scholarly journals Potential Effects of Immunosuppression on Oxidative Stress and Atherosclerosis in Kidney Transplant Recipients

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Marlena Kwiatkowska ◽  
Urszula Oldakowska-Jedynak ◽  
Ewa Wojtaszek ◽  
Tomasz Glogowski ◽  
Jolanta Malyszko
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Kidney Transplant ◽  
Immune Defense ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Chronic kidney disease is a public health problem that, depending on the country, affects approximately 8–13% of the population, involving both males and females of all ages. Renal replacement therapy remains one of the most costly procedures. It is assumed that one of the factors influencing the course of chronic kidney disease might be oxidative stress. It is believed that the main mediators of oxidative stress are reactive oxygen species (ROS). Transiently increased concentrations of ROS play a significant role in maintaining an organism’s homeostasis, as they are part of the redox-related signaling, and in the immune defense system, as they are produced in high amounts in inflammation. Systemic oxidative stress can significantly contribute to endothelial dysfunction along with exaggeration of atherosclerosis and development of cardiovascular disease, the leading cause of mortality in patients with kidney disease. Moreover, the progression of chronic kidney disease is strictly associated with the atherosclerotic process. Transplantation is the optimal method for renal replacement therapy. It improves better quality of life and prolongs survival compared with hemodialysis and peritoneal dialysis; however, even a successful transplantation does not correct the abnormalities found in chronic kidney disease. As transplantation reduces the concentration of uremic toxins, which are a factor of inflammation per se, both the procedure itself and the subsequent immunosuppressive treatment may be a factor that increases oxidative stress and hence vascular sclerosis and atherosclerotic cardiovascular disease. In the current work, we review the effect of several risk factors in kidney transplant recipients as well as immunosuppressive therapy on oxidative stress.

scholarly journals Quality of life of chronic kidney disease patients on renal replacement therapy

2018 ◽  
Vol 90 (6) ◽  
pp. 89-91
Author(s):  
Yu S Milovanov ◽  
I A Dobrosmyslov ◽  
S Yu Milovanova ◽  
M V Taranova ◽  
L Yu Milovanova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Active Metabolites ◽  
Home Dialysis

The study demonstrated the results of the comparative analysis of various types of renal replacement therapy effects on the quality of life patients with terminal stage of chronic kidney disease on the basis of standardized questionnaires. It has been shown that the quality of life is significantly improved after a kidney transplantation. At the same time, it has also been found that the introduction of home dialysis, epoetins, active metabolites of vitamin D, calcimimetics in the clinic care expanded the opportunities for the labor rehabilitation of the dialysis patients and made their quality of life comparable with the same of the kidney transplant recipients.

scholarly journals Living Donor Kidney Transplantation Improves Graft and Recipient Survival in Patients with Multiple Kidney Transplants

2020 ◽  
Vol 9 (7) ◽  
pp. 2118 ◽  
Author(s):  
Maria Irene Bellini ◽  
Aisling E Courtney ◽  
Jennifer A McCaughan
Keyword(s):  
Kidney Transplantation ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Living Donor ◽  
Patient Survival ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Background: Failed kidney transplant recipients benefit from a new graft as the general incident dialysis population, although additional challenges in the management of these patients are often limiting the long-term outcomes. Previously failed grafts, a long history of comorbidities, side effects of long-term immunosuppression and previous surgical interventions are common characteristics in the repeated kidney transplantation population, leading to significant complex immunological and technical aspects and often compromising the short- and long-term results. Although recipients’ factors are acknowledged to represent one of the main determinants for graft and patient survival, there is increasing interest in expanding the donor’s pool safely, particularly for high-risk candidates. The role of living kidney donation in this peculiar context of repeated kidney transplantation has not been assessed thoroughly. The aim of the present study is to analyse the effects of a high-quality graft, such as the one retrieved from living kidney donors, in the repeated kidney transplant population context. Methods: Retrospective analysis of the outcomes of the repeated kidney transplant population at our institution from 1968 to 2019. Data were extracted from a prospectively maintained database and stratified according to the number of transplants: 1st, 2nd or 3rd+. The main outcomes were graft and patient survivals, recorded from time of transplant to graft failure (return to dialysis) and censored at patient death with a functioning graft. Duration of renal replacement therapy was expressed as cumulative time per month. A multivariate analysis considering death-censored graft survival, decade of transplantation, recipient age, donor age, living donor, transplant number, ischaemic time, time on renal replacement therapy prior to transplant and HLA mismatch at HLA-A, -B and -DR was conducted. In the multivariate analysis of recipient survival, diabetic nephropathy as primary renal disease was also included. Results: A total of 2395 kidney transplant recipients were analysed: 2062 (83.8%) with the 1st kidney transplant, 279 (11.3%) with the 2nd graft, 46 (2.2%) with the 3rd+. Mean age of 1st kidney transplant recipients was 43.6 ± 16.3 years, versus 39.9 ± 14.4 for 2nd and 41.4 ± 11.5 for 3rd+ (p < 0.001). Aside from being younger, repeated kidney transplant patients were also more often males (p = 0.006), with a longer time spent on renal replacement therapy (p < 0.0001) and a higher degree of sensitisation, expressed as calculated reaction frequency (p < 0.001). There was also an association between multiple kidney transplants and better HLA match at transplantation (p < 0.0001). A difference in death-censored graft survival by number of transplants was seen, with a median graft survival of 328 months for recipients of the 1st transplant, 209 months for the 2nd and 150 months for the 3rd+ (p = 0.038). The same difference was seen in deceased donor kidneys (p = 0.048), but not in grafts from living donors (p = 0.2). Patient survival was comparable between the three groups (p = 0.59). Conclusions: In the attempt to expand the organ donor pool, particular attention should be reserved to high complex recipients, such as the repeated kidney transplant population. In this peculiar context, the quality of the donor has been shown to represent a main determinant for graft survival—in fact, kidney retrieved from living donors provide comparable outcomes to those from single-graft recipients.

123 Trends in Prevalence of Chronic Kidney Disease in Kidney Transplant Recipients

2011 ◽  
Vol 57 (4) ◽  
pp. B47
Author(s):  
Yihung Huang ◽  
Anca Tilea ◽  
Brenda Gillespie ◽  
Neil Powe ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals INDICATORS OF OXIDATIVE STRESS AND RESISTANCE OF ERYTHROCYTES IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE VD DEPENDING ON MODALITY OF RENAL REPLACEMENT THERAPY

2015 ◽  
pp. 57-64
Author(s):  
M. Kolesnyk ◽  
L. Korol ◽  
L. Migal ◽  
O. Burdeyna ◽  
V. Novakivskyy
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Chronic Kidney Disease Stage ◽  
Diagnostic Methods ◽  
Disease Stage ◽  
Control Group ◽  
Sh Groups

The object was to study the effect of oxidative factors and methods of renal replacement therapy (RRT) on indices of oxidative stress (OS) and resistance cells in blood in patients with chronic kidney disease stage V(CKD VD) and anemic syndrome. Material and methods. The study involved 47 patients with CKD VD: 14patients were treated by hemodiafiltration (HDF), 14 patients by hemodialysis (HD) and 19 patients by peritoneal dialysis (PD). The severity ofanemia was assessed according to the KDIGO (2012) criteria. The control group consisted of30 healthy people of the same age and sex. Along with the standard diagnostic methods, we defined the content of malonic dialdehyde in serum (MDAs) and in erythrocytes (MDAe), the content of ceruloplasmin (CPs), transferrin (TRs) and SH - groups in the blood serum, the index of the OS (IOS), catalase activity in serum (CTs), glucose - 6 - phosphate dehydrogenase (G - 6 - PDHe) and total peroxidase activity (TPA) in erythrocyte, osmotic (OR) and peroxide resistance (PR) of red blood cells and erythrocyte membrane permeability (EMP). Statistical analysis was performed using the programs Microsoft Excel 5,0 and MedStat. Results. It has been stated that in the CKD VD patients agains the rates in control group the MDAs content increased by 3.3 times and MDAe - 1.2 times, TRs content reduced by 34%, SH - groups - by 31%, TPAe - by 41% and G - 6 - FDGe - by 58%, marcers of OR by 30%, PR - by 60%; 4.6 times increased CTs activity and OSI; 2 times grew peroxide hemolysis (PH) and 1.3 times - EMP. The analysis (depending on the RRT modality) showed that the patients treated by HDF had typical MDAs increase by 3.9 times on a background of CPs by 24%o, TRs - 33%, SH - groups - 25%, TPAe - 51%, G6 - PDHe - 42%; the increase in serum OSI - 5.4 times and 2.6 times in erythrocytes, PR - by 3.6 times and CTs activity by 3,5 times; HD group were characterized by the highest value of MDAe, OSI, PH and CTs, along with more expressed decrease of indices TRs, SH - groups, TPA and G - 6 - FDHe activity compared with rates in patients with HDF. The patients treated with PD had the lowest content of MDAs and the highest values on the background ofTPAe, the significant increase of CPs by 1.7 times and lowest TRs and G - 6 - PDHe. The patients with PD showed twice lower OS activity by OSI. Conclusion.Thus, in patients with CKD VD, who had HD, HDF or PD an anemic syndrome was associated with high OS activity and the increased degree of hemolysis. These changes are stipulated by RRT methods: for patients receiving HDF were typical the lowest rates of hemolysis and the highest degree of protection for erythrocytes, and for patients treated with HD - the highest OS.

scholarly journals The Protective Role of Protocol Biopsy for Allograft Kidney Maintenance in Kidney Transplantation

2021 ◽  
Author(s):  
Okjoo Lee ◽  
Kyo Won Lee ◽  
Jae Berm Park ◽  
Jung Eun Lee ◽  
Na Young Hwang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Function ◽  
Protective Role ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Protocol Biopsy ◽  
Kidney Disease Progression

Abstract Many studies have reported that protocol biopsy (PB) may help preserve kidney function in kidney transplant recipients. Early detection and treatment of subclinical rejection may reduce the incidence of chronic allograft nephropathy and graft failure. However, no consensus has been reached regarding PB effectiveness, timing, and policy. This study aimed to evaluate the protective role of routine PB performed 2 weeks and 1 year after kidney transplantation. We reviewed 854 kidney transplant recipients at the Samsung Medical Center between July 2007 and August 2017, with PBs planned at 2 weeks and 1 year after transplantation. We compared the trends in graft function, chronic kidney disease progression, new-onset chronic kidney disease, infection, and patient and graft survival between the 504 patients who underwent PB and 350 who did not undergo PB. The PB group was again divided into two groups: the single PB group (n = 207) and the double PB group (n = 297). In the PB group, the donors and recipients were significantly older and there was a greater presence of recipient diabetes mellitus and donor hypertension, donor-specific antigen, and a higher proportion of ABO-incompatible kidney transplantations. The PB group was significantly different from the no-PB group in terms of the trends in graft function (estimated glomerular filtration rate). The Kaplan-Meier curve showed that PB did not significantly improve graft survival or overall patient survival. However, in the multivariate Cox analysis, the double PB group had advantages in graft survival, chronic kidney disease progression, and new-onset chronic kidney disease. PB can play a protective role in the maintenance of kidney grafts in kidney transplant recipients.

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