Pre-Transplant Weight Loss and Survival after Kidney Transplantation
We examined post-transplant survival among obese kidney candidates who were temporarily designated waitlist inactive (status 7) due to their weight. Methods: Using OPTN/United Network for Organ Sharing data, patient and graft survival of adult status 7 recipients with a registration body mass index (BMI) ≥30 kg/m2 (n = 328) were compared to all others (controls; n = 74,066). Status 7 recipients were then matched to controls to assess whether pre-transplant weight loss was associated with a survival benefit. Results: Median BMI at registration (38 vs. 27 kg/m2, p
CONCLUSIONS: In adult kidney transplant patients, a structured physical exercise program improved the aerobic capacity and ameliorated muscle performance and quality of life. No harms were observed in the short-term, but long-term RCTs are required. Overall, in mid-age kidney transplant patients without major comorbidities, an aerobic or resistance supervised exercise lasting 3-6 months could be suggested within the comprehensive treatment of kidney transplant. PMID: 30649716 [PubMed - as supplied by publisher]
Conclusion: A high rate of patients not adherent to the immunosuppressive treatment was identified (41.4%). There was no significant correlation between creatinine level and receptor age at time of KTP, time after KTP, immunosuppressive separation time and total score and scores of individual BAASIS® items. T his study showed that black, male recipients without a family support network, obese and autonomous are more likely not to adhere to immunosuppressive therapy. The evaluation of renal transplant recipient adhesion should be considered during all phases of the nursing process actions that make up the therapeutic pl...
Conclusions Dietary modifications through decreasing fructose intake and addressing systemic endotoxemia are plausible targets for improving metabolic health of KTRs.
Conclusion: Although TRVT is induced by multiple factors, an accurate diagnosis is often difficult. Understanding these factors, including obesity, and considering TRVT as a cause of allograft dysfunction are important during the pre-, peri-, and postoperative periods. Knowledge of TRVT can lead to early and accurate diagnosis and intervention, resulting in better outcomes for the patients with allograft dysfunction. PMID: 30538528 [PubMed]
ConclusionsAlthough bariatric surgery in the transplant population is not yet extensively studied and is mostly reported in small series, it seems a useful approach for the treatment of morbid obesity in these high-risk patients. Comparative data regarding optimal timing and type of bariatric procedure and long-term results are warranted.
Conclusions: The findings from this descriptive analysis suggest a paradoxical association between obesity and better survival. However, they also suggest that the shape of the BMI trajectory is important, with stable BMI trajectories being beneficial. Future research should be aimed at understanding the causes of weight changes during dialysis, to determine whether there could be strategies to improve patient survival.
Purpose of review The leading cause of death in both chronic kidney disease (CKD) and renal transplant patients is cardiovascular events. Post-transplant diabetes mellitus (PTx-DM), which is a major cardiovascular risk factor, is a metabolic disorder that affects 5.5–60.2% of renal allograft recipients by 1-year posttransplant (PTx). PTx-DM has been associated with a negative impact on patient and graft outcomes and survival. Recent findings Individuals who develop PTx-DM are usually prone to this condition prior to and/or after developing CKD. Genetic factors, obesity, inflammation, medications and CKD all are ...
Abstract Cardiovascular disease (CVD) remains one of the primary causes of death after kidney transplantation (KTX). Cyclosporine (CsA) metabolites may play a role in CVD. Metabolic ratio (MR) may be considered a measure of intra-individual differences of CsA metabolism. The study was aimed at analysis of associations of CVD with indices of CsA metabolism: MRs and dose-adjusted CsA concentrations (C/D and C/D/kg). The study was performed in the Department of Immunology, Transplant Medicine, and Internal Diseases of the Medical University of Warsaw and involved 102 KTX recipients. Whole blood concentrations of cycl...
Conclusions: This the first report of a patient with PHP-1A undergoing kidney transplantation. Normalization of biochemical parameters after the procedure demonstrates that renal tubular resistance to PTH is sufficient to explain the calcium/phosphate abnormalities observed in PHP-1A. PMID: 30418563 [PubMed - as supplied by publisher]
As the epidemics of obesity and type 2 diabetes mellitus increase worldwide, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing proportionately. The subtype of NAFLD which can be characterized as non-alcoholic steatohepatitis (NASH) is a potentially progressive liver disease that can lead to cirrhosis, hepatocellular carcinoma, liver transplantation, and death; it is associated with extrahepatic manifestations such as chronic kidney disease cardiovascular disease and sleep apnea.