Late Kidney Allograft Loss

Jevnikar, Anthony M.; Mannon, Roslyn B.

doi:10.2215/cjn.03040707

Cited by 103 publications

(76 citation statements)

References 131 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[30][31][32] Taking into account the role of calcineurin inhibitors in the progression of chronic allograft nephropathy and their importance in mediating the epithelial to mesenchymal transition, one can speculate that the nephroprotective effects of epoetin-b may be at least partly caused by the inhibition of calcineurin inhibitor-induced epithelial to mesenchymal transition by RHuEPO. Thus, correcting tissue hypoxia by raising Hb levels adds to the tissue protective effects of RHuEPO.…”

Section: Discussionmentioning

confidence: 99%

Correction of Postkidney Transplant Anemia Reduces Progression of Allograft Nephropathy

Choukroun¹,

Kamar²,

Dussol³

et al. 2012

Journal of the American Society of Nephrology

112

View full text Add to dashboard Cite

Retrospective studies suggest that chronic allograft nephropathy might progress more rapidly in patients with post-transplant anemia, but whether correction of anemia improves renal outcomes is unknown. An open-label, multicenter, randomized controlled trial investigated the effect of epoetin-b to normalize hemoglobin values (13.0-15.0 g/dl, n=63) compared with partial correction of anemia (10.5-11.5 g/dl, n=62) on progression of nephropathy in transplant recipients with hemoglobin ,11.5 g/dl and an estimated creatinine clearance (eCrCl) ,50 ml/min per 1.73 m 2 . After 2 years, the mean hemoglobin was 12.9 and 11.3 g/dl in the normalization and partial correction groups, respectively (P,0.001). From baseline to year 2, the eCrCl decreased by a mean 2.4 ml/min per 1.73 m 2 in the normalization group compared with 5.9 ml/min per 1.73 m 2 in the partial correction group (P=0.03). Furthermore, fewer patients in the normalization group progressed to ESRD (3 versus 13, P,0.01). Cumulative death-censored graft survival was 95% and 80% in the normalization and partial correction groups, respectively (P,0.01). Complete correction was associated with a significant improvement in quality of life at 6 and 12 months. The number of cardiovascular events was low and similar between groups. In conclusion, this prospective study suggests that targeting hemoglobin values $13 g/dl reduces progression of chronic allograft nephropathy in kidney transplant recipients.

show abstract

Section: Discussionmentioning

confidence: 99%

Correction of Postkidney Transplant Anemia Reduces Progression of Allograft Nephropathy

Choukroun¹,

Kamar²,

Dussol³

et al. 2012

Journal of the American Society of Nephrology

112

View full text Add to dashboard Cite

show abstract

“…Indeed, survival rates remain quite stable, with only 50% of kidneys from deceased donors still functioning 10-year after transplant (1). The leading cause of allograft failures is chronic allograft nephropathy, a complex phenomenon characterized by progressive renal dysfunction, chronic interstitial fibrosis, tubular atrophy, vascular occlusive changes, and glomerulosclerosis (2,3). Many risk factors are known to influence longterm graft survival, such as recipient age, race, delayed graft function (DGF), HLA mismatching, and acute rejection episodes (4,5).…”

mentioning

confidence: 99%

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Loock¹,

Bamoulid²,

Courivaud³

et al. 2010

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: Conflicting data have been reported concerning the use of kidney graft arterial resistance index (RI) measured by Doppler to predict death-censored graft loss. We hypothesized that changes in RI values could carry better information than a single measure of RI.Design, setting, participants, & measurements: Four hundred twenty-five renal transplant recipients were included in the study. We tested whether changes in renal arterial resistance index between 4 and 12 months after transplant (⌬RI 4312 ) were predictive of graft loss.Results: Neither 4-month nor 1-year RI predicted graft loss. The area under the receiver operating characteristics curve of ⌬RI 4312 for graft loss was 0.75. A ⌬RI 4312 >10% had the best sensitivity and specificity. One year after transplant, 22% of the study population had ⌬RI 4312 >10%. Fifty-five patients (12.9%) experienced graft loss during follow-up. The annual incidence of graft loss was higher in patients with ⌬RI 4312 >10% (3.5 versus 1.3%; P ‫؍‬ 0.009). In multivariate analysis, patients with ⌬RI 4312 >10% had an increased risk of graft loss (hazard ratio, 6.21; 95% confidence interval, 1.99 to 22.15; P ‫؍‬ 0.002).Conclusions: A variation in RI >10% in the first year after transplant is an independent risk factor for death-censored graft loss in renal transplant recipients.

show abstract

“…23 Data from the literature also suggest that patients simultaneously displaying acute and chronic changes in their KAG, for example, interstitial infiltrate on a background of fibrosis, have worse subsequent KAG function and morphology. 6,26,32,33 Several other reasons can explain the absence of coordinated increase in urinary enzyme activity in patients with low GFR in this study. First, patients with acute tubular injury were excluded from the study.…”

Section: Discussionmentioning

confidence: 70%

Untitled

Trailin

Pleten²,

Ostapenko³

et al. 2017

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Scant information is available on factors for predicting the rate of decline in kidney allograft function beyond 1 year posttransplant. We invest igated whether urinary enzymes (alanine amino transferase, alkaline phosphatase, aspartate aminotransferase, N-acetyl-β-D-hexosaminidase, and γ-glutamyl transpeptidase) in the late postoperative period can predict the decline in estimated glomerular filtration rate. confidence interval, 1.10-3.83; P = .023) over 2 years. It also predicted the drop in estimated glomerular filtration rate ≥ 25% after 1 year (odds ratio, 2.62; 95% confidence interval, 1.07-6.37; P = .034) and 2 years (odds ratio, 2.75; 95% confidence interval, 1.12-6.73; P = .027). Combined with time after transplant, urinary aspartate aminotransferase had good power for predicting an estimated glomerular filtration rate decrease ≥ 25% after 2 years of follow-up. Conclusions: Higher urinary activity of aspartate aminotransferase in the late posttransplant period is useful for identifying transplant patients who are at risk for progressive loss of graft function.

show abstract

Late Kidney Allograft Loss

Cited by 103 publications

References 131 publications

Correction of Postkidney Transplant Anemia Reduces Progression of Allograft Nephropathy

Correction of Postkidney Transplant Anemia Reduces Progression of Allograft Nephropathy

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Untitled

Contact Info

Product

Resources

About