scholarly journals Attitudes to Medication after Kidney Transplantation and Their Association with Medication Adherence and Graft Survival: A 2-Year Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mirjam Tielen ◽  
Job van Exel ◽  
Mirjam Laging ◽  
Denise K. Beck ◽  
Roshni Khemai ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplantation ◽  
Medication Adherence ◽  
Graft Survival ◽  
Renal Transplant Recipients ◽  
Kidney Recipients ◽  
Immunosuppressive Medications ◽  
Study Results ◽  
Intrapatient Variability

Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes.Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©-interview). Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation.Results. 113 renal transplant recipients (19–75 years old) participated in the study. Results revealed three attitudes towards medication adherence—attitude 1: “confident and accurate,” attitude 2: “concerned and vigilant,” and attitude 3: “appearance oriented and assertive.” We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival.Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor.

Advanced Donor Age Alone Is Not a Risk Factor for Graft Survival in Kidney Transplantation

2011 ◽  
Vol 43 (5) ◽  
pp. 1537-1543 ◽  
Author(s):  
T. Karatzas ◽  
J. Bokos ◽  
A. Katsargyris ◽  
K. Diles ◽  
G. Sotirchos ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplantation ◽  
Graft Survival ◽  
Donor Age

P1029SAFETY AND EFFICACY OF LONG-TERM ADMINISTRATION OF DPP-4 INHIBITORS IN PATIENTS WITH NEW ONSET DIABETES AFTER KIDNEY TRANSPLANTATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Adamantia Mpratsiakou ◽  
Marios Papasotiriou ◽  
Konstantinos Tsiotsios ◽  
Theodoros Ntrinias ◽  
Evangelos Papachristou ◽  
...  
Keyword(s):  
Renal Function ◽  
Body Weight ◽  
Kidney Transplantation ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Dpp Iv ◽  
The Mean ◽  
New Onset

Abstract Background and Aims New onset diabetes (NODAT) is a common complication after kidney transplantation. The available treatment options in this patient population have limitations due to reduced renal function, possible interactions with immunosuppressive drugs and side effects such as hypoglycemic events. The aim of this study was to investigate the long term safety and efficacy profile of dipeptidyl peptidase-IV (DDP-4 inhibitors) administration in renal transplant recipients with NODAT. Method The study included 12 patients treated with DPP-IV inhibitors monotherapy as well as 5 patients receiving insulin monotherapy as initial treatment immediately after NODAT diagnosis. All patients were monitored at every scheduled outpatient visit and for 12 months after diagnosis by measuring glycosylated hemoglobin (HbA1c), serum creatinine (eGFR calculation with CKD-EPI formula), plasma immunosuppressive trough levels, serum lipids, blood pressure, and body weight. The mean values of the aforementioned parameters for the last six months of follow up were compared to the ones at diagnosis. Results Patients receiving DPP-IV inhibitors were treated with either linagliptin (4 patients), sitagliptin (4 patients), vildagliptin (2 patients) or halogliptin (2 patients). These patients had a mean age of 59.4 ± 12 years, a mean HbA1c of 6.6% and a mean fasting glucose of 114.5 mg/dl at diagnosis. The mean HbA1c the last 6 months of one year of follow up after initiation of treatment, decreased to 6.1% (p=0.03). Renal function remained stable (mean eGFR from 58.8 to 61.7 ml/min/1.73m2, p=ns) while plasma tacrolimus levels did not appear to be affected (from 6.2 to 5.5 ng/dl, p=ns). Patients received a slightly reduced mean dose of tacrolimus during the last six months of follow up in comparison to the one at initiation of treatment (from 2.9 to 2.6 mg/24h, p=ns). No significant difference was shown in serum total, LDL, and HDL cholesterol before and after treatment, nevertheless, triglyceride levels were significantly reduced (from 214.4 to 174.9 mg/dl, p=0.0039). A decrease in body weight was observed (from 79.9 to 77.9 kg, p=ns) which was however not statistically significant. Finally, achieving the goal of lowering HbA1c levels was better in patients treated with DPP-IV inhibitors than in those treated with insulin (6.1% vs 7.1%, respectively, p=0.01). Conclusion Administration of DPP-IV inhibitors appears to be a safe and effective option for the treatment of NODAT in renal transplant recipients with the benefit of avoiding hypoglycemic episodes and possibly better diabetes control than with insulin therapy.

scholarly journals Analysis of recipient and graft survival after primary and second kidney transplantation

2021 ◽  
Vol 23 (2) ◽  
pp. 21-29
Author(s):  
A. V. Pinchuk ◽  
N. V. Shmarina ◽  
I. V. Dmitriev ◽  
V. E. Vinogradov ◽  
A. I. Kazantsev
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Survival Rates ◽  
Term Survival ◽  
Kidney Recipients ◽  
Significant Difference ◽  
History Of ◽  
First Time ◽  
Older Recipients

Objective: to evaluate the 1- and 5-year graft and recipient survival after primary and second kidney transplantation, to compare the outcomes depending on the age of recipients.Material and methods. The treatment outcomes for 364 patients who underwent kidney transplantation at Sklifosovsky Research Institute of Emergency Care, Moscow over the period from 2007 to 2019. Of these, 213 patients underwent kidney transplantation for the first time, while 151 patients were having a second transplantation. We analyzed the effect of previous transplants, as well as the age of the recipients on long-term survival rates.Results. No significant difference in 1- and 5-year survival of kidney recipients after primary and second transplantations was found. In contrast, the long-term graft survival significantly depended on this criterion and turned out to be significantly higher after primary transplantations. The 1- and 5-year survival of older recipients was lower than the survival of younger recipients after primary and second kidney transplantation. The 1-year graft survival after primary kidney transplantation was higher in young recipients than in older recipients of the same group, however, but there were no significant differences in the 5-year graft survival. After second transplantations, there were no significant differences in the 1- and 5-year graft survival depending on the age of recipients.Conclusion. A history of previous transplantation is an important factor in kidney transplantation outcome, which must be taken into account in clinical practice.

scholarly journals The incidence of interstitial and vascular kidney rejection after pancreas-kidney transplantation.

1995 ◽  
Vol 5 (11) ◽  
pp. 1918-1925
Author(s):  
J G Boonstra ◽  
J A Bruijn ◽  
J Hermans ◽  
H H Lemkes ◽  
J Ringers ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Induction Therapy ◽  
Vascular Rejection ◽  
Renal Graft ◽  
Kidney Recipients ◽  
Kidney Rejection ◽  
Pancreas Kidney Transplantation ◽  
Renal Graft Survival

Several groups have reported that recipients of a simultaneous pancreas-kidney transplantation suffer from more kidney rejection episodes than do recipients of a kidney transplantation (1-6). However, it is not known whether this is interstitial rejection, vascular rejection, or both. In this study, the renal biopsies and transplantectomies of 45 pancreas-kidney and 48 kidney transplant recipients were evaluated for the presence of interstitial and vascular rejection. Furthermore, the influence of OKT3 induction therapy on rejection after pancreas-kidney transplantation was studied. Of the 45 pancreas-kidney recipients. 4 patients did not suffer from rejection during follow-up, 28 suffered only from interstitial rejection, and 13 suffered from vascular (with or without interstitial) rejection, whereas 12, 19, and 14 of the 48 kidney transplant patients had no rejection, interstitial rejection, or vascular (with or without interstitial) rejection, respectively. Three patients with a kidney transplant were treated for rejection although no biopsy was taken. In the pancreas-kidney group, 38 of the total of 149 biopsies and transplantectomies taken contained no rejection, 92 had interstitial rejection, and 19 had vascular rejection. In the kidney group, these values were 13, 41, and 25, respectively, of 79 biopsies and transplantectomies taken (P = 0.002). Five-year renal graft survival was 79% in the kidney group and 60% in the pancreas-kidney group. Renal graft survival rates differed significantly (P = 0.02). Renal graft survival and occurrence of rejection did not reach significance between pancreas-kidney recipients treated with OKT3 induction therapy and pancreas-kidney recipients receiving conventional triple therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Long-Term Follow-Up after Paediatric Kidney Transplantation and Influence Factors on Graft Survival: A Single-Centre Experience of 16 years

2018 ◽  
Vol 100 (3) ◽  
pp. 317-321 ◽  
Author(s):  
Frank Friedersdorff ◽  
Therese-Marie Koch ◽  
Beatriz Banuelos-Marco ◽  
Ricardo Gonzalez ◽  
Tom Florian Fuller ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Influence Factors ◽  
Single Centre ◽  
Single Centre Experience ◽  
Long Term Follow Up

scholarly journals Minimal Proteinuria One Year after Transplant is a Risk Factor for Graft Survival in Kidney Transplantation

2009 ◽  
Vol 24 (Suppl 1) ◽  
pp. S129 ◽  
Author(s):  
Na Ree Kang ◽  
Jung Eun Lee ◽  
Wooseong Huh ◽  
Sung Joo Kim ◽  
Yoon-Goo Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplantation ◽  
Graft Survival ◽  
One Year

scholarly journals Serum Total Homocysteine and Cardiovascular Disease Occurrence in Chronic, Stable Renal Transplant Recipients: A Prospective Study

2000 ◽  
Vol 11 (1) ◽  
pp. 134-137 ◽  
Author(s):  
DIDIER DUCLOUX ◽  
GÉRARD MOTTE ◽  
BRUNO CHALLIER ◽  
ROGER GIBEY ◽  
JEAN-MARC CHALOPIN
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Renal Transplant ◽  
Cox Regression ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Creatinine Concentration ◽  
Cox Regression Analysis ◽  
Total Homocysteine

Abstract. Renal transplant recipients have disproportionately high rates of arteriosclerotic outcomes, and recent studies provided controlled evidence that clinically stable renal transplant recipients have an excess prevalence of hyperhomocysteinemia. Few studies suggest that hyperhomocysteinemia may be a cardiovascular risk factor in renal transplant recipients. In the study presented here, the association between atherosclerotic events and homocysteine concentrations was examined in 207 stable renal transplant recipients. The role of hyperhomocysteinemia was analyzed with respect to other known cardio-vascular risk factors. The mean follow-up was 21.2 ± 1.9 mo (range, 14 to 26). Mean total homocysteine (tHcy) was 21.1 ± 9.5 μmol/L and median concentration was 19 μmol/L. Seventy percent of patients (n = 153) were hyperhomocysteinemic (values >15 μmol/L). tHcy correlated negatively with folate concentration (r = -0.3; P <0.01). tHcy was closely related to creatinine concentration (r = 0.54; P < 0.001). Cardiovascular disease events (CVE) including death were observed in 30 patients (14.5%; 7.34 events per 1000 person-months of follow-up). Fasting tHcy values were higher in patients who experienced CVE (31.5 ± 10.3 versus 17.8 ± 7.5; P < 0.001). Cox regression analysis showed that tHcy was a risk factor for cardiovascular complications (relative risk [RR] 1.06; 95% confidence interval (95% CI), 1.04 to 1.09; P < 0.0001). This corresponds to an increase in RR for CVE of 6% per μmol/L increase in tHcy concentration. Age (RR 1.55; 95% CI, 1.09 to 2.19; P < 0.01) and creatinine concentration (RR 1.34; 95% CI, 1.08 to 1.66; P < 0.01) were also independent predictor for CVE. This study demonstrates that elevated fasting tHcy is an independent risk factor for the development of CVE in chronic stable renal transplant recipients. Randomized, place-bo-controlled homocysteine studies of the effect of tHcy lowering on CVE rates are urgently required in this patient population.

scholarly journals Evaluation of the effectiveness of prophylactic strategies for cytomegalovirus infection in pediatric kidney recipients

2021 ◽  
Vol 23 (4) ◽  
pp. 13-18
Author(s):  
O. M. Tsirulnikova ◽  
P. M. Gadzhieva ◽  
I. A. Miloserdov ◽  
D. A. Saydulaev ◽  
I. E. Pashkova
Keyword(s):  
Kidney Transplantation ◽  
Individual Characteristics ◽  
Artificial Organs ◽  
Renal Transplant Recipients ◽  
Kidney Graft ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cmv Infection ◽  
Effective Prevention ◽  
Kidney Recipients

Cytomegalovirus (CMV) infection is the most severe viral infection in renal transplant recipients, which can occur in the post-transplant period in both adult and pediatric recipients. Developing and applying an effective prevention and treatment strategy for pediatric renal graft recipients is a priority. Objective: to compare the effectiveness of the protocols used for the prevention of CMV infection in pediatric kidney transplant recipients.Materials and methods. The study enrolled 118 patients who underwent primary kidney transplantation at Shumakov National Medical Research Center of Transplantology and Artificial Organs. Based on retrospective analysis, all recipients were divided into two groups, depending on the prophylactic strategy after kidney transplantation. The followup period for pediatric kidney recipients ranged from 108 to 1803 (623.5 ± 379.5) days. CMV infection activity was monitored by polymerase chain reaction.Results. The frequency of CMV infection activation episodes at 3 and 6 months was independent of the prophylaxis strategy used. The recurrence rate of CMV infection one year after surgery was significantly lower (p = 0.037) with Strategy 2. No cases of CMV syndrome or CMV disease, graft dysfunction, or chronic rejection associated with CMV infection were reported. Increasing the dose of antiviral drugs in Strategy 1 did not increase the risk of cytotoxicity and nephrotoxicity, which are reversible (creatinine levels were not significantly different in the study groups at 3, 6, 12 months, p = 0.542, p = 0.287, p = 0.535, respectively). The incidence of kidney graft rejection did not increase in patients with lower doses of immunosuppressants in Strategy 2.Conclusion. Both prophylactic strategies are effective in pediatric kidney recipients. However, the choice of a strategy depends on the individual characteristics of the patient and requires a personalized approach.

scholarly journals P1695OUTCOMES OF KIDNEY TRANSPLANTATION IN RECIPIENTS WITH MENTAL RETARDATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
DAMLA ORS SENDOGAN ◽  
SIYAR ERDOGMUS ◽  
Gizem Kumru Şahin ◽  
SAHIN EYUPOGLU ◽  
Rezzan Eren Sadioğlu ◽  
...  
Keyword(s):  
Social Support ◽  
Mental Retardation ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Cystic Kidney ◽  
Acute Rejection Episode ◽  
Dialysis Access ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

Abstract Background and Aims Mental retardation in patients with chronic kidney disease is a relative contraindication for kidney transplantation. Currently, in the literature there are limited outcome data in renal transplant recipients with mental retardation and approaches to decision of transplantation changes in different centers. The aim of this study is to evaluate the results of kidney transplantation recipients with mental retardation in our center. Method In this study, we examined retrospectively 8 kidney transplant recipients with mental retardation in Renal Transplantation Unit of Ankara University School of Medicine between 2006-2018 years. Results The cause of mental retardation in these patients were; genetic syndromes in three patients, meningoencephalitis in one patient, prematurity in one patient, and chromosomal abnormality in one patient. In two patients, the cause of mental retardation is unknown. All patients had good social support for drug compliance and follow-up. The causes of end-stage renal failure were; cystic kidney disease in three patients, hypertensive nephropathy in one patient and vesicoureteral reflux in one patient. In three patients, the etiology of kidney disease is unknown. At the time of pretransplantation period evaluation, six candidates were receiving hemodialysis and two candidates were receiving peritoneal dialysis respectively. Mean dialysis duration before transplantation was 50.7±22.8 months (min 4-max 180). Cadaveric kidney transplantation was performed in three of eight patients (deceased donor kidney allocated to patient with medical urgency in the event of potential imminent loss of dialysis access in one patient and in normal conditions in two patients) and living kidney transplantation was performed in five patients. The mean follow-up period after transplantation was 54.1±48.0 months. Three patients had early posttransplant complications; including urinary tract infection in three patients, deep vein trombosis in one patient and cardiopulmoner arrest with septic shock secondary to femoral graft infection and parailiac abscess in one patient (Table). No patients underwent graft biopsy and no patients experienced acute rejection episode. At the end of the follow-up time, graft and patient survival were 100%. Conclusion Mental retardation is not a contraindication for kidney transplantation in candidates without the history of noncompliance with proper social support.

Malignancies after kidney transplantation: 3 clinical case reports

Open Medicine ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 322-327 ◽  
Author(s):  
Eglė Dalinkevičienė ◽  
Vytautas Kuzminskis ◽  
Laura Kairevičė ◽  
Rasa Jančiauskienė ◽  
Daimantas Milonas ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplantation ◽  
Renal Transplant ◽  
Testicular Cancer ◽  
Clinical Case ◽  
Case Reports ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Different Types

AbstractPost-transplant malignancies present an aggressive course and are a significant cause of morbidity and mortality. Tumours of viral ethiology have the greatest risk in renal transplant recipients. Oncogenic effect of immunosuppressive therapy is another major risk factor of post-transplant malignancy. We report cases of three different types of malignancies developed after kidney transplantation: non-Hodgkin’s lymphoma, Kaposi’s sarcoma and germ cell testicular cancer (nonseminoma).

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