Screening for Asymptomatic Coronary Artery Disease in Waitlisted Kidney Transplant Candidates: A Cost-Utility Analysis
ConclusionsNo further screening for CAD after waitlisting is likely to be cost-effective and may improve survival. Precision around CAD prevalence estimates and health care resource use will reduce existing uncertainty.
Bilateral renal agenesis has historically been described as “incompatible with life” as chronic anhydramnios results in pulmonary hypoplasia, leading to respiratory failure at birth. Recent reports have detailed the survival of infants with renal disease and severe oligo-/anhydramnios following prenatal serial amnioinfusions as a bridge to neonatal dialy sis with the goal of pediatric kidney transplant. Subsequently, clinical trials have proposed treating fetuses with bilateral renal agenesis with serial prenatal amnioinfusions to allow for pulmonary maturation and the potential for long-term survival.
Publication date: Available online 24 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Darcy K. Weidemann, Alison G. Abraham, Jennifer L. Roem, Susan L. Furth, Bradley A. WaradyRationale &ObjectiveSoluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker associated with incident chronic kidney disease (CKD) and has been identified as an independent risk factor for CKD progression in children, although these findings remain preliminary, limited to a single point in time, and unreplicated in pediatric cohorts.Study DesignProspective longitudinal cohort study.Setting &Participants5...
Publication date: Available online 23 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Jennifer Y. So, Karen M. Warburton, Ilene M. RosenDaytime sleepiness, also known as hypersomnolence, is common among patients receiving maintenance dialysis and following successful kidney transplantation. Sleepiness may be secondary to medical comorbid conditions, medication side effect, insufficient sleep syndrome, and sleep-disordered breathing or the result of a primary central disorder of hypersomnolence, such as narcolepsy. Unrecognized and untreated sleep disorders are associated with substantial morbidity and mor...
BKV is ubiquitous with 80-90% seropositivity. BKV establishes latency in kidney tubular epithelial/urothelial cells but is shed in urine. Reactivation may cause interstitial nephritis (BKV-IN) after renal transplant (Ktxp) and hemorrhagic cystitis (HC) and/or BKV-IN after allo-HSCT. BKV-HC occurs 2-8 wks after HSCT. Diagnosis requires: cystitis, macroscopic hematuria and urine (U) BK VL>7log10 copies/ml. High-level BK viruria occurs in>80% post allo-HSCT but only 5-20% develop HC. Plasma (PL) VLs are elevated in 60% and declining PL-VL correlates with improvement.
Recipients of solid organ transplant (SOT) are at risk of viral infection and development of viral-driven malignancy (EBV-PTLD) due to immunosuppressive medications to prevent organ rejection. Treatments are limited by poor efficacy and organ toxicity, and reduction in immunosuppression to enable the patient's immune system fight the infection risks organ rejection. Allogeneic viral specific T-cells (VST) have been used to treat viral infections after stem cell transplant, and here we evaluated VST for the treatment of CMV, ADV, EBV-PTLD and BK in six SOT (heart, liver, kidney, lung) recipients.
Acute kidney injury (AKI) is common in hematopoietic cell transplant (HCT) recipients. Few studies have evaluated whether BK polyomavirus (BKV) infections are associated with kidney disease in the HCT population, and results have not been conclusive.
Chimeric Antigen Receptor T cell (CAR T) therapy has shown significant therapeutic potential but carries risk of treatment related toxicity. There is limited data describing risk of acute kidney injury (AKI) related to CAR T therapy.
Acute kidney injury (AKI) occurs frequently after hematopoietic cell transplant, affecting anywhere from 10-73% of patients and is associated with higher post-transplant mortality. In this retrospective study, we identified incidence and risk factors of AKI in cord blood transplant (CBT) recipients and evaluated the impact of AKI on non-relapse mortality (NRM) and overall survival (OS).
The reported incidence of acute kidney injury (AKI) after allogeneic hematopoietic cell transplantation (allo-HCT) varies from 10 to 73%. The association between GVHD, calcineurin inhibitors (CNIs) and risk for kidney injury remains controversial. We sought to describe the incidence of AKI and identify modifiable risk factors in large cohort of patients undergoing allo-HCT in our institution.