scholarly journals Impact of the Post-Transplant Period and Lifestyle Diseases on Human Gut Microbiota in Kidney Graft Recipients

2020 ◽  
Vol 8 (11) ◽  
pp. 1724
Author(s):  
Nessrine Souai ◽  
Oumaima Zidi ◽  
Amor Mosbah ◽  
Imen Kosai ◽  
Jameleddine El Manaa ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Gut Microbiota ◽  
Kidney Transplant ◽  
Molecular Techniques ◽  
Time Shift ◽  
Kidney Graft ◽  
Healthy Controls ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Lifestyle Diseases

Gaining long-term graft function and patient life quality remain critical challenges following kidney transplantation. Advances in immunology, gnotobiotics, and culture-independent molecular techniques have provided growing insights into the complex relationship of the microbiome and the host. However, little is known about the over time-shift of the gut microbiota in the context of kidney transplantation and its impact on both graft and health stability. Here we aimed to characterize the structure of gut microbiota within stable kidney graft recipients. We enrolled forty kidney transplant patients after at least three months of transplantation and compared them to eighteen healthy controls. The overall microbial community structure of the kidney transplanted group was clearly different from control subjects. We found lower relative abundances of Actinobacteria, Bacteroidetes, and Verrucomicrobia within the patient group and a higher abundance of Proteobacteria compared to the control group. Both richness and Shannon diversity indexes were significantly lower in the kidney graft recipients than in healthy controls. Post-graft period was positively correlated with the relative abundance of the Proteobacteria phylum, especially Escherichia.Shigella genus. Interestingly, only Parabacteroides was found to significantly differentiate patients that were not suffering from lifestyle diseases and those who suffer from post-graft complications. Furthermore, network analysis showed that the occurrence of lifestyle diseases was significantly linked with a higher number of negative interactions of Sutterella and Succinivibrio genera within patients. This study characterizes gut microbiome fluctuation in stable kidney transplant patients after a long post-allograft period. Analysis of fecal microbiota could be useful for nephrologists as a new clinical tool that can improve kidney allograft monitoring and outcomes.

Evaluation of Quality of Life among Kidney Transplant Patients- A Cross Sectional Study

2021 ◽  
Vol 15 (11) ◽  
pp. 3087-3089
Author(s):  
Rashida Jabeen ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Sadia Khan
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Kidney transplantation is the famous and most important choice of treatment of renal replacement therapies (RRTs) because of its positive impact on morbidity, survival and cost. The health related quality of life is becoming important outcome. Quality of life is usually impaired in patients who have renal transplant because of renal transplant patients have anxiety, lack of social, physical and emotional support and diminished ability to take care of themselves. The basic purpose of renal transplantation is to achieve maximum quality of life with minimum side effects. Methods: A cross sectional study was conducted at Rukhsana Akhtar Bahria International Orchard Hospital Lahore after approval from institution board of university of Lahore. 36 patients were enrolled in study by using purposive sampling technique. After taking informed consent all Kidney transplant patients aged between 18 years to 60 years, visited the post-transplantation OPD and continuously in follow-up sessions were included in study. A validated and standard WHO questionnaire of “Kidney Disease and Quality of Life (KDQOL-36™)” was used for data collection. Data was entered and analyzed in SPSS version.21.Chi-square test was applied to find out significant association between qualitative variables. P -Value < 0.05will be considered as statistically significant. Results: Majority of patients were from 40-49 years 10(27.0%). Females were more as compared to men (20(55.6) vs 16(44.4%)). 10(27.8) patients can read and write and 8(22.2%) have done matriculation. More patients live in Urban area as compared to rural area(19(52.8%) vs 17(47.2%)).8(22.2%) patients have less than 1 year of post kidney transplantation time and 19(52.8%) have 1 to 3 years. All the seven domains of KDQOL show poor QOL. General Health, Physical function and physical and emotional function shows average QOL and Emotional, social, daily activities and overall KDQOL shows poor QOL. There was insignificant association with age, gender, education; residential area and Post kidney transplantation length of time (years)(p-value > 0.05). Conclusions: After renal transplantation HRQOL becomes very important factor. After kidney transplantation HRQOL depends on many factors. It was concluded from current study that the HRQOL was not as good as it should be. Over the period of transplantation time patient’s quality of life remain same. The society, government, family, and medical staff need to support patients so they can also improve their QOL. Key word: Renal Diseases, Kidney transplant, Quality of life, KDQOL-36

scholarly journals Nursing Care for Kidney Transplant Patients: A Scoping Review

Aquichan ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 1-15
Author(s):  
Cintia Capistrano Teixeira Rocha ◽  
Alcides Viana da Lima Neto ◽  
Ana Beatriz Pereira da Silva ◽  
Victor Alexandre Silva Farias ◽  
Aurean D’Eça Junior ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Nursing Care ◽  
Scoping Review ◽  
Scientific Rigor ◽  
Transplant Patients ◽  
Primary Health ◽  
Study Results ◽  
Kidney Transplant Patients ◽  
Selection Of

Objectives: Mapping nursing care in kidney transplant patients. Materials and method: A scoping review was conducted according to the recommendations of the Joanna Briggs Institute Reviewers’ Manual. Data were collected through 13 national and international databases from December 2020 to January 2021, following scientific rigor in the selection of the material. The pre-selection was made by reading the title, abstract and introductory text in advance; the materials included in this stage were read in full to define the content for the study. Results: Fifteen studies were included. Of these, 60% are articles; dissertations, manuals, protocols, guidelines and bulletins totaled 40% of the material studied. 86.6% of the material has a quantitative approach. Regarding the methodological design, 73.3% were descriptive/transversal character studies. Regarding the mapping of nursing care, it was possible to divide them into two categories: nursing care after kidney transplantation (immediate, mediated and late) and nursing care after kidney transplantation in primary health/extra-hospital care. Conclusions: It is concluded that the study allowed mapping nursing care to kidney transplant patients in the immediate, late and primary health care periods.

scholarly journals Pretransplant dialysis treatment and vascular calcification of the iliac artery and abdominal aorta in kidney transplant patients

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kentaro Nakai ◽  
Shutaro Yamamoto ◽  
Megumi Inoue ◽  
Chiaki Kohara ◽  
Tomoya Shukuri ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Vascular Calcification ◽  
Treatment Modality ◽  
Rapid Progression ◽  
Dialysis Modality ◽  
Dialysis Treatment ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Abstract Introduction Patients with chronic kidney disease often suffer from cardiovascular disease, and vascular calcification has been identified as one of the risk factors for cardiovascular disease. We aimed to examine the effect of dialysis treatment before kidney transplantation on graft survival, vascular calcification, and its progression after kidney transplantation. Methods Among the 102 patients who underwent kidney transplant between 2008 and 2017, two patients were excluded for moved and lost to follow-up and primary nonfunction. The clinical characteristics and laboratory data were assessed according to pretransplant treatment modality. Rapid progression of vascular calcification was defined when patients showed an increase in the highest tertile of progression of each iliac artery calcification thickness (IACT) and aortic calcification index (ACI). Results Cox proportional hazard models did not show any significant association between pretransplant treatment modality and graft survival to the doubling of creatinine from nadir creatinine during the first 3 months after kidney transplantation. At baseline, the IACT was significantly higher in hemodialysis patients than in preemptive kidney transplant patients, whereas the ACI was comparable among the pretransplant treatment modality groups. IACT was independently associated with dialysis vintage. There was no significant association between rapid progression of vascular calcification (IACT and ACI) and dialysis modality. Conclusions Dialysis modality was an independent factor related to IACT, whereas there was no legacy effect for the progression of vascular calcification after kidney transplantation.

scholarly journals Direct-acting Antivirals in Kidney Transplant Patients: Successful Hepatitis C Treatment and Short Term Reduction in Urinary Protein/Creatinine Ratios

2017 ◽  
Vol 2 (3) ◽  
pp. 366 ◽  
Author(s):  
Michael R. Goetsch ◽  
Ashutosh Tamhane ◽  
Mohit Varshney ◽  
Anuj Kapil ◽  
Edgar T. Overton ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Post Treatment ◽  
Kidney Graft ◽  
Direct Acting Antivirals ◽  
Short Term ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Pre Treatment ◽  
Direct Acting

Introduction: The role of Hepatitis C Virus (HCV) clearance in long-term kidney graft survival is unknown. In this study, we examined short-term trends of urinary protein/creatinine (P/C) ratios in a cohort of HCV-infected kidney transplant recipients with stable graft function and treated with direct-acting antivirals (DAAs).Methods: We conducted a retrospective study of 19 kidney transplant patients with chronic HCV infection treated with DAAs at the University of Alabama at Birmingham 1917 Viral Hepatitis Clinic between January 2013 and June 2016. Markers of glomerular damage were assessed using average protein/creatinine (P/C) ratios measured pre- and post-treatment. We also described treatment efficacy using sustained virologic response at 12 weeks post-HCV treatment (SVR12).Results: The median age of the 19 patients included was 59 years (Q1=58, Q3=64) at completion of treatment. Of these patients, 68% were African American, 32% were White and 63% were male. The median time between kidney transplant and initiation of DAA therapy was 2.25 years (Q1=0.79, Q3=3.79). Post-treatment P/C ratios (median=0.127, Q1=0.090, Q3=0.220) were significantly lower (p=0.01) than pre-treatment ratios (median=0.168, Q1=0.118, Q3=0.385). P/C ratios decreased in 14 of 19 patients (74%) with median change of -0.072 (median percent change= -40%). Post-treatment eGFRs (median=58.9, Q1=48.9, Q3=72.3) were not significantly different (p=0.82) than the pre-treatment values (median=57.0, Q1=48.8, Q3=67.8).Conclusions: In this preliminary study, there was a statistically significant decrease in P/C ratios associated with HCV clearance, suggesting a potential role for DAAs in improving kidney graft survival. Larger cohort studies will be needed to assess the clinical and long-term benefits of DAAs in this special population of HCV infected patients. 

scholarly journals Autoantibodies Against Ro/SS-A, CENP-B, and La/SS-B are Increased in Patients with Kidney Allograft Antibody-Mediated Rejection

2020 ◽  
Author(s):  
Sergi Clotet-Freixas ◽  
Max Kotlyar ◽  
Caitriona M. McEvoy ◽  
Chiara Pastrello ◽  
Sonia Rodríguez-Ramírez ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Hla Antigens ◽  
Kidney Graft ◽  
Hla Antibodies ◽  
Antibody Mediated Rejection ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Donor Specific Antibodies ◽  
Cellular Rejection ◽  
Independent Cohort

ABSTRACTAntibody-mediated rejection (AMR) causes >50% of late kidney graft losses. Although donor-specific antibodies (DSA) against HLA cause AMR, antibodies against non-HLA antigens are also linked to rejection. Identifying key non-HLA antibodies will improve our understanding of antibody-mediated injury.We analyzed non-HLA antibodies using protein microarrays in sera from 91 kidney transplant patients with AMR, mixed rejection, acute cellular rejection (ACR), or acute tubular necrosis (ATN). IgM and IgG antibodies against 134 non-HLA antigens were measured pre-transplant, at the time of biopsy-proven diagnosis, and post-diagnosis. Findings were validated in 60 kidney transplant patients from an independent cohort.Seventeen non-HLA antibodies were significantly increased (p<0.05) in AMR and mixed rejection compared to ACR or ATN pre-transplant, nine at diagnosis and six post-diagnosis. AMR and mixed cases showed significantly increased pre-transplant levels of IgG anti-Ro/SS-A and anti-CENP-B, compared to ACR. Together with IgM anti-CENP-B and anti-La/SS-B, these antibodies were also significantly increased in AMR/mixed rejection at diagnosis. Increased IgG anti-Ro/SS-A and anti-CENP-B pre-transplant and at diagnosis, and IgM anti-La/SS-B at diagnosis, were associated with the presence of microvascular lesions, but not with tubulitis or interstitial/total inflammation. All three antibodies were associated with the presence of class-II DSA (p<0.05). Significantly increased IgG anti-Ro/SS-A in AMR/mixed compared to ACR (p=0.01), and numerically increased IgM anti-CENP-B (p=0.05) and anti-La/SS-B (p=0.06), were validated in the independent cohort.This is the first study that implicates autoantibodies against Ro/SS-A and CENP-B in AMR. These non-HLA antibodies may participate in the crosstalk between autoimmunity and alloimmunity in kidney AMR.SIGNIFICANCE STATEMENTAntibody-mediated rejection (AMR) causes >50% of kidney graft losses. Although donor-specific antibodies against HLA cause AMR, antibodies against non-HLA antigens are also linked to rejection. Serum samples of 91 kidney transplant patients were analyzed using protein arrays against 134 non-HLA antigens. AMR and mixed rejection cases showed significantly increased pre-transplant levels of IgG anti-Ro/SS-A and anti-CENP-B, compared to acute cellular rejection. Together with IgM anti-CENP-B and anti-La/SS-B, these antibodies were significantly increased in AMR/mixed rejection at diagnosis and were validated in a second, independent cohort. Increased IgG anti-Ro/SS-A, IgG anti-CENP-B and IgM anti-La/SS-B were associated with the presence of microvascular lesions and anti-HLA class-II antibodies. This is the first study to implicate anti-Ro/SS-A, anti-La/SS-B and anti-CENP-B autoantibodies in AMR.

Use of Nurse Practitioners in Pediatric Kidney Transplant: A Model for Providing Comprehensive Care to Children and Families

2011 ◽  
Vol 21 (4) ◽  
pp. 306-311
Author(s):  
Jessica Brennan ◽  
Marilyn McEnhill
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Comprehensive Care ◽  
Pediatric Nurse ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Pediatric Nurse Practitioners

It is well documented that kidney transplantation is the treatment of choice for children with end-stage renal disease. Pediatric kidney transplant patients are a complex population because of their need for lifelong immunosuppression, potential for delayed growth and development, and increased risk of heart disease and cancer. Although many large pediatric kidney transplant programs use nurse practitioners, the role of the nurse practitioner is still emerging in relation to the transplant coordinator role. This article describes the practice of pediatric nurse practitioners caring for children who require a kidney transplant and why nurse practitioners are ideal for providing comprehensive care to this population. Transplant programs are regulated by the United Network for Organ Sharing and the Centers for Medicare and Medicaid Services. Both organizations require transplant programs to designate a transplant coordinator with the primary responsibility of coordinating clinical aspects of transplant care. Incorporating transplant coordinator activities into the role of the pediatric nurse practitioner is discussed as a model for providing care throughout the process of kidney transplantation. Transplant pediatric nurse practitioners are in a unique position to expand the care for pediatric kidney transplant patients by assuming the role of clinician, educator, administrator, and coordinator.

scholarly journals Impact of Timely Public Health Measures on Kidney Transplantation in Austria during the SARS-CoV-2 Outbreak—A Nationwide Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3465
Author(s):  
Bruno Watschinger ◽  
Clara Watschinger ◽  
Roman Reindl-Schwaighofer ◽  
Elias L. Meyer ◽  
Andras T. Deak ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Case Fatality ◽  
Organizational Structures ◽  
Kidney Transplant Recipients ◽  
Healthcare Facilities ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
The Government ◽  
Considerable Morbidity

SARS-CoV-2 led to considerable morbidity/mortality worldwide and tremendously impacted on daily life. Strict lockdown measures were implemented early to contain the viral outbreak in Austria. Massive changes in organizational structures of healthcare facilities followed with unclear implications on the care of non-COVID-19-affected patients. We studied the nationwide impact of COVID-19 on kidney transplantation in Austria during the first six months of 2020. Concurrent with general lockdown measures, all kidney transplant activity was suspended from 13 March to 9 April. Nevertheless, between January and June, total transplant (p = 0.48) and procured donor organ numbers (p = 0.6) did not differ significantly from earlier years. Ten (0.18%) of 5512 prevalent Austrian kidney transplant recipients were diagnosed with SARS-CoV-2. The case fatality rate (one death; 10%) in renal transplant patients was less than in other countries but higher than in Austria’s general population (2.4%). We conclude that early and strict general lockdown measures imposed by the government allowed an early, however cautious, re-opening of Austrian transplant programs and played a crucial role for the favorable outcomes of SARS-CoV-2 in Austrian kidney transplant patients. Even though it may be uncertain whether similar results may be obtainable in other countries, the findings may support early intervention strategies during similar episodes in the future.

scholarly journals Grupo de orientação multiprofissional para pacientes transplantados renais e familiares

2021 ◽  
Vol 11 (34) ◽  
pp. 296-306
Author(s):  
Beatriz Pinheiro da Mota Costa ◽  
Alessandra Rosa Vicari ◽  
Carla Elisabete da Silva Oliveira ◽  
Fernanda Guarilha Boni ◽  
Isabel Cristina Echer
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Personal Growth ◽  
Family Members ◽  
Structured Interview ◽  
University Hospital ◽  
Transplant Patients ◽  
Group I ◽  
Kidney Transplant Patients ◽  
The Impact

Conhecer a percepção de pacientes e familiares acerca do grupo de orientação multiprofissional para transplantados renais. Método: trata-se de um estudo qualitativo realizado em hospital universitário do sul do Brasil nos meses de fevereiro a maio do ano de 2019. As informações foram coletadas pelos pesquisadores por meio de entrevista estruturada com os participantes do grupo de orientação multiprofissional. Foi realizada a técnica de análise de conteúdo. Resultados: participaram 15 pacientes transplantados renais e quatro familiares. A análise dos depoimentos resultou em três categorias: “Motivação para participar do grupo”, “Sou transplantado renal, e agora?” e “Compreendendo as orientações: o impacto no autocuidado”. As orientações em grupo foram consideradas objetivas, claras e relevantes para a recuperação. Considerações finais: participar do grupo possibilitou estreitamento de laços familiares/profissionais, crescimento pessoal, maior conhecimento sobre o transplante renal, mudança de comportamento e comprometimento com o autocuidado.Descritores: Enfermagem, Transplante de Rim, Equipe de Assistência ao Paciente, Educação em Saúde. Multiprofessional guidance group for kidney and family transplant patientsAbstract: To know the perception of patients and family members about the multiprofessional guidance group for kidney transplant patients. Method: this is a qualitative study carried out at a university hospital in southern Brazil from February to May of 2019. The information was collected by the researchers through a structured interview with the participants of the multiprofessional guidance group. The content analysis technique was performed. Results: 15 kidney transplant patients and four family members participated. The analysis of the testimonies resulted in three categories: “Motivation to participate in the group”, “I am a kidney transplanted, what now?” and “Understanding the guidelines: the impact on self-care”. The group guidelines were considered objective, clear and relevant to recovery. Final considerations: to participate in the group allowed for closer family/professional ties, personal growth, greater knowledge about kidney transplantation, behavior change and commitment to self-care.Descriptors: Nursing, Kidney Transplantation, Patient Care Team, Health Education. Grupo de orientación multiprofesional para pacientes con trasplante renal y familiarResumen: Conocer la percepción de los pacientes y familiares sobre el grupo de orientación multiprofesional para pacientes con trasplante renal. Método: es un estudio cualitativo realizado en un hospital universitario del sur de Brasil de febrero a mayo de 2019. La información fue recolectada por los investigadores mediante una entrevista estructurada con los participantes del grupo de orientación multiprofesional. Se realizó la técnica de análisis de contenido. Resultados: participaron 15 pacientes con trasplante renal y cuatro familiares. El análisis de los testimonios resultó en tres categorías: “Motivación para participar en el grupo”, “Soy un trasplante de riñón, ¿ahora qué?” y “Comprender las pautas: el impacto en el autocuidado”. Las pautas del grupo se consideraron objetivas, claras y relevantes para la recuperación. Consideraciones finales: participar en el grupo permitió estrechar lazos familiares/profesionales, crecimiento personal, mayor conocimiento sobre trasplante de riñón, cambio de comportamiento y compromiso con el autocuidado.Descriptores: Enfermería, Trasplante de Riñón, Grupo de Atención al Paciente, Educación en Salud.

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