Consanguinity-associated kidney diseases in Lebanon: an epidemiological study

Barbari, A; Stephan, A; Masri, Marwan; Karam, A; Aoun, S; Nahas, J El; Khalil, Jibril

doi:10.1016/s0161-5890(03)00065-8

Cited by 31 publications

(26 citation statements)

References 16 publications

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“…Because, as is commonly observed in the Middle East countries, 10 living donors and recipients had frequently a familial heredity, and because this heredity was mainly transmitted by women (Table 1), the role of familial factors in the mechanism of increased PWV was important to discriminate. For this purpose, PWV was measured in 2 populations of healthy volunteers, one being RR and the other NRR.…”

Section: Discussionmentioning

confidence: 99%

Aortic Stiffness, Living Donors, and Renal Transplantation

Bahous

Stephan²,

Blacher³

et al. 2006

Hypertension

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Abstract-In subjects with renal disease, reduced renal function and increased arterial stiffness are significantly associated in cross-sectional studies. The relationship is independent of age, blood pressure (BP), and atherosclerosis. Because both variables are independent predictors of cardiovascular risk, time-dependent relationships between them are important to determine. Aortic pulse wave velocity was measured noninvasively by comparison with healthy volunteers in 101 living kidney donors and their 101 corresponding recipients. Healthy volunteers were divided into 2 groups: one was recipient related through familial links and the other was nonrecipient related. Independently of age, gender, and BP, pulse wave velocity was significantly elevated in donors and recipients by comparison with the 2 groups of healthy volunteers. Pulse wave velocity was significantly higher in the recipient-related than in the nonrecipient-related group. Whereas in healthy volunteers, pulse wave velocity was exclusively related to age, gender, and BP, in donors and recipients, it was rather associated with a cluster of cardiovascular risk factors, including smoking habits and plasma glucose. Major factors related to pulse wave velocity were renal: time since nephrectomy (donation date) in donors, in whom pulse pressure was specifically associated with proteinuria, and renal rejection in recipients. Plasma creatinine doubling secondary to chronic allograft nephropathy was significantly associated with renal rejection and donor pulse wave velocity, independent of age.

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Section: Discussionmentioning

confidence: 99%

Aortic Stiffness, Living Donors, and Renal Transplantation

Bahous

Stephan²,

Blacher³

et al. 2006

Hypertension

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“…ESRD is increased in those who smoke, are obese, and have a family history of renal disease (64,(71)(72)(73). Although smoking may be on the decline, it is still not obsolete, and the weight of the world's population is increasing (www.oas.samhsa.gov).…”

Section: Concerns For the Futurementioning

confidence: 99%

Living-Donor Kidney Transplantation

Davis

Delmonico

2005

Journal of the American Society of Nephrology

301

244

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The first successful living-donor kidney transplant was performed 50 yr ago. Since then, in a relatively brief period of medical history, living kidney transplantation has become the preferred treatment for those with ESRD. Organ replacement from either a live or a deceased donor is preferable to dialysis therapy because transplantation provides a better quality of life and improved survival. The advantages of live versus deceased donor transplantation now are readily apparent as it affords earlier transplantation and the best long-term survival. Live kidney donation has also been fostered by the technical advance of laparoscopic nephrectomy and immunologic maneuvers that can overcome biologic obstacles such as HLA disparity and ABO or cross-match incompatibility. Congressional legislation has provided an important model to remove financial disincentives to being a live donor. Federal employees now are afforded paid leave and coverage for travel expenses. Candidates for renal transplantation are aware of these developments, and they have become less hesitant to ask family members, spouses, or friends to become live kidney donors. Living donation as practiced for the past 50 yr has been safe with minimal immediate and long-term risk for the donor. However, the future experience may not be the same as our society is becoming increasingly obese and developing associated health problems. In this environment, predicting medical futures is less precise than in the past. Even so, isolated abnormalities such as obesity and in some instances hypertension are no longer considered absolute contraindications to donation. These and other medical risks bring additional responsibility in such circumstances to track the unknown consequences of a live-donor nephrectomy.

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“…Dr. A. Barbari and colleagues demonstrated a close relation between consanguinity and hereditary renal disease. 27 This relation between consanguinity and hereditary renal disease puts genetically related donors at a higher risk of developing end-stage renal disease. Rather than devising new allocation rules to prioritize living donors, a strict choice of potential donors should be adopted to protect them.…”

Section: Proper Selection Of the Donormentioning

confidence: 99%

Untitled

Stephan

2017

Exp Clin Transplant

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The shortage of organs for transplant is a universal problem. The World Health Organization is urging every nation to seek self-sufficiency regarding their organ procurement program. Reaching self-sufficiency inevitably requires the provision of a well-developed deceased-donor organ procurement program. Most countries represented by the Middle East Society for Organ Transplantation still rely on living-donor organ donations. Some of these countries have been relatively successful in promoting deceased-donor donation as well. In our region, deceased-donor organs are recovered exclusively from patients who have been declared brain dead. However, with improvements in preventive and therapeutic interventions, the pool of potential brain dead donors is rapidly shrinking. This should, therefore, stimulate our interest in developing a program for recovering organs after cardiac death. However, increasing the pool of donors, even to optimal levels, may still not be enough to meet the growing demand. More resources must be invested in reducing the demand for organs. This is especially true in our region, where primary care programs aimed at slowing or containing disease progression that may lead to organ failure are lacking. This problem is compounded by limited access to such programs and, for that matter, limited access to even the most basic primary care. Continued efforts to increase the supply of donor organs must be pursued. At the same time, we must work to more effectively treat the diseases that could lead to end-stage renal disease and the increased demand for donor organs. A comprehensive approach to the problem of donor organ shortages in countries in the Middle East also must consider the relatively limited financial resources that are available.

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Consanguinity-associated kidney diseases in Lebanon: an epidemiological study

Cited by 31 publications

References 16 publications

Aortic Stiffness, Living Donors, and Renal Transplantation

Aortic Stiffness, Living Donors, and Renal Transplantation

Living-Donor Kidney Transplantation

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