The influence of clinical, environmental, and socioeconomic factors on five-year patient survival after kidney transplantation

Ruppel, Priscila; Felipe, Cláudia Rosso; Medina-Pestana, José; Hiramoto, Liliane Lumi; Viana, Laila Almeida; Ferreira, Alexandra; Aguiar, Wilson; Ivani, Mayara; Bessa, Adrieli; Cristelli, Marina; Tavares, Melissa Gaspar; Tedesco‐Silva, Hélio

doi:10.1590/2175-8239-jbn-3865

Cited by 16 publications

(12 citation statements)

References 32 publications

(38 reference statements)

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“…[5,6] In a recent study, 8.6% of kidney transplant recipients (KTRs) died within 5 years of transplantation and 53% of those deaths were due to infection, a rate that is twice that of the second most common cause of death. [7] Infections were also the main cause of death in another study that was conducted over 15 years, in which 10,400 KTRs were enrolled. [8] In that study, there were 404 cases of complications associated with infection, and in 34% of those cases the patient died.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and etiology of repeat infection in kidney transplant recipients

Chen

et al. 2019

Medicine

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Kidney transplantation (KT) is the best therapy available for patients with end-stage renal disease, but postoperative infections are a significant cause of mortality.In this retrospective study the frequency, risk factors, causative pathogens, and clinical manifestations of infection in KT recipients from Beijing Chao-Yang Hospital, Capital Medical University were investigated. Ninety-seven KT recipients who were hospitalized with infection between January 2010 and December 2016 were included. Clinical characteristics, surgery details, laboratory results, and etiology were compared in patients who developed single infection and patients who developed repeated infection (2 or more) after KT.A total of 161 infections were adequately documented in a total of 97 patients, of which 57 patients (58.8%) had 1 infection, 24 (24.7%) had 2, 11 (11.3%) had 3; 3 (3.1%) had 4, and 2 (2.1%) had 5 or more. The most common infection site was the urinary tract (90 infections; 56%), both overall and in the repeated infection group. The most frequently isolated pathogen was Pseudomonas aeruginosa. In the repeated infection patients, in most cases of P. aeruginosa infection (54%) it was cultured from urine. For first infections, a time between KT and infection of ≤ 21 days (area under receiver operating characteristic curve [AUC] 0.636) and a tacrolimus level ≥ 8 ng/mL (AUC 0.663) independently predicted repeat infection. The combination of these two predictive factors yielded an AUC of 0.716, which did not differ statistically significantly from either predictor alone.With regard to first infections after KT, a time between KT and infection of ≤ 21 days, and a tacrolimus level ≥ 8 ng/mL each independently predicted repeated infection in KT recipients.

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Section: Introductionmentioning

confidence: 99%

Risk factors and etiology of repeat infection in kidney transplant recipients

Chen

et al. 2019

Medicine

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“…O que corrobora com os dados encontrados no estudo de Sandes-Freitas e colaboradores (2015) e Baid-Agrawal e colaboradores (2016), no qual DM, HAS e glomerulopatias também foram as principais causas de lesão renal que levaram o paciente ao transplante 11,13 .O que leva a uma preocupação relacionada ao desenvolvimento de FTE, já que os receptores que tiveram como doença de base HAS e DM tem mais probabilidade de desenvolver essa complicação. Da mesma forma, a DM foi um fator de risco para perda do enxerto renal em 1 ano, assim como um fator de risco associado a mortalidade 14,15 .…”

Section: Discussionunclassified

Fatores que influenciam o tempo de internação no transplante renal

Fraga

Silva

Oliveira

et al. 2021

SaudColetiv (Barueri)

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Objetivo: Identificar os elementos que interferem no tempo de internação do paciente transplantado renal. Método: Trata-se de um estudo transversal e retrospectivo realizado em um hospital de Fortaleza. Foram analisados 236 prontuários de pacientes transplantados, entre 2017 e 2019. Utilizou-se uma planilha eletrônica para organização dos dados, que posteriormente foram analisados no programa Statistical Package for the Social Sciences. Resultados: Constatou-se que a maioria possuía a doença de base de etiologia desconhecida, diabetes e hipertensão. Dos 236 pacientes, 40,3% tiveram função imediata do enxerto, 80,9% não apresentaram nenhum foco de infecção, com média de 11 dias de internação. Aqueles que apresentaram creatinina normal passaram menos dias internado. Conclusão: A creatinina, a função tardia do enxerto e infecção foram fatores diretamente relacionados com o tempo de internação hospitalar, sendo essencial que os profissionais busquem estratégias para evitar e/ou minimizar as complicações no pós-transplante.

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“…The increased mortality may be explained by an increased incidence of RCC and metastatic RCC in these patients. In a study of 15 kidney transplant centers in France, the incidence of recurrent RCC after kidney transplant was 9.1% and the 5‐year survival of these patients was 41.7% 36 as compared to 91.4% in kidney transplant population without RCC 37 . In a meta‐analysis of 11 studies, the mortality rate in kidney transplant recipients with RCC was 15.0% at a mean follow‐up of 42 months after RCC diagnosis 38 .…”

Section: Prognosis Of Kidney Transplant Recipients With Cancermentioning

confidence: 99%

When ESKD complicates cancer screening and cancer treatment

Yasin

Holley

2020

Seminars in Dialysis

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End-stage kidney disease (ESKD) affects the recommended screening, incidence, treatment, and mortality of cancer. Cancer occurring in a patient with ESKD can influence candidacy for kidney transplantation as well as dialysis decision-making and cancer treatment. Certain cancers are more common among ESKD patients, notably, viral-mediated cancers that are associated with human papilloma or hepatitis viruses, and urothelial cancers associated with analgesic and Balkan nephropathies. Solid tumors are not believed to occur more frequently in ESKD patients. The presence of ESKD may confer a higher risk of post-surgical complications as well as mortality. The cost-effectiveness of cancer screening depends upon individual cancer risk and estimated overall survival. The high mortality associated with ESKD argues against routine cancer screening in dialysis patients. Cancer treatment in ESKD may be complicated by the need to avoid, adjust doses of and/or coordinate the timing of administration of imaging contrast, chemotherapy, and immunotherapy with dialysis treatments. There is a general dearth of information on the treatment of cancer in ESKD patients. These issues will be discussed, and some general guidelines presented based upon the current literature.

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The influence of clinical, environmental, and socioeconomic factors on five-year patient survival after kidney transplantation

Abstract: This analysis confirmed that in this population, infection is the leading cause of mortality over the first 5 years after kidney transplantation. Several demographic and socioeconomic risk factors were associated with death, most of which are not readily modifiable.

Cited by 16 publications

References 32 publications

Risk factors and etiology of repeat infection in kidney transplant recipients

Risk factors and etiology of repeat infection in kidney transplant recipients

Fatores que influenciam o tempo de internação no transplante renal

When ESKD complicates cancer screening and cancer treatment

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