Pretransplant NT-proBNP, Dialysis Vintage, and Posttransplant Mortality in Kidney Transplant Recipients

Yeung, Stanley M H; Londen, Marco van; Nakshbandi, Uzma; Said, M. Yusof; Eisenga, Michele F.; Hepkema, Bouke; Nolte, Ilja M.; Berger, Stefan P.; Borst, Martin H. de; Bakker, Stephan J. L.

doi:10.1097/tp.0000000000003125

Cited by 9 publications

(6 citation statements)

References 41 publications

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“…Like, other easily assessable biomarkers have been identified as useful tools to detect chronic graft damage before its histological evidence or clinical manifestation. Speaking of this, pre-transplant serum levels of NT-proBNP were independently associated with all-cause mortality in a wide series of kidney-transplanted patients more than 10 years after the study [60]. In summary, ongoing evidence advocates for the seeking of specific pre-transplant predictive biomarkers which, supporting subsequent histological exam of the harvested organs, will help to target the recipient's clinical management by identifying the graft's probability of developing acute and chronic damages.…”

Section: New Toolsmentioning

confidence: 86%

The Puzzle of Preimplantation Kidney Biopsy Decision-Making Process: The Pathologist Perspective

Eccher,

Becker,

Pagni

et al. 2024

Life

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Kidney transplantation is the best treatment for end-stage renal disease since it offers the greatest survival benefit compared to dialysis. The gap between the number of renal transplants performed and the number of patients awaiting renal transplants leads to a steadily increasing pressure on the scientific community. Kidney preimplantation biopsy is used as a component of the evaluation of organ quality before acceptance for transplantation. However, the reliability and predictive value of biopsy data are controversial. Most of the previously proposed predictive models were not associated with graft survival, but what has to be reaffirmed is that histologic examination of kidney tissue can provide an objective window on the state of the organ that cannot be deduced from clinical records and renal functional studies. The balance of evidence indicates that reliable decisions about donor suitability must be made based on the overall picture. This work discusses recent trends that can reduce diagnostic timing and variability among players in the decision-making process that lead to kidney transplants, from the pathologist’s perspective.

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Section: New Toolsmentioning

confidence: 86%

The Puzzle of Preimplantation Kidney Biopsy Decision-Making Process: The Pathologist Perspective

Eccher,

Becker,

Pagni

et al. 2024

Life

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“…Pretransplant serum NT-proBNP, a marker associated with volume overload and congestive heart failure, was independently associated with all-cause mortality in 658 kidney transplant recipients during a median follow-up of 12.7 years ( 53 ). The hazard rate per 1 standard deviation of NT-proBNP increase was 1.67 with a 95% confidence interval of 1.48 to 1.89 ( 53 ). Even after adjusting for age, gender, and several other factors, the association between NT-proBNP and mortality remained significant ( 53 ).…”

Section: Pretransplant Biomarkers and Long-term Outcomementioning

confidence: 99%

“…The hazard rate per 1 standard deviation of NT-proBNP increase was 1.67 with a 95% confidence interval of 1.48 to 1.89 ( 53 ). Even after adjusting for age, gender, and several other factors, the association between NT-proBNP and mortality remained significant ( 53 ).…”

Section: Pretransplant Biomarkers and Long-term Outcomementioning

confidence: 99%

Pretransplant characteristics of kidney transplant recipients that predict posttransplant outcome

Tepel

Nagarajah²,

Saleh³

et al. 2022

Front. Immunol.

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Better characterization of the potential kidney transplant recipient using novel biomarkers, for example, pretransplant plasma endotrophin, will lead to improved outcome after transplantation. This mini-review will focus on current knowledge about pretransplant recipients’ characteristics, biomarkers, and immunology. Clinical characteristics of recipients including age, obesity, blood pressure, comorbidities, and estimated survival scores have been introduced for prediction of recipient and allograft survival. The pretransplant immunologic risk assessment include histocompatibility leukocyte antigens (HLAs), anti-HLA donor-specific antibodies, HLA-DQ mismatch, and non-HLA antibodies. Recently, there has been the hope that pretransplant determination of markers can further improve the prediction of posttransplant complications, both short-term and long-term outcomes including rejections, allograft loss, and mortality. Higher pretransplant plasma endotrophin levels were independently associated with posttransplant acute allograft injury in three prospective European cohorts. Elevated numbers of non-synonymous single-nucleotide polymorphism mismatch have been associated with increased allograft loss in a multivariable analysis. It is concluded that there is a need for integration of clinical characteristics and novel molecular and immunological markers to improve future transplant medicine to reach better diagnostic decisions tailored to the individual patient.

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“…Risk stratification strategies using sensitive measures, like strain, may eventually be incorporated into clinical practice, although therapies for abnormal strain and heart failure with preserved ejection fraction do not yet exist outside preclinical studies. N-terminal prohormone B-type natriuretic peptide (NT-proBNP) measured pretransplant is independently associated with post-transplant mortality, whereas post-transplant NT-proBNP associates with left ventricular hypertrophy (92,93). Use of NT-proBNP to guide diagnosis or treatment of de novo heart failure post-transplant is not established.…”

Section: Cardiovascular Disease In the Kidney Transplant Recipientmentioning

confidence: 99%

Post-Transplant Cardiovascular Disease

Birdwell

Park

2021

CJASN

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Cardiovascular disease remains a leading cause of death and morbidity in kidney transplant recipients and a common reason for post-transplant hospitalization. Several traditional and nontraditional cardiovascular risk factors exist, and many of them present pretransplant and worsened, in part, due to the addition of immunosuppression post-transplant. We discuss optimal strategies for identification and treatment of these risk factors, including the emerging role of sodium-glucose cotransporter 2 inhibitors in post-transplant diabetes and cardiovascular disease. We present common types of cardiovascular disease observed after kidney transplant, including coronary artery disease, heart failure, pulmonary hypertension, arrhythmia, and valvular disease. We also discuss screening, treatment, and prevention of post-transplant cardiac disease. We highlight areas of future research, including the need for goals and best medications for risk factors, the role of biomarkers, and the role of screening and intervention.

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Pretransplant NT-proBNP, Dialysis Vintage, and Posttransplant Mortality in Kidney Transplant Recipients

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Cited by 9 publications

References 41 publications

The Puzzle of Preimplantation Kidney Biopsy Decision-Making Process: The Pathologist Perspective

The Puzzle of Preimplantation Kidney Biopsy Decision-Making Process: The Pathologist Perspective

Pretransplant characteristics of kidney transplant recipients that predict posttransplant outcome

Post-Transplant Cardiovascular Disease

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