Functional immune assay using interferon-gamma could predict infectious events in end-stage kidney disease
Publication date: Available online 30 November 2019Source: Clinica Chimica ActaAuthor(s): S. Boyer-Suavet, M. Cremoni, T. Dupeyrat, K. Zorzi, V. Brglez, S. Benzaken, V. Esnault, B. Seitz-PolskiAbstractBackgroundInfections remain the second most common cause of death in patients with end-stage kidney disease (ESKD). We aimed to evaluate non-specific cell-mediated immunity in an ESKD cohort using a functional assay applicable to routine use, QuantiFERON-Monitor (Qiagen), and assess whether it can predict infectious events.MethodsIn this prospective study, we performed the QuantiFERON-Monitor test in 80 subjects including 54 patients with ESKD. QuantiFERON-Monitor is based on the measurement of plasma interferon-gamma (IFN-γ) after stimulation of NK-cells with a TLR-7 agonist, and T-cells with a TCR agonist. Patients were subsequently followed for 6 to 12 months.ResultsQuantiFERON-Monitor showed lower stimulated IFN-γ production in ESKD patients (n=54) compared to healthy donors (n=19) (p
CONCLUSIONS: Overall, it is likely that oral protein-based nutritional supplements increase both mean change in serum albumin and serum albumin at end of intervention and may improve serum prealbumin and mid-arm muscle circumference. The improvement in serum albumin was more evident in haemodialysis and malnourished participants. However, it remains uncertain whether these results translate to improvement in nutritional status and clinically relevant outcomes such as death. Large well-designed RCTs in this population are required. PMID: 32390133 [PubMed - in process]
Hemodialysis has become a routine procedure in the management of acute kidney injury and as a bridge therapy for chronic kidney disease before transplantation (1). Hemodialysis poses several challenges in infants because of the inherently low intravascular volume. The rapid shifts in intravascular and third space volume at the time of hemodialysis might result in hypovolemia and shock. Hence, peritoneal dialysis, a safer modality that provides more gradual, steady, and predictable clearance, is preferred in neonates and infants.
The objectives of the conservative treatment for chronic kidney disease are to slow down the progression of kidney dysfunction, treat complications (anemia, bone diseases, cardiovascular diseases), vaccination for hepatitis B, and preparation for kidney replacement therapy.
AbstractBackgroundEnteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age.MethodsRetrospective study of pre-transplant, pre-pubertal children (
CONCLUSION: There is a high CKD burden in the ME countries. There needs to be emphasis on prevention of ESRD and provision of adequate care for the total ESRD patient population. National renal registries are needed to monitor the status of ESRD patients. Health expenditures should be increased to cover all aspects of RRT in ME Countries. PMID: 31793874 [PubMed - as supplied by publisher]
Abstract BACKGROUND: Infections remain the second most common cause of death in patients with end-stage kidney disease (ESKD). We aimed to evaluate non-specific cell-mediated immunity in an ESKD cohort using a functional assay applicable to routine use, QuantiFERON-Monitor (Qiagen), and assess whether it can predict infectious events. METHODS: In this prospective study, we performed the QuantiFERON-Monitor test in 80 subjects including 54 patients with ESKD. QuantiFERON-Monitor is based on the measurement of plasma interferon-gamma (IFN-γ) after stimulation of NK-cells with a TLR-7 agonist, and T-cells ...
Conclusion: We identified a higher proportion of patients with extra-pulmonary TB in our population compared to the national figure of 58.0% in all patients diagnosed with TB. Despite co-morbidity of patients with CKD on RRT, the treatment completion rates and mortality of these patients were similar to national rates for all patients with active TB.
This article discusses mechanisms of AGE formation and reviews published literature on SAF as a biomarker and risk factor across the spectrum of kidney disease. Recent findings SAF is elevated in adults and children on dialysis. Higher SAF is an independent risk factor for cardiovascular and all-cause mortality in persons receiving haemodialysis and for all-cause mortality in persons performing peritoneal dialysis, though the increase in discrimination when SAF was added to traditional risk factors was modest. In less advanced chronic kidney disease, higher SAF predicts all-cause mortality and progression. SAF is elevat...
The objective of this review is to show an overview to know the main UT produced in end-stage renal disease patients, and how prebiotics and probiotics intervention acts as a helpful tool in CKD treatment.
CONCLUSIONS: The study highlights the exceptionally high cost of dialysis treatment. Dialysis should be made more accessible by implementing measures to address the main cost drivers. Moreover, a comprehensive approach that includes prevention of CKD at primary healthcare level, an organ donation programme and an effective kidney transplant programme is urgently required in Limpopo. Further research is required to evaluate the cost-effectiveness of the PPP approach. PMID: 31456551 [PubMed - in process]