Creatinine Reduction Ratio on Post-Transplant Day Two as Criterion in Defining Delayed Graft Function

Rodrigo, Emilio; Ruiz, J.C.; Piñera, Celestino; Fernández‐Fresnedo, Gema; Escallada, R; Palomar, Rosa; Cotorruelo, J.G; Zubimendi, J.A; Francisco, A.L.M. de; Arias, Manuel

doi:10.1111/j.1600-6143.2004.00488.x

Cited by 103 publications

(62 citation statements)

References 32 publications

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“…Early allograft dysfunction was defined in two ways: serum creatinine greater than 265 umol/L with or without hemodialysis on day 7 posttransplantation (30,31); or the need for dialysis within the first week after transplantation (the usual definition of DGF (30,32). The study investigators were not involved in the decision to initiate dialysis.…”

Section: Clinical Assessment Of Kidney Allograftsmentioning

confidence: 99%

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

Kreepala

Famulski

Chang

et al. 2013

American Journal of Transplantation

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We hypothesized that measurement of previously defined acute kidney injury-induced transcripts at the time of implantation would add a new dimension to existing methods based on donor factors, histology and recipient factors. We analyzed microarray results from implantation biopsies taken after reperfusion from 70 kidneys from 53 deceased donors. We used two definitions of early dysfunction: serum creatinine > 265 umol/L at day 7 posttransplant; and dialysis in the first week. The strongest correlate with early dysfunction was the mean expression of 30 injury transcripts. Older donor and recipient age were associated with early dysfunction, but histologic lesions were not. Prediction was best when the injury transcript expression was combined with donor or recipient age, particularly in standard criteria donors. In contrast, although extended criteria donor kidneys had a high risk of early dysfunction, no variables tested, including injury transcripts, predicted risk significantly, probably because these kidneys were allocated preferentially to old, high risk recipients. The injury transcripts did not predict late function, which was mainly associated with donor age. Thus, measurement of injury-induced transcripts at the time of implantation improves the prediction of early kidney dysfunction, but risk prediction may fail when old kidneys are transplanted into old recipients.

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Section: Clinical Assessment Of Kidney Allograftsmentioning

confidence: 99%

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

Kreepala

Famulski

Chang

et al. 2013

American Journal of Transplantation

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“…10 Even in patients not dialyzed after transplant, studies have shown poorer long-term outcomes with "slow graft function (SGF)" compared with "immediate graft function (IGF)." 3,11,12 Although most studies agree that DGF is associated with poorer outcomes, multiple DGF definitions are used. [13][14][15][16][17] Current means of diagnosing DGF or SGF, using Scr and urine output (UOP), require knowledge of previous values to interpret, are affected by diuretic use, and can take a number of days to confirm.…”

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confidence: 99%

IL-18 and Urinary NGAL Predict Dialysis and Graft Recovery after Kidney Transplantation

Hall¹,

Yarlagadda²,

Coca³

et al. 2010

Journal of the American Society of Nephrology

288

218

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Current methods for predicting graft recovery after kidney transplantation are not reliable. We performed a prospective, multicenter, observational cohort study of deceased-donor kidney transplant patients to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL), IL-18, and kidney injury molecule-1 (KIM-1) as biomarkers for predicting dialysis within 1 wk of transplant and subsequent graft recovery. We collected serial urine samples for 3 d after transplant and analyzed levels of these putative biomarkers. We classified graft recovery as delayed graft function (DGF), slow graft function (SGF), or immediate graft function (IGF). Of the 91 patients in the cohort, 34 had DGF, 33 had SGF, and 24 had IGF. Median NGAL and IL-18 levels, but not KIM-1 levels, were statistically different among these three groups at all time points. ROC curve analysis suggested that the abilities of NGAL or IL-18 to predict dialysis within 1 wk were moderately accurate when measured on the first postoperative day, whereas the fall in serum creatinine (Scr) was not predictive. In multivariate analysis, elevated levels of NGAL or IL-18 predicted the need for dialysis after adjusting for recipient and donor age, cold ischemia time, urine output, and Scr. NGAL and IL-18 quantiles also predicted graft recovery up to 3 mo later. In summary, urinary NGAL and IL-18 are early, noninvasive, accurate predictors of both the need for dialysis within the first week of kidney transplantation and 3-mo recovery of graft function.

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“…Las complicaciones médicas no infecciosas más comúnmente halladas fueron la NTA, las crisis hipertensivas, el EAP y las arritmias. En el caso particular de la NTA es la complicación médica más frecuente en la casi absoluta totalidad de las series de pacientes de TR [14][15][16] . En nuestro caso, si consideramos que habitualmente trasplantamos con tiempos de isquemia fría superiores a las 20 horas, no es de asombrarse estos resultados, pues es conocido que el tiempo de isquemia es un factor de riesgo muy importante para el desarrollo de NTA 13, 17, 18 .…”

Section: Discussionunclassified

Complicaciones del trasplante renal en el Instituto de Nefrología. 2001-2005

Martínez

Méndez

García

et al. 2010

Rev Soc Esp Enferm Nefrol

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Introduction and Objectives: Despite the development of transplants our results are affected by the appearance of medical and surgical complications that hinder their evolution. Our aim was to identify the most frequent complications in the first week after a kidney transplant and their effects on patient and graft survival one month and one year after the transplant.Complicaciones del trasplante renal en el Instituto de

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Creatinine Reduction Ratio on Post-Transplant Day Two as Criterion in Defining Delayed Graft Function

Cited by 103 publications

References 32 publications

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

Comparing Molecular Assessment of Implantation Biopsies With Histologic and Demographic Risk Assessment

IL-18 and Urinary NGAL Predict Dialysis and Graft Recovery after Kidney Transplantation

Complicaciones del trasplante renal en el Instituto de Nefrología. 2001-2005

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