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From the Editor: Referring a Patient for Kidney Transplant Needs Improvement

Ajay K. Singh A recent paper published by Patzar and colleagues from Emory in JAMA1 reveals a low rate and marked variability in kidney transplant referrals within the state of Georgia. Once referred, only a fraction of patients actually get listed. Georgia has the lowest rate of transplantation in the United States at approximately 25%. Prior research might have explained ... Read More »

Long-Term Risk of Gout in Living Kidney Donors

Among the general population, risk factors for gout include high concentrations of serum uric acid. According to researchers, concentration of serum uric acid increases in donors following nephrectomy; however, there are few data on whether kidney donation increases a living donor’s risk of gout. Using a large healthcare database, Ngan N. Lam, MD, and colleagues conducted a retrospective matched cohort ... Read More »

Alemtuzumab Safe in Post-Transplant Patients with PTLD

Dallas—Patients who develop lymphoproliferative disorder (PTLD) following kidney transplantation have poor outcomes, including inferior graft survival. Researchers at Stony Brook Medicine, Division of Nephrology, led by Yezina Nigatu, MD, recently conducted a study to determine the incidence and outcome of PTLD among kidney transplant patients who received induction with alemtuzumab. The researchers reported study results during a poster session at ... Read More »

Antibody Induction Superior to Steroid induction in Patients with DGF

Dallas—For renal transplantation patients at risk of delayed graft function (DGF), use of antibody induction decreases the incidence of acute rejection compared with use of steroid induciton. That was among the findings of a study conducted recently by Muhammad Atiq, MD, and colleagues. The researchers reported study results during a poster session at the NKF Spring Clinical Meetings. The poster ... Read More »

Cinacalcet Following Kidney Transplantation

Dallas—Results of a small study suggest that cinacalcet may be a safe alternative for parathyroidectomy in managing post-renal transplant hypercalcemia and hyperparathyroidism. The researchers noted, however, that larger studies are needed. Abhinandan Pakanati, MD, and colleagues conducted the results during a poster session at the NKF Spring Clinical Meetings in a poster titled Role of Cinacalcet in Management of Post-Renal ... Read More »

Levofloxacin Does Not Prevent BK Virus After Transplantation

A 3-month course of levofloxacin begun soon after transplantation did not prevent BK viruria among kidney transplant recipients. That was the primary finding of a trial conducted recently by Greg A Knoll, MD, and colleagues, and reported online in the Journal of the American Medical Association [doi:10.1001/jama.2014.14721]. Due in part to the development of potent immunosuppressant medication, BK virus infection ... Read More »

Association of Dialysis modality and Likelihood of Kidney Transplant

Dallas—Of patients who initiated home dialysis within 6 months of a diagnosis of end-stage renal disease (ESRD), those who began daily home hemodialysis (DHHD) were significantly more likely to receive a kidney transplant than a matched cohort of patients who began peritoneal dialysis (PD). Likewise, patients who began daily home hemodialysis within 6 months of ESRD diagnosis were significantly more ... Read More »

Proton Pump Inhibitors versus H2 Blockers and Risk of Hypomagnesemia

Philadelphia—At many transplant centers, the use of proton pump inhibitors (PPIs) has replaced the use of H2 receptor blockers (H2B) for gastrointestinal prophylaxis, despite a lack of evidence for superior efficacy of PPIs over H2Bs. According to researchers, although PPIs are generally safe medications, their use has been associated with hypomagnesemia due to impaired gastrointestinal absorption. Mohamad Alhosaini, MD, and ... Read More »

Vitamin K Insufficiency Associated with Increased Risk of Mortality

There is an independent association between vitamin K insufficiency and increased risk of mortality among stable kidney transplant recipients. That was the primary finding of an observational study conducted recently by Charlotte A. Keyzer, MD, and colleagues. Study results were reported in the American Journal of Kidney Diseases [2015;65(3):474-483]. The prognosis of patients with end-stage renal disease is substantially improved ... Read More »

Induction with Alemtuzumab Has Low Incidence of BK Nephropathy

Philadelphia—Kidney injury and graft failure are increasingly being associated with BK nephropathy. Current literature suggests an association between high immunosuppression dose and increased incidence of BK viruria, viremia, and nephropathy. According to Pradeep Vaitla, MD, and colleagues, most transplant centers in the United States use antibody induction with rabbit antihymocyte globulin or alemtuzumab to minimize maintenance immunosuppression. The researchers recently ... Read More »