Comparison of Markers of Appetite and Inflammation Between Hemodialysis Patients With and Without Failed Renal Transplants

Çalışkan, Yaşar; Yelken, Berna; Görgülü, Numan; Özkök, Abdullah; Yazıcı, Halil; Telci, Ayşegül; Türkmen, Aydın; Yildiz, Alaattin; Sever, Mehmet Şükrü

doi:10.1053/j.jrn.2011.07.005

Cited by 18 publications

(6 citation statements)

References 54 publications

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“…All these findings revealing inflammation in dialysis patients can be associated with both chronic kidney disease and dialysis-related factors, including hypercatabolism, malnutrition, complement system activation, and oxidative stress. We have found that elevated serum ghrelin levels and inflammation may cause diminished appetite and malnutrition in patients with failed renal allografts when compared to naïve HD patients (20). In another study from our group, we have noted that when compared to never transplanted patients, anthropometric measurements and serum albumin levels were significantly lower and hs-CRP levels were significantly higher in patients with failed transplants.…”

Section: Discussionmentioning

confidence: 99%

Elevated Resistin Levels are Associated with Inflammation in Hemodialysis Patients with Failed Renal Allografts

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Elevated Resistin Levels are Associated with Inflammation in Hemodialysis Patients with Failed Renal Allografts

et al. 2014

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“…There are other potential consequences of retaining a failed kidney allograft. A failed allograft is increasingly being recognized as a risk factor for a more pronounced chronic inflammatory state compared with ESRD alone, contributing to erythropoiesis stimulating agent resistance , endothelial dysfunction , and features consistent with protein energy wasting/malnutrition inflammation complex syndrome , which have in turn been associated with a greater risk of cardiovascular and infection‐related mortality in CKD , dialysis , and kidney transplant patients .…”

Section: Immunosuppression Withdrawal and Transplant Nephrectomymentioning

confidence: 99%

Timing of Return to Dialysis in Patients with Failing Kidney Transplants

Molnar

Ichii

Lineen

et al. 2013

Seminars in Dialysis

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In the last decade, the number of patients starting dialysis after a failed kidney transplant has increased substantially. These patients appear to be different from their transplant‐naïve counterparts, and so may be the timing of dialysis therapy initiation. An increasing number of studies suggest that in transplant‐naïve patients, later dialysis initiation is associated with better outcomes. Very few data are available on timing of dialysis reinitiation in failed transplant recipients, and they suggest that an earlier return to dialysis therapy tended to be associated with worse survival, especially among healthier and younger patients and women. Failed transplant patients may also have unique issues such as continuation of immunosuppression versus withdrawal or the need for remnant allograft nephrectomy with regard to dialysis reinitiation. These patients may have a different predialysis preparation work‐up, worse blood pressure control, higher or lower serum phosphorus levels, lower serum bicarbonate concentration, and worse anemia management. The choice of dialysis modality may also represent an important question for these patients, even though there appears to be no difference in mortality between patients starting peritoneal versus hemodialysis. Finally, failed transplant patients returning to dialysis appear to have a higher mortality rate compared with transplant‐naïve incident dialysis patients, especially in the first several months of dialysis therapy. In this review, we will summarize the available data related to the timing of dialysis initiation and outcomes in failed kidney transplant patients after returning to dialysis.

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“…These antibodies could theoretically prevent the highly sensitized patients from receiving another kidney transplant in a timely manner. Although most patients appear clinically asymptomatic after they return to dialysis, a failed graft left in place might induce a chronic inflammatory state with elevated markers of inflammation such as ferritin, C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α), as well as decreased albumin, associated with failure to thrive, low-grade fever, erythropoietin resistance, and malnutrition, causing increased morbidity and mortality [10,11,12]. Although finding inflammation in the failed graft might be expected, there is a paucity of data on the histologic examination of nephrectomy specimens in regards to ongoing inflammation and the extent of lesions.…”

Section: Introductionmentioning

confidence: 99%

Transplant Nephrectomy: Histologic Findings - A Single Center Study

Goral

Brukamp²,

Ticehurst³

et al. 2014

Am J Nephrol

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Aims: To identify the histopathological features of transplant nephrectomy (TN) specimens. Methods: We performed retrospective analysis of 73 nephrectomies to review the histopathology in detail and correlate the Banff grading characteristics of TN specimens with time post engraftment and clinical features. Retrospective data on donor-specific antibodies (DSA) were also collected. Results: The majority of patients who had TN in less than 3 months posttransplant (n = 20; median time to TN: 4 days) had hemorrhagic infarction; 7patients (35%) had grade 3 acute rejection (AR). Patients who had TN later than 3 months posttransplant (n = 53; median time to TN: 67 months) had AR, grade 2B (21%) and 3 (43%), coexisting with advanced vascular injury in the form of interstitial hemorrhage, extensive interstitial fibrosis and tubular atrophy (IF/TA) as well as the presence of DSAs. Overall, the majority of patients without DSA pre-TN developed DSA post-TN. Conclusions: Our data revealed extensive inflammation and ongoing immunologic activity in a subset of patients with a failed graft. Careful and individualized approach based on clinical and laboratory data should guide the decision for transplant nephrectomy. i 2014 S. Karger AG, Basel

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Comparison of Markers of Appetite and Inflammation Between Hemodialysis Patients With and Without Failed Renal Transplants

Cited by 18 publications

References 54 publications

Elevated Resistin Levels are Associated with Inflammation in Hemodialysis Patients with Failed Renal Allografts

Elevated Resistin Levels are Associated with Inflammation in Hemodialysis Patients with Failed Renal Allografts

Timing of Return to Dialysis in Patients with Failing Kidney Transplants

Transplant Nephrectomy: Histologic Findings - A Single Center Study

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