Reduction in new-onset diabetes mellitus after renal transplant with erythropoietin-stimulating agents: a retrospective cohort study

The objective of this study is to examine the relationship between ESA exposure post-renal transplant and the development of NODAT.DesignWe performed a single center, retrospective cohort analysis.PatientsWe compared patients who received a first live or deceased donor renal allograft, with any exposure to an ESA vs. those without such exposure and who developed NODAT and who did not. Patients with a prior history of diabetes mellitus or multi-organ transplant, including a second renal transplant were excluded.Measurements and methodsNODAT was defined based on the 2008 Canadian Diabetes Association criteria. Multivariate logistic regression analysis was performed to determine factors independently associated with NODAT.ResultsOne hundred thirty-two (29  %) patients were exposed to an ESA, four of which developed NODAT compared to 128 who did not develop NODAT (p 
Source: Canadian Journal of Kidney Health and Disease - Category: Urology & Nephrology Source Type: research

Related Links:

SummaryImmunosuppression (IS) is administered to kidney transplant recipients to prevent rejection episodes and loss of the renal allograft. Most centers rely on a triple IS after induction with either interleukin ‑2 receptor antibodies or antithymocyte globulin. The most frequently used substances for maintenance IS are glucocorticoids, antimetabolites, mTOR inhibitors (mTORi), calcineurin inhibitors (CNI) and the costimulation blocker belatacept. Guidelines recommend a triple combination consisting of CNI s, antimetabolites and corticosteroids for the majority of patients. The long-term risk for malignancy in general i...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: We propose that epigenetics mechanisms involving microRNAs may integrate human transplantation tolerance mechanisms, and regulate key members of the cell death/survival signaling. miR-885-5p could favor cell survival in OT by diminishing the levels of CRADD/RAIDD and CASP3. Nonetheless, given the nature of any complex phenomenon in humans, only cumulative data will help to determine whether this microRNA differential profile may be related to the cause or consequence of operational tolerance. Introduction Despite its clinical success, allotransplantation still faces important challenges, such as preventi...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion As a critical regulator of inflammation and cell survival, the NFκB pathway is a promising target for diagnosing and treating kidney diseases. For modulation of the NFκB pathway in the clinic, a number of molecules can effectively inhibit NFκB signaling by targeting the receptors, associated adaptors, IKKs, IκBs and transcriptional regulators (144). There is further clinical evidence on small-molecule inhibitors of IKKα and NIK from recent trials on anti-cancer therapies (145). These clinical trials showed that the cancer-selective pharmacodynamic response of DTP3, the co-inhibitor...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
In conclusion, the number of donor-specific IL-21 pc is associated with an increased risk of both early and late rejection, giving it the potential to be a new biomarker in kidney transplantation. Introduction Interleukin (IL)-21 is a pro-inflammatory cytokine and is produced by several T lymphocytes, including CD4+, T follicular helper (Tfh) and T-helper 17 (Th17) cells (1, 2). Natural killer T cells (NKT) cells and CD8+ T cells can also produce IL-21 (3–5). IL-21 has a diverse effect on a broad range of immune cells. IL-21 drives T and B cell dependent responses. This pleiotropic cytokine is crucial for T ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsThe tolerance induction protocol with combination therapy of RGI-2001 and anti-CD154 antibody promoted islet allograft acceptance in a mouse diabetic model. This protocol may be clinically applied to islet transplantation for type 1 diabetes mellitus.
Source: Acta Diabetologica - Category: Endocrinology Source Type: research
We examined the clinicopathologic significance of hyalinosis in the vasa recta in the medulla of allograft kidney biopsies.MethodWe analyzed biopsy specimens from January 2010 to December 2015, obtained from both the cortex and medulla (including the vasa recta)  ≥ 1 year after living-donor kidney transplantation. We excluded biopsy specimens from recipients who had undergone transplantation due to diabetic nephropathy or who had diabetes mellitus after transplantation. We evaluated hyaline arteriolopathy in the cortex using the aah score determined by the Banff 2007 classification.ResultAmong 381 bio...
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Abstract OBJECTIVES: Kidney transplant is the optimal therapy for patients with end-stage renal disease. The presence of donor diabetes mellitus is a recognized risk factor for impaired kidney graft survival and is incorporated into the Kidney Donor Profile Index. At present, however, there are limited assessments of the severity of this risk factor. Hemoglobin A1c reflects glycemic control over the preceding 3 months, and we hypothesized that donor hemoglobin A1c levels could confer additional discriminatory power in assessments of deceased donors with diabetes mellitus. MATERIALS AND METHODS: The United Net...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
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 ...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research
This article is protected by copyright. All rights reserved.
Source: Transplant Infectious Disease - Category: Transplant Surgery Authors: Tags: Case Report Source Type: research
Abstract Immunosuppression management in clinical transplantation aims to balance delivery of efficacy against adverse reactions using therapeutic drug monitoring. Adherence to posttransplant immunosuppressive medications and minimizing variability in drug exposure are important considerations in preventing rejection and maximizing overall transplant outcomes. The availability of once-daily tacrolimus may add a potential benefit by simplifying immunosuppressive regimens, though improving compliance among transplant recipients. The aim of our study is to investigate the safety and efficacy of the once-daily formula...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
More News: Bone Graft | Canada Health | Diabetes | Diabetes Mellitus | Endocrinology | Kidney Transplant | Kidney Transplantation | Pancreas | Study | Sugar | Transplant Surgery | Transplants | Urology & Nephrology