Effect of severe diarrhoea on kidney transplant outcomes

Kim, Ji Eun; Ha, Jongwon; Kim, Yon Su; Han, Seung Seok

doi:10.1111/nep.13599

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…However, the role of gut microbiota, being called “the second genome,” in the pharmacokinetics of CSA might be neglected. Studies mentioned that there could be higher risks of graft failure and all-cause mortality in transplant patients with diarrhoea than patients without diarrhoea, but adjusting the dose of immunological agents could improve about 20% of these patients’ graft survival ( Kim et al, 2020 ; Sonambekar et al, 2020 ). This suggests that microbiota disturbance is a potential factor affecting the pharmacokinetics of cyclosporine A.…”

Section: Introductionmentioning

confidence: 99%

Effects of intestinal microbiota on pharmacokinetics of cyclosporine a in rats

et al. 2022

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BackgroundIntestinal microbiota has been confirmed to influencing the pharmacokinetic processes of a variety of oral drugs. However, the pharmacokinetic effects of the gut microbiota on cyclosporine A, a drug with a narrow therapeutic window, remain to be studied.MethodTwenty-one rats were randomly divided into three groups: (a) control group (CON), (b) antibiotic treatment group (ABT) and (c) fecal microbe transplantation group (FMT). The ABT group was administrated with water containing multiple antibiotics to deplete microorganisms. FMT was with the same treatment, followed by oral administration of conventional rat fecal microorganisms for normalization.ResultThe bioavailability of CSA increased by 155.6% after intestinal microbes were consumed by antibiotics. After intestinal microbiota reconstruction by fecal transplantation, the increased bioavailability was significantly reduced and basically returned to the control group level. Changes in gut microbiota alter the protein expression of CYP3A1, UGT1A1 and P-gp in liver. The expressions of these three proteins in ABT group were significantly lower than those in CON and FMT groups. The relative abundance of Alloprevolleta and Oscillospiraceae UCG 005 was negatively correlated with CSA bioavailability while the relative abundance of Parasutterella and Eubacterium xylanophilum group was negatively correlated with CSA bioavailability.ConclusionIntestinal microbiota affects the pharmacokinetics of CSA by regulating the expression of CYP3A1, UGT1A1 and P-GP.

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Section: Introductionmentioning

confidence: 99%

Effects of intestinal microbiota on pharmacokinetics of cyclosporine a in rats

et al. 2022

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Healthcare associated diarrhea, not Clostridioides difficile

Turner

Saullo

Polage

2020

Current Opinion in Infectious Diseases

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Purpose of review The aim of this article is to review the epidemiology, cause, diagnostic evaluation, and management of healthcare-associated diarrhea (HCAD) with particular attention to current epidemiology and recent developments in diagnostics. Recent findings Multiplex polymerase chain reaction gastrointestinal panels allow rapid detection of a wide array of potential enteropathogens but the role, yield, and utility of these tests have not been systematically assessed in patients with HCAD. Recent epidemiologic studies reaffirm that HCAD is predominantly a noninfectious condition most often caused by medications or underlying medical conditions, sometimes Clostridioides difficile, and occasionally viruses. Other infections are rare. Summary Clinical assessment remains fundamental to the evaluation of HCAD and targeted testing for C. difficile is sufficient in most patients. Multiplex gastrointestinal panels may have a role in immunocompromised patients but more study is needed. Medication-induced diarrhea is common and underappreciated and not limited to antibiotics, laxatives, and enemas.

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Analysis of risk factors and prognosis of diarrhea after renal transplantation

Zhu,

Lin,

et al. 2024

THC

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BACKGROUND: Diarrhea is a prevalent complication after renal transplantation. OBJECTIVE: To examine the risk factors for diarrhea after renal transplantation, evaluate their combined predictive values, and analyze the prognosis. METHODS: Clinical data of patients who underwent allogeneic renal transplantation in the Second People’s Hospital of Shanxi Province from January 2019 to March 2020 were retrospectively analyzed, cases were screened and grouped, independent risk factors for diarrhea after renal transplantation were analyzed by univariate analysis and multivariate analysis, and their predictive value was evaluated by receiver operating characteristic (ROC) curve. The survival time of recipient grafts in diarrhea and non-diarrhea groups were evaluated by Kaplan-Meier and log-rank test. RESULTS: We included 166 recipients in the study and the incidence of diarrhea was 25.9%; univariate and logistic regression multivariate analyses revealed that independent risk factors for diarrhea in recipients were that the type of renal transplant donor was DCD (donation after circulatory death), immunity induction was onducted with basiliximab + antithymocyte globulin (ATG), and ATG alone, the type of mycophenolic acid (MPA) used was mycophenolate mofetil capsules, and delayed graft function (DGF) occurred after transplantation. The ROC curve indicated that the combination of the four factors had good accuracy in predicting the occurrence of diarrhea in recipients. The graft survival rate two years after the operation in the diarrhea group was significantly lower than that in the non-diarrhea group. CONCLUSION: Diarrhea affected the two-year survival rate of the graft. The type of donor, immunity induction scheme, and the type of MPA and DGF were independent risk factors for diarrhea in recipients, and the combination of the four factors had good prognostic prediction value.

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Effect of severe diarrhoea on kidney transplant outcomes

Cited by 3 publications

References 31 publications

Effects of intestinal microbiota on pharmacokinetics of cyclosporine a in rats

Effects of intestinal microbiota on pharmacokinetics of cyclosporine a in rats

Healthcare associated diarrhea, not Clostridioides difficile

Analysis of risk factors and prognosis of diarrhea after renal transplantation

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