Long-Term Cardiovascular Morbidity and Mortality in Autosomal Dominant Polycystic Kidney Disease Patients After Renal Transplantation

Florijn, K. W.; Chang, P. C.; Woude, Fokko J. van der; Bockel, J.H. van; Saase, Jan L.C.M. van

doi:10.1097/00007890-199401000-00014

Cited by 58 publications

(31 citation statements)

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“…In particular, several reports indicate that hypercholesterolemia contributes to cardiovascular risk after transplantation, as in nontransplant patients (3,4,25).…”

Section: Discussionmentioning

confidence: 99%

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Blum

2002

American Journal of Transplantation

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This report describes the effects of sirolimus on plasma lipids, and uses the Framingham risk model to assess the clinical importance of these effects. Lipid data from two large controlled studies of 1295 renal transplant patients were analyzed retrospectively. Sirolimus 2 mg/day and 5 mg/day were compared with placebo or azathioprine, and administered concomitantly with steroids and cyclosporine over 12 months. Hypercholesterolemia and hypertriglyceridemia occurred in all treatment groups and were maximal at 2-3 months. The sirolimus groups evidenced higher lipid levels than the controls, but the elevations diminished over time. At 1 year, the patients given sirolimus 2 mg/ day had a mean cholesterol level 17 mg/dL greater and a mean triglyceride level 59 mg/dL greater than the controls. Among the patients given sirolimus 5 mg/day, mean cholesterol was 30 mg/dL greater and mean triglycerides were 103 mg/dL greater than the controls. Treatment with statins and fibrates was effective in reducing cholesterol and triglyceride levels, respectively, in the sirolimus-treated patients. The Framingham risk model predicted that the 17 mg/dL elevation in cholesterol would increase the incidence of coronary heart disease (CHD) by 1.5 new cases per 1000 persons per year and CHD death by 0.7 events per 1000 persons per year. Lipid elevations observed in the sirolimus-treated patients were manageable, improved over time, and responded to lipid-lowering therapy. Based on the Framingham risk model, the CHD risks associated with these cholesterol elevations are small compared with the baseline risks of the transplant population.

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“…In particular, several reports indicate that hypercholesterolemia contributes to cardiovascular risk after transplantation, as in nontransplant patients (3,4,25).…”

Section: Discussionmentioning

confidence: 99%

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Blum

2002

American Journal of Transplantation

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“…Florijn et al publicaron en 1994 una serie de 101 TxR con RPQ, efectuados en Holanda entre 1967-1991, los que compararon con 692 controles con otras nefropatías. Encontraron que la sobrevida de los injertos en pacientes con RPQ no fue diferente a la de sus controles 17 . Hallazgos similares fueron publicados en 1997 por Hadimeri et al quienes en 114 pacientes con RPQ, trasplantados en Suecia entre 1985-1993, encontraron una sobrevida de injertos a 5 años de 62% vs 61% en los controles 13 .…”

Section: Sobrevida De Injertosunclassified

“…Florijn et al en 101 pacientes con RPQ encontraron una mayor incidencia de infarto al miocardio y accidentes cerebrovasculares que en los controles, en los que usaron azatioprina. Ello no ocurrió en los que usaron ciclosporina 17 . En nuestra serie, en que más de 70% de los pacientes utilizó ciclosporina, la incidencia de hospitalizaciones por complicaciones cardiovasculares no fue estadísticamente diferente entre los pacientes con RPQ y sus controles.…”

Section: Complicacionesunclassified

“…Esta diferencia de sobrevida por género no se encontró en los controles 16 . Florijn et al, en 101 pacientes con RPQ encontraron una sobrevida de pacientes similar a la de los controles, pero una mayor frecuencia de muerte con riñón funcionante por enfermedades cardiovasculares 17 . Brazda et al, en 104 injertos en pacientes con RPQ observaron una sobrevida a 5 años de 95%, la cual no fue diferente a la de los controles, 90%.…”

Section: Sobrevida De Pacientesunclassified

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Resultados del trasplante renal en portadores de ríñones poliquísticos

et al. 2012

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“…Although there had been a remarkable progress in surgical and anesthesiological expertise, there remained significant morbidity and the conclusion of these studies was that ADPKD kidneys should not be removed unless they caused significant problems. Temporary controversy on this issue existed after Florijn et al [8] reported that despite the higher morbidity of bilateral nephrectomy, patient survival after transplant was higher in those patients who had undergone nephrectomy. But this could not be confirmed in further studies.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneoscopic Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: Initial Experience

Wyler

Bachmann²,

Ruszat³

et al. 2007

Urol Int

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Introduction: Nephrectomy for autosomal dominant polycystic kidney disease (ADPKD) has been reported to have significant morbidity and mortality. Because of the large kidney size, laparoscopic nephrectomy is technically demanding and there have been only few reports on this subject. We describe our retroperitoneoscopic technique and review the literature. Methods: Retroperitoneoscopic nephrectomy was performed in 2 patients. A four-port retroperitoneal access was used, after hilar control the kidney was freed and extracted. Results: The mean operative time was 155 min, the mean intraoperative blood loss was 125 ml. There were no intraoperative complications. A postoperative retroperitoneal hematoma in 1 of the patients was managed conservatively with transfusion. Conclusion: Retroperitoneoscopic nephrectomy for ADPKD is feasible. The main advantages of this technique compared to transperitoneal laparoscopy are the quick and easy access to the hilar vessels even in large polycystic kidneys and the strict extraperitoneal route.

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Long-Term Cardiovascular Morbidity and Mortality in Autosomal Dominant Polycystic Kidney Disease Patients After Renal Transplantation

Cited by 58 publications

References 0 publications

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk Model

Resultados del trasplante renal en portadores de ríñones poliquísticos

Retroperitoneoscopic Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: Initial Experience

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