Donation, Not Disease! A Multiple-Hit Hypothesis on Development of Post-Donation Kidney Disease

AbstractPurpose of ReviewThe risks following living kidney donation has been the subject of rigorous investigation in the past several decades. How to utilize the burgeoning new knowledge base to better the risk assessment, education, and health maintenance of donors is unclear. We review the physiologic and epidemiologic evidences on the post-donation state and submit a multiple-hit hypothesis to reconcile the finite elevation in risk of kidney disease after donation with the benign course of most kidney donors.Recent FindingsThe risk of end-stage kidney disease is higher in kidney donors compared to similarly healthy non-kidney donors. Nonetheless, post-donation kidney disease is uncommon and arises mostly in the setting of other “hits”—either a “first hit” present at birth or a “second hit” acquired later in life.SummaryThe transplant community ’s focus should be directed toward (1) personalized risk assessment to inform consent before donation and (2) preventing and treating development of “second hits” following kidney donation.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

Related Links:

Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Tiffany Wong, Simin GoralLupus nephritis (LN) is the cause of end-stage kidney disease (ESKD) for 1.9% of the ESKD population in the United States. Although the incidence rates of ESKD from LN stopped rising in recent years, racial disparities in waiting time, pre-emptive kidney transplant, and transplant outcomes still exist. Patients with LN who progress to ESKD tend to be female, of African ancestry, and young. Kidney transplantation is safe in this population and associated with a substantial survival benefit, prima...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Conclusions: The present study seeks to provide new insight in the pathophysiological mechanisms linking reduced kidney function to cardiovascular disease. In addition, we aim to enlighten predictors of adverse cardiovascular outcome in living kidney donors. The study is registered at Clinical-Trials.gov (identifier: NCT03729557). PMID: 31718316 [PubMed - as supplied by publisher]
Source: Blood Pressure - Category: Hematology Tags: Blood Press Source Type: research
This article provides an overview of current findings published in the recent five years regarding the relationship between tacrolimus exposure and variation therein and the development of dnDSA.Expert opinion: In this review we describe how combining data on tacrolimus intra-patient variability and mean pre-dose concentration may be an effective tool to identify kidney transplant recipients who are at higher risk of developing dnDSA. PMID: 31721605 [PubMed - as supplied by publisher]
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research
Donate Life America is now in partnership with a large dialysis corporation to expand living donor resources for waiting recipients on the kidney transplant list.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Nephrology News Source Type: news
We report a high vertebral fracture prevalence and incidence in transplantation-eligible patients on dialysis, suggesting that these patients may benefit from radiographic screening for vertebral fractures. Parathyroid hormone had a U-shaped association with vertebral fracture risk.IntroductionVertebral fractures are often overlooked, but even undiagnosed vertebral fractures negatively impact physical functioning, quality of life, and mortality. The risk of vertebral fractures in end-stage renal disease (ESRD) patients is unclear, and parathyroid hormone (PTH) might play a role in the development of vertebral fractures. We...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Surgeons at the Cleveland Clinic managed to implant a donor kidney into a patient using a surgical robot, and all through one small incision. The technique, in which instruments as well as the donor kidney can be passed through a four centimeter (1.6...
Source: Medgadget - Category: Medical Devices Authors: Tags: Surgery Urology Source Type: blogs
ConclusionsMarked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors. These findings warrant further validation with more robust data to better inform clinical practice guidelines.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
We report on the prespecified secondary outcome, echocardiographic indexes of LV function, from a previously reported study of the effect of lung ultrasound (US)-guided dry weight reduction on systolic blood pressure.Study DesignSingle-blind randomized trial.Settings &Participants71 clinically euvolemic hypertensive hemodialysis patients in Greece and Slovenia.InterventionThe active intervention group’s (n = 35) volume removal was guided by the total number of lung US B-lines observed every week before a midweek dialysis session. The usual-care group (n = 36) was treated using standard-of-care...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome o...
Source: BMC Nephrology - Category: Urology & Nephrology Authors: Tags: Research article Source Type: research
No abstract available
Source: Annals of Surgery - Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research
More News: Education | Epidemiology | Kidney Transplant | Kidney Transplantation | Transplant Surgery | Transplants | Universities & Medical Training | Urology & Nephrology