Focus on Transplantation

Maternal and Fetal Outcomes in Pregnant Kidney Transplant Recipients

Due to disruption of hypothalamic gonadal axis, women with end-stage renal disease (ESRD) have impaired fertility, resulting in a very low incidence of conception in women on dialysis (range, 0.9% to 7%). In some cases, recipients of kidney transplantation experience a rapid restoration of fertility, making transplantation the optimal treatment for women with ESRD who wish to become pregnant. There ... Read More »

Stroke Risk and Predictors in Kidney Transplant Recipients

Kidney transplantation is the gold standard treatment for patients with end-stage renal disease (ESRD). The prevalence of mortality and major cardiovascular events in kidney transplant recipients has declined in recent years, and is lower among transplant recipients than in a matched chronic kidney disease (CKD) population. However, kidney transplant recipients continue to have an increased mortality and cardiovascular event risk ... Read More »

Recurrent Diabetic Nephropathy in Transplant Recipients

San Diego—There are few data on recurrent diabetic nephropathy in kidney transplant recipients. Aleksandra Kukla, MD, and colleagues at the Mayo Clinic in Rochester, Minnesota, conducted a study designed to identify the incidence, timing, and severity of recurrent diabetic nephropathy in transplant recipients with pretransplant type 1 and type 2 diabetes. Results of the study were reported during a poster ... Read More »

Using the Hume Formula to Estimate Body Composition

Aberrant body composition, notably muscle and protein-energy wasting, and elevated levels of adiposity, are common characteristics of chronic kidney disease (CKD). Malnutrition, reductions in physical function, and quality of life are negatively affected by abnormal body composition; in addition, there is an association between abnormal body composition and increased risk for adverse clinical outcomes and mortality. Estimates are that 9% ... Read More »

New Hypertension Targets Improve Patient and Graft Survival

San Diego—Utilizing data from SPRINT (Systolic Blood pressure Intervention Trial), American national guidelines reduced the blood pressure goal from 140.90 mm Hg to 130/80 mm HG for subjects with increased cardiovascular risk, including patients with chronic kidney disease (CKD). There are few data available on whether renal transplant recipients benefit from the reduced blood pressure goals. Nikolaos Pagonas, MD, and ... Read More »

Prognostic Importance of Atrial Fibrillation in Kidney Transplant Recipients

Atrial fibrillation (AF) affects three to six million people in the United States, and nearly 30 million people worldwide. AF is associated with higher risk of mortality and adverse cardiovascular events including stroke. Among patients with end-stage renal disease (ESRD), the prevalence of AF is particularly high compared to the general population. In addition, the 1-year mortality risk of patients ... Read More »

Variations in Duration of Kidney Transplant Donor Evaluation

Among patients with kidney failure, kidney transplantation is associated with improved survival, better quality of life, and reduced healthcare costs compared with dialysis therapy. Living donor transplantation provides advantages over deceased donor transplantation, including superior rates of graft and patient survival and shorter time to transplantation. When potential living donors contact a transplantation center, the evaluation process begins with a ... Read More »

Coronary Artery Calcification Score in Recipients of Renal Transplant

San Diego—There is an association between coronary artery calcification and cardiovascular morbidity. Due to the heterogeneity in the population of kidney transplant recipients, there may be variation in the presence and severity of coronary artery calcification in those patients. Using baseline data from a clinical trial, Jennifer S. Lees, MBChB, MRCP, and colleagues in Scotland recently conducted an analysis to ... Read More »

Nutritional Status of Children with ESRD Varies with Renal Replacement Therapy Modality

Among pediatric patients with end-stage kidney disease (ESRD), the frequency of protein-energy malnutrition ranges from 20% to 80%, resulting in loss of lean mass, depletion of fat mass, and deceleration of growth, affecting height. Multiple factors are involved in these alterations, including hormonal imbalance, low nutrient intake, decreased residual renal function, use of renal replacement therapies (RRT), i.e., hemodialysis and ... Read More »

INTENT Trial Examines Intervention to Prevent Excessive Weight Gain Post-Transplant

Recipients of kidney transplant have markedly improved outcomes compared with patients on dialysis; however, survival among kidney transplant recipients is significantly reduced compared with age-matched general population. The reduction in survival is due, in large part, to an increase in the risk of cardiovascular disease. Weight gain, obesity, and diabetes are risk factors for cardiovascular disease, and there is an ... Read More »