Longitudinal Assessment of Serum Creatinine Levels on Graft Survival After Renal Transplantation: Joint Modeling Approach

Maraghi, Elham; Foroushani, Abbas Rahimi; Younespour, Shima; Rahimi, Zohreh; Einollahi, Behzad; Eshraghian, Mohammad Reza; Akhoond, Mohammad Reza; Mohammad, Kazem

doi:10.5812/numonthly.37666

Cited by 16 publications

(17 citation statements)

References 28 publications

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“…Medical management and dialysis provide a temporary relief to the patient, but for long term management, the renal transplant has been adopted as a favored approach in the past few decades [ 1 , 4 ]. Limited data are available on the etiologies of transplant dysfunction especially in our region, and the purpose of this original article is to contribute to the literature and help in establishing the local registry [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Renal Transplant Pathology: Demographic Features and Histopathological Analysis of the Causes of Graft Dysfunction

Bashir

Hussain

Khan

et al. 2020

International Journal of Nephrology

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Background. Renal transplant has emerged as a preferred treatment modality in cases of end-stage renal disease; however, a small percentage of cases suffer from graft dysfunction. Aim. To evaluate the renal transplant biopsies and analyze the various causes of graft dysfunction. Materials and Methods. 163 renal transplant biopsies, reported between 2014 and 2019 and who fulfilled the inclusion criteria, were evaluated with respect to demographics, clinical, histological, and immunohistochemical features. Results. Of 163 patients, 26 (16%) were females and 137 (84%) were males with a mean age of 34 ± 7 years. 53 (32.5%) cases were of rejection (ABMR and TCMR), 1 (0.6%) was borderline, 15 were of IFTA, and rest of 94 cases (57.7%) belonged to the others category. SCr (serum creatinine) in cases of rejection was 3.85 ± 0.55 mg/dl. Causes of early graft dysfunction included active ABMR (7.1 ± 4.7 months), acute TCMR (5.5 months), and acute tubular necrosis (after 6 ± 2.2 months of transplant) while the causes of late rejection were CNIT and IFTA (34 ± 4.7 and 35 ± 7.8 months, respectively). Conclusion. Renal graft dysfunction still remains a concerning area for both clinicians and patients. Biopsy remains the gold standard for diagnosing the exact cause of graft dysfunction and in planning further management.

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Section: Discussionmentioning

confidence: 99%

“…In our study, the demographic details of the recipient and donor were almost comparable to those reported from nearby countries. The donors in all of our cases were living-related compared to 97.6% living donors in an Iranian study [ 14 ] [ Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

Renal Transplant Pathology: Demographic Features and Histopathological Analysis of the Causes of Graft Dysfunction

Bashir

Hussain

Khan

et al. 2020

International Journal of Nephrology

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“…The product data sheet does not recommend the use of rocuronium in patients with renal failure until future research has evaluated its safety and tolerability profile [7]. Two case reports/series without control groups reported the use of the rocuronium-sugammadex complex during renal transplantation, but they were mainly focused on the evaluation of rocuronium-sugammadex activities [8,9]. Our casecontrol study aimed to compare the effect on renal function of rocuronium-sugammadex versus cisatracurium-neostigmine after kidney transplantation in order to determine the best neuromuscular block management in this scenario.…”

Section: Introductionmentioning

confidence: 99%

Effects of Sugammadex Plus Rocuronium vs Neostigmine Plus Cisatracurium During Renal Transplantation on Graft Function: A Retrospective, Case-Control Study

Vargas

Buonanno

Sica

et al. 2021

Transplantation Proceedings

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“…The dosage, donor age, DGF, BMI, and donor type were positively associated with the creatinine level, which agreed with findings in the literature (Katari et al, 1997;Gerchman et al, 2009;Foucher et al, 2016). In contrast, the recipient age was negatively associated with the creatinine level, suggesting that younger patients tend to have lower creatinine levels (Maraghi et al, 2016). Diabetes history also decreased the creatinine level.…”

Section: Experimental Results: Model Fittingmentioning

confidence: 88%

Personalized Dynamic Treatment Regimes in Continuous Time: A Bayesian Approach for Optimizing Clinical Decisions with Timing

et al. 2022

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Accurate models of clinical actions and their impacts on disease progression are critical for estimating personalized optimal dynamic treatment regimes (DTRs) in medical/health research, especially in managing chronic conditions. Traditional statistical methods for DTRs usually focus on estimating the optimal treatment or dosage at each given medical intervention, but overlook the important question of "when this intervention should happen." We fill this gap by developing a two-step Bayesian approach to optimize clinical decisions with timing. In the first step, we build a generative model for a sequence of medical interventions-which are discrete events in continuous time-with a marked temporal point process (MTPP) where the mark is the assigned treatment or dosage. Then this clinical action model is embedded into a Bayesian joint framework where the other components model clinical observations including longitudinal medical measurements and time-to-event data conditional on treatment histories. In the second step, we propose a policy gradient method to learn the personalized optimal clinical decision that maximizes the patient survival by interacting the MTPP with the model on clinical observations while accounting for uncertainties in clinical observations learned from the posterior inference of the Bayesian joint model in the first step. A signature application of the proposed approach is to schedule follow-up visitations and assign a dosage at each visitation for patients after kidney transplantation. We evaluate our approach with comparison to alternative methods on both simulated and real-world datasets. In our experiments, the personalized decisions made by the proposed method are clinically useful: they are interpretable and successfully help improve patient survival.

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Longitudinal Assessment of Serum Creatinine Levels on Graft Survival After Renal Transplantation: Joint Modeling Approach

Cited by 16 publications

References 28 publications

Renal Transplant Pathology: Demographic Features and Histopathological Analysis of the Causes of Graft Dysfunction

Renal Transplant Pathology: Demographic Features and Histopathological Analysis of the Causes of Graft Dysfunction

Effects of Sugammadex Plus Rocuronium vs Neostigmine Plus Cisatracurium During Renal Transplantation on Graft Function: A Retrospective, Case-Control Study

Personalized Dynamic Treatment Regimes in Continuous Time: A Bayesian Approach for Optimizing Clinical Decisions with Timing

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