scholarly journals Risk factors for complications and graft failure in kidney transplant patients with sepsis

2018 ◽  
Author(s):  
Syuan-Hao Syu ◽  
Yung-Wei Lin ◽  
Ke-Hsun Lin ◽  
Liang-Ming Lee ◽  
Chi-Hao Hsiao ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Peripheral Vascular ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Immunosuppressive therapies decreased the incidence of acute kidney rejection after kidney transplantation, but also increased the risk of infections and sepsis. This study aimed to identify the risk factors associated with complications and/or graft failure in kidney transplant patients with sepsis. A total of 14,658 kidney transplant patients with sepsis, identified in the National Inpatient Sample (NIS) database (data from 2005–2014), were included in the study and classified into three groups: patients without complications or graft failure/dialysis (Group 1), patients with complications only (Group 2), and patients with complications and graft failure/dialysis (Group 3). Multinomial logistic regression analyses were conducted to evaluate factors associated with kidney transplant recipients. Multivariate analysis showed that, compared to Group 1, patients from Group 2 or Group 3 were more likely to be Black and to have cytomegalovirus infection, coagulopathy, and glomerulonephritis (p ≤ 0.041). Also, Group 2 was more likely to have herpes simplex virus infection, and Group 3 was more likely to have hepatitis C infection and peripheral vascular disorders, compared to Group 1 (p ≤ 0.002). In addition, patients from Group 3 were more likely to be Black and to have hepatitis C infection, peripheral vascular disorders, coagulopathy, and hypertension compared to Group 2 (p ≤ 0.039). Age and female gender were associated with lower odds of complications after kidney transplantation regardless of graft rejection/dialysis (p ≤ 0.049). Hyperlipidemia and diabetes decreased the chance of complications and graft failure/dialysis after kidney transplant (p < 0.001). In conclusion, the study highlights that black race, male gender, and specific comorbidities can increase the risk of complications and graft failure in kidney transplant patients with sepsis.

scholarly journals Delayed Graft Function and Acute Rejection in Kidney Transplant Patients with Positive Panel-Reactive Antibody and Negative Donor-Specific Antibodies

2020 ◽  
Vol 12 (4) ◽  
Author(s):  
Ha Nguyen Thi Thu ◽  
Manh Bui Van ◽  
Dung Nguyen Thi Thuy ◽  
Kien Truong Quy ◽  
Duc Nguyen Van ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Graft Function ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Group 2 ◽  
Reactive Antibody ◽  
Group 1

Background: Delayed graft function (DGF) and acute rejection (AR) are common complications in kidney transplant patients. Objectives: The study evaluated DGF and AR in highly sensitized patients and their effects on kidney function for six months post-transplantation. Methods: We enrolled 95 patients with kidney transplants from living donors who were divided into two groups. Group 1 included 47 highly sensitized patients with panel reactive antibody (PRA) < 20.0% and negative donor-specific antigen, and group 2 included 48 patients with negative PRA. All patients were followed for the state of DGF, AR, and kidney function for six months. Results: Group 1 showed a significantly higher proportion of DGF and AR than group 2 (27.7% versus 2.1%, P < 0.001 and 14.9% versus 2.1%, P = 0.031, respectively). The rates of positive PRA in DGF and AR patients were significantly higher than those in non-DGF and non-AR patients (92.9% versus 42.0%, P < 0.001 and 87.5% versus 46.0%, P = 0.031, respectively). Transplanted kidney function was significantly worse in patients with PRA and DGF and/or AR than in patients with negative PRA and non-DGF and non-AR only in the seventh-day post-transplantation. Conclusions: Kidney transplant in highly sensitized patients with positive PRA was related to the increased ratio of DGF and AR.

scholarly journals Review of Outcomes after Diagnosis of Malignancy in Kidney Transplant Patients: UNOS Database

2021 ◽  
Vol 2 (3) ◽  
pp. 253-263
Author(s):  
Het Patel ◽  
Nikhil Agrawal ◽  
Voravech Nissaisorakarn ◽  
Ridhi Gupta ◽  
Francesca Cardarelli
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Event Analysis ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Time To Event ◽  
Transplant Patients ◽  
Kaplan Meier ◽  
Lung Malignancy ◽  
Kidney Transplant Patients

Malignancy is the third major cause of death among transplant recipients. Patient and kidney transplant outcomes after the diagnosis of malignancy are not well described. We reviewed incidences and outcomes of colorectal, lung, PTLD, and renal malignancy after transplant among patients who received a transplant from January 2000 to December 2018 using the UNOS/OPTN database. Incidence of each malignancy was measured at 5 years and 10 years of transplant. The Kaplan–Meier curve was used for time-to-event analysis (graft and patient outcomes). Additionally, we sought to identify the causes of graft failure among these recipients. We found that 12,764 (5.5%) patients suffered malignancy, excluding squamous and basal cell skin carcinoma after transplant. During the first 5 years of transplant, incidence of colorectal, lung, PTLD, and renal malignancies was 2.99, 9.21, 15.61, and 8.55 per 10,000 person-years, respectively. Rates of graft failure were 10.3%, 7.6%, 19.9%, and 18.8%, respectively, among these patients at 5 years. Mortality rate was highest among patients who suffered lung malignancy (84%), followed by colorectal (61.5%), PTLD (49.1%), and renal (35.5%) at 5 years after diagnosis of malignancy. In conclusion, kidney transplant recipients diagnosed with lung malignancy have the lowest graft survival, compared to PTLD, colorectal, and renal malignancy. PTLD has the highest incidence rate in the first 5 years of transplant.

Predictors of hospital prenotification for STEMI and association of prenotification with outcomes

2021 ◽  
pp. emermed-2020-210522
Author(s):  
David Blusztein ◽  
Diem Dinh ◽  
Dion Stub ◽  
Luke Dawson ◽  
Angela Brennan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Multivariable Analysis ◽  
Coronary Intervention ◽  
Factors Associated ◽  
Cerebrovascular Events ◽  
Group 3 ◽  
Male Patients ◽  
Group 2 ◽  
Time Of Presentation ◽  
Group 1

BackgroundDelay to reperfusion in ST-elevation myocardial infarction (STEMI) is detrimental, but can be minimised with prehospital notification by ambulance to the treating hospital. We aimed to assess whether prenotification was associated with improved first medical contact to balloon times (FMC-BT) and whether this resulted in better clinical outcomes. We also aimed to identify factors associated with use of prenotification.MethodsThis was a retrospective study of prospective Victorian Cardiac Outcomes Registry data for patients undergoing primary percutaneous coronary intervention for STEMI from 2013-2018. Postcardiac arrest were excluded. Patients were grouped by whether they arrived by ambulance with prenotification (group 1), arrived by ambulance without prenotification (group 2) or self-presented (group 3). We compared groups by FMC-BT, incidence of major adverse cardiac and cerebrovascular events (MACCE), mortality and factors associated with the use of prenotification.Results2891 patients were in group 1 (79.3% male), 1620 in group 2 (75.7% male) and 1220 in group 3 (82.9% male). Patients who had prenotification were more likely to present in-hours (p=0.004) and self-presenters had lowest rates of cardiogenic shock (p<0.001). Prenotification had shorter FMC-BT than without prenotification (104 min vs 132 min, p<0.001) Self-presenters had superior clinical outcomes, with no difference between ambulance groups. Groups 1 and 2 had similar 30-day MACCE outcomes (7.4% group 1 vs 9.1% group 2, p=0.05) and similar mortality (4.6% group 1 vs 5.9% group 2, p=0.07). In multivariable analysis, male gender, right coronary artery culprit and in-hours presentation independently predicted use of prenotification (all p<0.05).ConclusionDifferences in clinical characteristics, particularly gender, time of presentation and culprit vessel may influence ambulance prenotification. Ambulance cohorts have high-risk features and worse outcomes compared with self-presenters. Improving system inequality in prehospital STEMI diagnosis is recommended for fastest STEMI treatment.

scholarly journals Surgical outcomes for older patients with glioblastoma multiforme: preoperative factors associated with decreased survival

2011 ◽  
Vol 114 (3) ◽  
pp. 587-594 ◽  
Author(s):  
Kaisorn L. Chaichana ◽  
Khan K. Chaichana ◽  
Alessandro Olivi ◽  
Jon D. Weingart ◽  
Richard Bennett ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Median Survival ◽  
Older Patients ◽  
Motor Deficit ◽  
Factors Associated ◽  
Group 3 ◽  
Group 2 ◽  
Insight Into ◽  
Preoperative Factors ◽  
Group 1

Object As the population ages, the incidence of glioblastoma multiforme (GBM) among older patients (age > 65 years) will increase. Older patients, unlike their younger counterparts, are not often offered aggressive surgery because of their age, comorbidities, and potential inability to tolerate surgery. The goal of this study was to identify preoperative factors associated with decreased survival for older patients who underwent resection of a GBM. The identification of these factors may provide insight into which patients would benefit most from aggressive surgery. Methods All patients older than 65 years who underwent nonbiopsy resection of an intracranial GBM at a single institution between 1997 and 2007 were retrospectively reviewed. Factors associated with overall survival were assessed using multivariate proportional hazards regression analysis after controlling for peri- and postoperative factors known to be associated with outcome (extent of resection, carmustine wafer implantation, temozolomide chemotherapy, and radiation therapy). Variables with p < 0.05 were considered statistically significant. Results A total of 129 patients with an average age of 73 ± 5 years met the inclusion/exclusion criteria. At last follow-up, all 129 patients had died, with a median survival of 7.9 months. The preoperative factors that were independently associated with decreased survival were Karnofsky Performance Scale (KPS) score less than 80 (p = 0.001), chronic obstructive pulmonary disease (p = 0.01), motor deficit (p = 0.01), language deficit (p = 0.005), cognitive deficit (p = 0.02), and tumor size larger than 4 cm (p = 0.002). Patients with 0–1 (Group 1), 2–3 (Group 2), and 4–6 (Group 3) of these factors had statistically different survival times, where the median survival was 9.2, 5.5, and 4.4 months, respectively. In log-rank analysis, the median survival for Group 1 was significantly longer than that for Group 2 (p = 0.004) and Group 3 (p < 0.0001), while Group 2 had longer survival than Group 3 (p = 0.02). Conclusions Older patients with an increasing number of these factors may not benefit as much from aggressive surgery as patients with fewer factors. This may provide insight into identifying which patients older than 65 years of age may benefit from aggressive surgery.

scholarly journals PO 8595 FACTORS ASSOCIATED WITH VIROLOGIC FAILURE AMONG WOMEN WITH PRIOR EXPOSURE TO ANTIRETROVIRAL DRUGS FOR PMTCT, KISUMU, KENYA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A60.3-A61
Author(s):  
Francis Angira ◽  
Eucabeth Awuonda ◽  
Jacinter Oruko ◽  
Oyaro Boaz ◽  
Elijah Asadhi ◽  
...  
Keyword(s):  
Virologic Failure ◽  
Antiretroviral Drugs ◽  
Prior Exposure ◽  
Hiv Care ◽  
First Line ◽  
Factors Associated ◽  
Art Initiation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundUse of antiretroviral drugs (ARVs) for a discrete period for Preventing Mother-to-Child HIV transmission (PMTCT) only may be compared to Structured Treatment Interruption, which has been associated with virologic failure (VF). We sought to determine factors associated with VF among women on Antiretroviral Therapy (ART) but with prior exposure to short-term ARVs for PMTCT.MethodsHIV-infected women presenting for ART initiation in three HIV care clinics in Kisumu County, Kenya were enrolled in the KiBS follow-up study (2010–2013) if they had previously received triple ARVs for PMTCT (Group 1) or short-course ARVs for PMTCT (Group 2) or were ARVs-naïve (Group 3). First-line ART was provided as per 2010 WHO treatment guidelines and viral load (VL) tests were conducted every six months for 24 months. VF was defined as any confirmed VL value ≥400 copies/ml after 6 months of ART initiation. Frequencies and proportions were used in the descriptive analysis while Pearson’s Chi-square/Fisher’s exact test was used to determine the association between VF and eight independent variables. Univariate and Multivariate Cox-proportional regression model was fitted to investigate factors associated with VF.ResultsOut of 284 participants data for 245 were analysed (Group 1: 27; Group 2: 107; Group 3: 111). Majority were aged 25–29 years and over 60% had primary/lesser education. There were 39 (Group 1: 5; Group 2: 16; Group 3: 18) VFs with a total VF incidence of 8.12 [95% CI (5.96, 11.17)] per 1000 Person months of observation (PMOs). Group 2 had the lowest VF incidence. Baseline CD4 <349 cells/mm3 and initiation/use of TDF/3TC/EFV were associated with virologic failure (VF).ConclusionWomen at risk of VF based on the identified risk factors should be identified and targeted with appropriate intervention. Further studies are needed to verify and understand the mechanisms of association between VF and TDF/3TC/EFV which is a WHO-recommended first-line ART regimen.

Risk Factors Associated With Invasive Fungal Infections in Kidney Transplant Patients

2020 ◽  
Vol 359 (2) ◽  
pp. 108-116 ◽  
Author(s):  
Sara Leitheiser ◽  
Andrew Harner ◽  
Jennifer L. Waller ◽  
Jake Turrentine ◽  
Stephanie Baer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Factors Associated ◽  
Transplant Patients ◽  
Kidney Transplant Patients

scholarly journals Fibromyalgia syndrome and related factors in hemodialysis, peritoneal dialysis, and renal transplant patients: A cross-sectional study

2021 ◽  
Author(s):  
Ayla Çağlıyan Türk ◽  
Sultan Özkurt ◽  
İbrahim Doğan ◽  
Füsun Şahin
Keyword(s):  
Peritoneal Dialysis ◽  
Depressive Symptoms ◽  
Renal Transplant ◽  
Point Prevalence ◽  
Healthy Controls ◽  
Transplant Patients ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives: This study aims to investigate the point prevalence of fibromyalgia in patients on hemodialysis and peritoneal dialysis and after renal transplantation compared to healthy controls and to evaluate depressive symptoms, anxiety level, and the impact of fibromyalgia on quality of life (QoL). Patients and methods: Between January 2018 and January 2019, a total of 107 hemodialysis patients (Group 1) (48 males, 59 females; median age: 50 years; range, 42 to 56 years), 51 peritoneal dialysis patients (Group 2) (32 males, 19 females; median age: 49 years; range, 39 to 54 years), 52 renal transplant patients (Group 3) (23 males, 29 females; median age: 45.5 years; range, 37 to 52 years), and 50 healthy controls (Group 4) (23 males, 27 females; median age: 46.5 years; range, 42 to 50 years) were included in the study. Age, sex, amount of time spent on dialysis, and laboratory data were recorded. Impact of fibromyalgia on QoL was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), while depressive symptoms and anxiety level were assessed using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. Results: The point prevalence of fibromyalgia was 14% in Group 1 (n=15), 5.9% in Group 2 (n=3), 9.6% in Group 3 (n=5), and 4% in Group 4. There was a significant difference in the point prevalence of fibromyalgia between the hemodialysis group and healthy controls (p<0.05). The median FIQ scores were significantly higher in all patient groups than Group 4 (p<0.001); however, there was no significant difference between the patient groups (p>0.05). The median BDI scores were significantly higher in Group 1 and Group 2 than Group 4 (p<0.05). The median BAI scores were significantly higher in Group 1 than Group 4 (p<0.05). When the patients with and without fibromyalgia were compared, FIQ and BAI in Group 1, BAI in Group 2, and FIQ in Group 3 significantly differed (p<0.05). There was no relationship between fibromyalgia and any of the laboratory data, age, or time spent on dialysis (p>0.05). Conclusion: Fibromyalgia is significantly more common among hemodialysis patients than healthy individuals with a similar prevalence to the healthy individuals for peritoneal dialysis and renal transplant patients. The presence of fibromyalgia is related to depressive symptoms, anxiety, and higher impact on QoL for patients with chronic kidney disease.

scholarly journals Incidence and factors associated Post-transplantation anemia in kidney transplant patients at a tertiary-care hospital in Thailand

2020 ◽  
Vol 47 (3) ◽  
pp. 294-300
Author(s):  
Sayamon Sukkha ◽  
Panupong Tiansuwan ◽  
Kunvadee Choochaeam ◽  
Atiporn Ingsathit ◽  
Punlop Wiwattanathum ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Post Transplantation ◽  
Factors Associated ◽  
Transplant Patients ◽  
Kidney Transplant Patients
Sign in / Sign up

Export Citation Format

Share Document