Angiotensin-Converting Enzyme Inhibitors After Renal Transplantation

Bravo, Paco E.; Felgueiras, Joana; Santos, Clara; Oliveira, Cláudia Maria Costa de; Ponce, Pedro

doi:10.1016/j.transproceed.2008.03.014

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…‘Emerging’ factors that seem to be related to the absence of anemia in CKD patients have recently been described, such as IGF-1 [17], insulin [18] and renin [19]. The study by Shih et al [17] included patients with erythrocytosis on HD and found that IGF-1 and insulin can act as stimulants of erythropoiesis in these patients, since they had elevated levels of these factors and erythrocytosis even with suppressed eEPO levels.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to the Absence of Anemia in Hemodialysis Patients

et al. 2011

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Background: A small number of hemodialysis (HD) patients have normal hemoglobin (Hb) levels without the need for erythropoiesis-stimulating agents (ESAs). The factors associated with this condition have been little studied. The objective of this prospective study was to determine these factors in a prevalent population of HD patients. Materials and Methods: All patients who had normal Hb levels and who had not received ESAs in the last 6 months (non-ESA group) were included. Epidemiological and laboratory data were collected and we performed an abdominal ultrasound to assess hepatic and renal cysts. This group was compared to a control group of 205 prevalent HD patients on ESA therapy (control group). Results: We included 45 patients (16% from the whole group) in the non-ESA group. In this group, there was a higher proportion of men (76.5 vs. 61%), patients were younger (61.1 ± 14.7 vs. 67.5 ± 15.2 years), had a longer duration of renal replacement therapy (RRT) (9.4 ± 8.3 vs. 5.3 ± 5.8 years) and had a higher prevalence of adult polycystic kidney disease (APKD) and hepatitis C virus (HCV) liver disease (42.2 vs. 10.2%), p < 0.01. In the non-ESA group, HCV+ patients had a lower prevalence of APKD (2.2 vs. 38.4%) and hepatic cysts (2.2 vs. 19.2%), but significantly higher endogenous erythropoietin levels (55.8 ± 37.1 vs. 30.9 ± 38.4 mU/ml). No significant differences in anemia, iron metabolism, insulin, IGF-1 and renin were found between non-ESA and control groups. Non-ESA patients had a significantly higher number of renal (90.6 vs. 36.5%) and hepatic cysts (12.5 vs. 3.4%), and these were also larger in size (3.3 ± 2.4 vs. 1.5 ± 0.8 cm). In the multivariate Cox analysis, independent predictor factors for absence of anemia in HD patients were number of renal cysts >10 cysts (95% CI 1.058–1.405; p = 0.00), HCV+ liver disease (95% CI 1.147–1.511; p = 0.05) and time on RRT (95% CI 1.002–1.121; p = 0.05). Conclusions: The absence of anemia in HD patients is not infrequent. Its frequency is higher in men and younger patients with long-term RRT, in patients with HCV+ liver disease and in APKD. It is associated with increased endogenous erythropoietin production and the presence of renal and hepatic cysts.

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Section: Discussionmentioning

confidence: 99%

Factors Related to the Absence of Anemia in Hemodialysis Patients

et al. 2011

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“…Different studies presented same findings. [21,22] Our findings suggest that PTE may reduce the predicted benefits of obtaining a higher-quality kidney transplant by showing that patients with PTE did not have improved patient or allograft survival during a 5-year follow-up period despite having greater kidney quality. In this context, it's important to remember that a prior research by Kiberd et al demonstrated that recipients with PTE had better overall survival but worse renal allograft survival [23].…”

Section: Discussionmentioning

confidence: 80%

Prevalence and Predisposing Factors of Post Renal Transplant Erythrocytosis

Mazharulhaq¹,

Aimal²,

Tahir³

2022

PJMHS

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Objective: Aim of current study was to determine the factors and prevalence of post-transplant erythrocytosis after kidney transplantation. Study Design: Retrospective study Place and Duration: Institute of Kidney Diseases Hayatabad Peshawar during June 2021 to December 2021. Methods: Total 118 patients of renal transplant were presented. Participants' full demographic information was recorded after getting written consent from each participant. Association of risk factors and prevalence of post-transplant erythrocytosis were recorded. Hematocrit (Ht) above 52% and haemoglobin (Hb) over 18 g/dl in males and Ht over 50% and Hb over 17 g /dl in females were considered to be indicative of true PTE. We used SPSS 18.0 to analyze all data. Results: The mean age of the patients was 50.6±2.31 years with mean BMI 27.4±11.52 kg/m2. There were majority 76 (64.4%) patients were males and 42 (35.6%) patients were females. Frequency of PTE was found in 23 (19.5%) cases and 95 (80.5%) cases were without PTE. Most common factors for PTE development were endogenous erythropoietin, local renal hypoxia, endogenous androgens, insulin-like growth factors and the renin-angiotensin- aldosterone system. Mean duration of dialysis in PTE group was 25.1±7.48 months and duration of patients without PTE was 51.9±6.75 months. Frequency of diabetes, hypertension, glomerulonephritis, polycystic kidney disease and graft failure were higher in PTE patients as compared to non-PTE. We found higher number of acute rejection in PTE patients as compared to non PTE cases with p value <0.009. Conclusion: We concluded in this study that the shorter duration of dialysis and higher number of acute rejection before kidney transplant were the risk factors for post transplant erythrocytosis. Most common factor for PTE development was renin-angiotensin- aldosterone system. Keywords: Erythrocytosis, Transplantation, Kidney, Dialysis

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