Syndrome of rapid-onset end-stage renal disease in two consecutive renal transplant recipients

Ma, Onuigbo

doi:10.4103/0971-4065.111861

Cited by 9 publications

(14 citation statements)

References 7 publications

(11 reference statements)

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“…Rapid decline in kidney function to ESRD was considered to have occurred if a patient was documented to have estimated GFR >30 mL/min/1.73 m 2 within 3 months prior to the initiation of chronic dialysis . Incidentally, we must observe here that their definition very closely mirrored our standard definition of SORO‐ESRD . Lee et al revealed that 8 of 105 incident chronic dialysis patients in one dialysis unit (7.6%; 95% confidence interval [CI] 3.4%–14.5%) and 9 of 71 incident patients at another dialysis unit (12.7%, 95% CI 6.0%–22.7%), suffered rapid yet permanent decline in kidney function consistent with SORO‐ESRD …”

Section: Introductionmentioning

confidence: 84%

“…In 2010, we first described the syndrome of rapid onset end‐stage renal disease (SORO‐ESRD), from the Renal Unit of Mayo Clinic Health System, Eau Claire, in Northwestern Wisconsin, USA, in the journal, Renal Failure . This syndrome represents acute precipitate yet irreversible renal failure following acute kidney injury (AKI) in contradistinction to “classic” end‐stage renal disease (ESRD) where CKD to ESRD progression is progressive, linear, time‐dependent, and predictable over years to sometimes decades, going through penultimate CKD stages to inexorably end in ESRD, requiring permanent renal replacement therapy in the form of dialysis and/or renal transplantation . Remarkably, “classic” ESRD is typified by patients with CKD who demonstrate often predictably increasing serum creatinine levels and, therefore, simultaneously falling estimated GFR levels, associated increasing proteinuria where applicable and ultimately leading inexorably to terminal symptomatic ESRD and the need for permanent renal replacement therapy (RRT) …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In our later report from 2011, we had reported on SORO‐ESRD in two renal transplant recipients (RTRs) . Whereas late renal allograft loss remains a major challenge in current renal transplantation practice, the contribution of SORO‐ESRD to late renal allograft loss has since remained speculative . Mehrotra et al in 2012 had concluded that AKI is increasingly common and associated with transplant failure and death and that later CKD stage increased the risk of AKI, but AKI‐associated risks of transplant failure were greater in those with higher levels of kidney function (earlier CKD stage) .…”

Section: Introductionmentioning

confidence: 99%

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A Mayo Clinic 13‐year investigation of the syndrome of rapid onset ESRD among renal transplant recipients: An analysis of the implications of renal allograft biopsy results

Onuigbo

Agbasi

2017

Hemodialysis International

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Introduction: We first described the syndrome of rapid onset end stage renal disease (SORO-ESRD), acute yet irreversible renal failure, in 2010.Objective: The impact of SORO-ESRD renal allograft survival remains speculative and we plan to study this question.Methods: A retrospective analysis of individual adult patient-level serum creatinine trajectories of ESRD patients on maintenance hemodialysis for >90 days at Mayo Clinic, Rochester, 2001Rochester, -2013 Results: Of 1461 ESRD patients, 149 (10%) patients including 13 renal transplant recipients (RTRs) satisfied the diagnosis of SORO-ESRD -4 males, 9 females, 12 Caucasians/one other, age 45 (18-83) years. Serum creatinine was 1.4 (0.8-1.7) mg/dL in the last year before hemodialysis initiation. Initial hemodialysis access was a dialysis catheter in all 13 patients. AKI precipitating SORO-ESRD followed acute rejection (4), postoperative (2), tubulo-interstitial nephritis (2), unknown (2), infection/sepsis (1), contrast nephropathy (1), BKV nephropathy (1), and cardio-renal syndrome (1). Renal allograft survival was 1469 (277-4939) days (4 years). Renal allograft biopsies were available in 9/14 (69%) RTRs -Four showed acute rejection, two of which followed interruption of immunosuppression, three revealed acute tubular necrosis and four others also showed chronic transplant glomerulopathy. Time on hemodialysis was 856 (129-1630) days (2.4 years). 5/13 RTRs with SORO-ESRD (38%) died -3 (60%) following cardiac arrest, 2 (40%) after stopping hemodialysis. 4/13 (31%) were re-transplanted in the period of this study.Conclusion: SORO-ESRD contributed significantly to late renal allograft loss and return to hemodialysis with 100% initial dialysis catheter rate. Potentially preventable causes of AKI leading to SORO-ESRD were identified. The application of experience gained from such studies would help reduce late renal allograft loss and the need for re-transplantation. This would further help reduce Correspondence to: M. A. Onuigbo,

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Mayo Clinic 13‐year investigation of the syndrome of rapid onset ESRD among renal transplant recipients: An analysis of the implications of renal allograft biopsy results

Onuigbo

Agbasi

2017

Hemodialysis International

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“…concluded that acute kidney injury on top of CKD may be the reason for a suboptimal dialysis start in over 30% of CKD patients with established nephrologist care . Onuigbo have extensively reviewed this phenomenon, which they have termed the syndrome of rapid‐onset end‐stage renal disease (SORO‐ESRD), and in a large‐scale review of acute kidney injury studies in the literature, they noted SORO‐ESRD rates ranging from 1% to 85% . With incident HD catheter access around 71% in the United States even in patients with predialysis nephrology care, we suggest that the unpredictable and often accelerating rate of decline in eGFR plays a role in this poor outcome.…”

Section: Discussionmentioning

confidence: 99%

Late acceleration of glomerular filtration rate decline is a risk for hemodialysis catheter use in patients with established nephrology chronic kidney disease care

Chin

Nguyen

Dinesh

et al. 2014

Hemodialysis International

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Chronic kidney disease (CKD) patients with established nephrology care have a high rate of tunneled dialysis catheters (TDC) as first vascular access when transitioning to hemodialysis (HD). We sought to identify factors associated with this problem. Patients who started HD and had prior CKD care within our renal clinic were categorized according to access type at incident HD. Clinical factors, all estimated glomerular filtration rates (eGFR), renal clinic attendance records, hospital admissions in the 6 months preceding HD start, and patient participation in predialysis education course were analyzed. Three hundred thirty-eight patients initiated HD, 107 received pre-HD CKD care within our clinics. Seventy patients started with a TDC. All groups started HD at similar eGFR values. The trajectory of eGFR decline in the 6 months prior to HD start was significantly more rapid in the TDC group. Patients in the TDC group had more acute health events in the prior 6 months. Multivariate modeling showed that failure to attend a predialysis education course and having a more rapid rate of eGFR decline in the 6 months prior to dialysis initiation were both associated with TDC use. Patients with CKD nephrology care who initiated HD with a TDC as first vascular access had a more rapid rate of decline in eGFR in the months preceding dialysis start and were less likely to have attended our predialysis education course. This appears to correspond with the observed increased number of emergency and hospital visits in the 6 months prior to end-stage renal disease.

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Serum Creatinine Trajectories in Kidney Disease

Onuigbo¹,

Agbasi²,

Oguejiofor³

et al. 2016

Biomarkers in Kidney Disease

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Syndrome of rapid-onset end-stage renal disease in two consecutive renal transplant recipients

Cited by 9 publications

References 7 publications

A Mayo Clinic 13‐year investigation of the syndrome of rapid onset ESRD among renal transplant recipients: An analysis of the implications of renal allograft biopsy results

A Mayo Clinic 13‐year investigation of the syndrome of rapid onset ESRD among renal transplant recipients: An analysis of the implications of renal allograft biopsy results

Late acceleration of glomerular filtration rate decline is a risk for hemodialysis catheter use in patients with established nephrology chronic kidney disease care

Serum Creatinine Trajectories in Kidney Disease

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