Urologic Evaluation and Management of Pediatric Kidney Transplant Patients

Urologic causes of end-stage renal disease are estimated between 25% and 40% of causes. The goal of renal transplantation in chronic kidney disease patients is to provide renal replacement therapy with less morbidity, better quality of life, and improved overall survival compared with dialysis. A patient ’s urologic history can be a significant source of problems related to infections, recurrence of disease, and surgical complications. Many of the urologic risks are modifiable. Proper evaluation and management can mitigate the potential problems after transplantation, and these patients with compl ex urologic problems are seen to have similar graft function outcomes.
Source: Urologic Clinics of North America - Category: Urology & Nephrology Authors: Source Type: research

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Abstract BACKGROUND: Diabetes is the commonest cause of chronic kidney disease (CKD). Both conditions commonly co-exist. Glucometabolic changes and concurrent dialysis in diabetes and CKD make glucose-lowering challenging, increasing the risk of hypoglycaemia. Glucose-lowering agents have been mainly studied in people with near-normal kidney function. It is important to characterise existing knowledge of glucose-lowering agents in CKD to guide treatment. OBJECTIVES: To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose levels in people with diabetes and CKD...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
ConclusionsPredialysis cognitive impairment is associated with a lower likelihood of PD as a first dialysis modality and of venous catheter avoidance at dialysis therapy initiation. Future studies may consider addressing cognitive function when testing strategies to improve patient transitions to dialysis therapy.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Infection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy and in those with a kidney transplant. Since the publication of the original Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2008, major advances in HCV management, particularly with the advent of direct-acting antiviral therapies, have now made the cure of HCV possible in CKD patients. In addition, diagnostic techniques have evolved to enable the noninvasive diagnosis of liver fibrosis.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Guideline Summary Source Type: research
This study aimed to evaluate plasma concentrations of leptin and total ghrelin in children with chronic kidney disease (CKD) and assess their roles in protein-energy wasting (PEW).MethodsThis study consisted of three different CKD populations [CKD group (20 patients with non-dialysis CKD), dialysis group (39 patients on dialysis), and kidney transplant (KTx) group (35 KTx recipients)] and control group (18 healthy children). Plasma leptin and total ghrelin levels were measured. Multi-frequency bioimpedance analysis was used for the assessment of fat and lean mass. PEW was defined using criteria including body mass, muscle ...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
(Oxford University Press USA) A new study in Nephrology Dialysis Transplantation indicates that consuming more caffeine may help reduce the risk of death for people with chronic kidney disease.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
ConclusionsIn this cohort of children with CKD, higher parental health literacy was associated with a nearly 30% longer time to the composite CKD progression outcome.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Renal transplantation remains the treatment of choice for end stage renal disease, offering vastly improved survival and morbidity compared to chronic dialysis treatment. Peripheral arterial disease is much more common in patients with chronic kidney disease compared to the general population. Unrecognized peripheral artery disease, particularly aortoiliac disease, prior to kidney transplantation can result in significant complications including renal artery stenosis, anastomosis failure, graft loss, and even limb loss.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Abstracts Presented to the Florida Vascular Society Source Type: research
In what ways might serum magnesium levels impact the risk for all-cause mortality among patients with chronic kidney disease?Nephrology Dialysis Transplantation
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Nephrology Journal Article Source Type: news
CONCLUSIONS: In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to place...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Over the past decade, implantable left ventricular assist devices (LVAD) have become an acceptable alternative to support patients with advanced heart failure, either as a bridge to transplantation or as destination therapy for patients who are not candidates for heart transplantation. As the number of LVAD implantation increases, greater number of LVAD recipients requiring long term renal replacement therapy (RRT), usually chronic hemodialysis (HD), will be seen. This is due to common simultaneous chronic kidney disease in patients with heart failure, but more frequently due to irreversible acute kidney injury occurring i...
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 236 Source Type: research
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