Melatonin rhythms in renal transplant recipients with sleep–wake disturbances

Burkhalter, Hanna; Geest, Sabina De; Wirz‐Justice, Anna; Cajochen, Christian

doi:10.3109/07420528.2016.1169192

Cited by 12 publications

(6 citation statements)

References 67 publications

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“…Burkhalter et al also measured saliva melatonin in 29 stable RTRs more than 1 year post-transplantation. In these RTRs with sleep-wake disturbances, they found low melatonin levels, mainly in the RTRs without dim-light melatonin onset, and this was related to health impairment in this group [21]. In line with our study results, they found a high percentage of RTRs with fairly low to no melatonin production.…”

Section: Discussionsupporting

confidence: 89%

Urinary Excretion of 6-Sulfatoxymelatonin, the Main Metabolite of Melatonin, and Mortality in Stable Outpatient Renal Transplant Recipients

Veen

Minovíc

Faassen

et al. 2020

JCM

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Melatonin is a multifaceted hormone which rises upon the onset of darkness. Pineal synthesis of melatonin is known to be disturbed in patients with end-stage renal disease, but it is not known if its production is restored to normal after successful renal transplantation. We hypothesized that urinary excretion of 6-sulfatoxymelatonin, the major metabolite of melatonin, is lower in renal transplant recipients (RTRs) compared to healthy controls and that this is associated with excess mortality. Urinary 6-sulfatoxymelatonin was measured via LC-MS/MS in 701 stable outpatient RTRs and 285 healthy controls. Median urinary 6-sulfatoxymelatonin in RTR was 13.2 nmol/24 h, which was 47% lower than in healthy controls. Urinary 6-sufatoxymelatonin appeared undetectable in the majority of 36 RTRs with diabetic nephropathy as primary renal disease. Therefore, this subgroup was excluded from further analyses. Of the remaining 665 RTRs, during 5.4 years of follow-up, 110 RTRs died, of whom 38 died due to a cardiovascular cause. In Cox-regression analyses, urinary 6-sulfatoxymelatonin was significantly associated with all-cause mortality (0.60 (0.44–0.81), p = 0.001) and cardiovascular mortality (0.49 (0.29–0.84), p = 0.009), independent of conventional risk factors and kidney function parameters. Based on these results, evaluation and management of melatonin metabolism could be considered for improvement of long-term outcomes in RTRs.

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Section: Discussionsupporting

confidence: 89%

Urinary Excretion of 6-Sulfatoxymelatonin, the Main Metabolite of Melatonin, and Mortality in Stable Outpatient Renal Transplant Recipients

Veen

Minovíc

Faassen

et al. 2020

JCM

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“…Sleep disorders are very common in kidney transplant patients; the causes can regard demographic factors, lifestyles, diseaserelated factors, and social factors (28,47,52). If not adequately treated, they interfere with a good post-transplant quality of life and so they have recently stimulated interest of the researchers, with the need to investigate non-pharmacological interventions, such as "Bright light therapy" (BLT) (50,58,66,69,78).…”

Section: Discussionmentioning

confidence: 99%

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more indepth knowledge of the candidate to plan coping strategies and possible posttransplant psychotherapy.

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“…Daytime sleepiness improves [ 22 ] after kidney transplantation; however, those for whom it persists are more prone to immunosuppression non-adherence [ 33 ]. No [ 22 ] or little improvement [ 34 ] was found with objective measurements such as melatonin secretion or circadian rhythms.…”

Section: Discussionmentioning

confidence: 99%

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

et al. 2017

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BackgroundPoor sleep quality (SQ) is common after solid organ transplantation; however, very little is known about its natural history. We assessed the changes in SQ from pre- to 3 years post-transplant in adult heart, kidney, liver and lung recipients included in the prospective nation-wide Swiss Transplant Cohort Study. We explored associations with selected variables in patients suffering persistent poor SQ compared to those with good or variable SQ.MethodsAdult single organ transplant recipients enrolled in the Swiss Transplant Cohort Study with pre-transplant and at least 3 post-transplant SQ assessment data were included. SQ was self-reported pre-transplant (at listing), then at 6, 12, 24 and 36 months post-transplant. A single SQ item was used to identify poor (0–5) and good sleepers (6–10). Between organ groups, SQ was compared via logistic regression analysis with generalized estimating equations. Within the group reporting persistently poor SQ, we used logistic regression or Kaplan-Meier analysis as appropriate to check for differences in global quality of life and survival.ResultsIn a sample of 1173 transplant patients (age: 52.1±13.2 years; 65% males; 66% kidney, 17% liver, 10% lung, 7% heart) transplanted between 2008 and 2012, pre- transplant poor SQ was highest in liver (50%) and heart (49%) recipients. Overall, poor SQ decreased significantly from pre-transplant (38%) to 24 months post-transplant (26%) and remained stable at 3 years (29%). Patients reporting persistently poor SQ had significantly more depressive symptomatology and lower global quality of life.ConclusionBecause self-reported poor SQ is related to poorer global quality of life, these results emphasize the need for further studies to find suitable treatment options for poor SQ in transplant recipients.

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Melatonin rhythms in renal transplant recipients with sleep–wake disturbances

Cited by 12 publications

References 67 publications

Urinary Excretion of 6-Sulfatoxymelatonin, the Main Metabolite of Melatonin, and Mortality in Stable Outpatient Renal Transplant Recipients

Urinary Excretion of 6-Sulfatoxymelatonin, the Main Metabolite of Melatonin, and Mortality in Stable Outpatient Renal Transplant Recipients

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

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