CMV infection were associated with greater risk of stroke.

scholarly journals Delirium in Covid-19 Patients: Incidence, Risk Factors and Early Outcomes.

2021 ◽  
Author(s):  
Jorge Humberto Mejia-Mantilla ◽  
Andrés Gempeler ◽  
Leidy K Gaviria ◽  
Pablo Amaya ◽  
Jose Luis Aldana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Functional Outcomes ◽  
Patient Characteristics ◽  
Frequent Event ◽  
High Incidence ◽  
Incidence Risk ◽  
Prolonged Icu Stay ◽  
The Impact

Abstract Background Delirium is a frequent event in severely ill patients; its incidence and prevalence varies depending on several factors; Covid has been associated to high incidence of delirium leading to speculation of specific mechanisms of neurotoxicity by the SARS-CoV-2. We present the analysis of risk factors for delirium incidence and the impact of delirium in the functional outcomes. Methods We included patients admitted to a referral center in Cali, Colombia between April and August 2020. Patients were evaluated for demographics, severity of disease, comorbidities, clinical outcomes, delirium and survival at discharge. We evaluated the association of patient characteristics and disease factors with delirium incidence by multivariate analysis (Hosmer and Lemeshow) and the associations of delirium with functional outcome at discharge Results Among 333 patients, 58 (17.42%. 95% CI: 13.62–21.77%) presented delirium 16 (IQR: 11 − 20) days after symptom onset. Patients with delirium were older, reported muscular weakness more often, had a higher NEWS2 score at admission, and had more comorbidities (mainly Diabetes Mellitus II). Multivariate analysis of hospitalization events and treatments found mechanical ventilation as the only significant covariate. The association between need for mechanical ventilation and delirium development was estimated at OR = 11.72, (95%CI = 4.16–34.23). Patients who developed delirium had a higher frequency of functional impairment: mRs > 2 (70.7% vs 24.7%, p < 0.001) and had a prolonged ICU stay (median 13 days, IQR 8–21 vs median 5, IQR 3–10 days, p < 0.0001) compared to patients without delirium. Conclusion Our data show that premorbid functional status, the severity of respiratory disfunction and the presence of inflammatory markers are determinant in the risk of delirium; we believe that delirium might not be specially related to SARS-CoV-2 infections, its high frequency during this pandemic could be the result of concurring factors shared between critically-ill patients and severe COVID-19 patients. Further research is granted to clarify this aspect

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