scholarly journals Long-Term Projections of Patients Undertaking Renal Replacement Therapy Under the Universal Coverage Scheme in Thailand

2020 ◽  
Vol Volume 13 ◽  
pp. 27-34 ◽  
Author(s):  
Noppakun Thammatacharee ◽  
Rapeepong Suphanchaimat
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Universal Coverage ◽  
Universal Coverage Scheme

scholarly journals Long-Term Outcome After Renal Replacement Therapy in Severe Burns

2020 ◽  
Vol 41 (4) ◽  
pp. 866-870
Author(s):  
Ilmari Rakkolainen ◽  
Kukka-Maaria Mustonen ◽  
Jyrki Vuola
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Burn Injury ◽  
Kidney Injury ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Discharged Patients

Abstract Acute kidney injury is a common sequela after major burn injury, but only a small proportion of patients need renal replacement therapy. In the majority of patients, need for renal replacement therapy subsides before discharge from the burn center but limited literature exists on long-term outcomes. A few studies report an increased risk for chronic renal failure after burn injury. We investigated the long-term outcome of severely burned patients receiving renal replacement therapy during acute burn injury treatment. Data on 68 severely burned patients who received renal replacement therapy in Helsinki Burn Centre between November 1988 and December 2015 were collected retrospectively. Thirty-two patients survived and remained for follow-up after the primary hospital stay until December 31, 2016. About 56.3% of discharged patients were alive at the end of follow-up. In 81.3% of discharged patients, need for renal replacement therapy subsided before discharge. Two patients received renal replacement therapy for longer than 3 months; however, need for renal replacement therapy subsided in both patients. One patient required dialysis several years later on after the need for renal replacement therapy had subsided. This study showed that long-term need for renal replacement therapy is rare after severe burn injury. In the vast majority of patients, need for renal replacement therapy subsided before discharge from primary care. Acute kidney injury in association with burns is a potential but small risk factor for later worsening of kidney function in fragile individuals.

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.

scholarly journals Long-term outcome on renal replacement therapy in patients who previously received a keto acid–supplemented very-low-protein diet

2009 ◽  
Vol 90 (4) ◽  
pp. 969-974 ◽  
Author(s):  
Philippe Chauveau ◽  
Lionel Couzi ◽  
Benoit Vendrely ◽  
Valérie de Précigout ◽  
Christian Combe ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Keto Acid ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Low Protein ◽  
Very Low Protein Diet

Long-Term Survival on Renal Replacement Therapy for Primary Hyperoxaluria Type I

Nephron ◽  
1993 ◽  
Vol 63 (2) ◽  
pp. 217-221 ◽  
Author(s):  
P. Calzavara ◽  
M. Marangelld ◽  
M. Petrarulo ◽  
P. Ballanti ◽  
E. Bonucci ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Primary Hyperoxaluria ◽  
Type I ◽  
Term Survival ◽  
Primary Hyperoxaluria Type ◽  
Hyperoxaluria Type I ◽  
Primary Hyperoxaluria Type I ◽  
Hyperoxaluria Type

scholarly journals The changing patterns of access overtime to the renal replacement therapy programme in Thailand

2019 ◽  
Author(s):  
Noppakun Thammatacharee ◽  
Anne Mills ◽  
Dorothea Nitsch ◽  
Adisorn Lumpaopong
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Transplant ◽  
Cohort Analysis ◽  
Universal Coverage ◽  
Programme Implementation ◽  
Health Security ◽  
Middle Income ◽  
Number Of Patients ◽  
Over Time

Abstract Based on projected numbers, approximately only 50% of those requiring renal replacement therapy (RRT) receive it. Many patients who require RRT live in low- and middle-income countries. The objective of this study was to examine the changing pattern over time of entry into the RRT programme in Thailand following RRT’s inclusion in the Universal Coverage Scheme. This study was an ecological study using the age-period-cohort analysis to look at dialysis registration and kidney transplant trends during RRT programme implementation. Data from 2008 to 2016 of patients diagnosed with end-stage renal disease (ESRD) were obtained from the National Health Security Office. The study found that the numbers of new patients with ESRD, aged 20–69, registered with the dialysis programme increased over time. For patients aged 20–40 years, the dialysis programme took up to 400 new patients for every 1000 new ESRD diagnoses. For kidney transplant, the rates increased slowly. The kidney transplant programme could at best treat only around 50 cases for every 1000 new ESRD diagnoses in patients aged 20–30 years. Findings of this study highlighted the importance of promoting strategies to reduce the increasing number of patients with kidney disease, to consider conservative therapy for older/frail patients, and to improve access to kidney transplantation and live-donation.

scholarly journals Urgent-Start Peritoneal Dialysis as a Bridge to Definitive Chronic Renal Replacement Therapy: Short- and Long-Term Outcomes

2019 ◽  
Vol 9 ◽  
Author(s):  
Ewa Wojtaszek ◽  
Agnieszka Grzejszczak ◽  
Katarzyna Grygiel ◽  
Jolanta Małyszko ◽  
Joanna Matuszkiewicz-Rowińska
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Long Term Outcomes ◽  
Short And Long Term
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