The Relationship Between Chronic Inflammation and Glucidic-Lipidic Profile Disorders in Kidney Transplant Recipients

AbstractIntroduction: Chronic inflammation has a proven role in atherogenesis, lipid profile parameters being related to cytokine production. In kidney transplant recipients, interleukin 6 (IL-6) is significantly associated with graft-related outcomes and also alterations of cholesterol and triglyceride metabolism. The aim of this study was to investigate the relationship between chronic inflammation and glucidic-lipidic metabolism disorders in a group of patients with kidney transplantation as renal replacement therapy. Methods: A prospective observational study which enrolled thirtysix non-diabetic kidney transplant recipients was conducted in the Nephrology and Peritoneal Dialysis Department, County Clinic Hospital of Tirgu Mures. The study group was divided as following: recipients with serum IL-6 concentration higher than 3.8 pg/ml (group A) and IL-6 within the normal range (group B). Results: Allograft recipients with higher serum IL-6 had significant higher erytrocyte sedimentation rate(ESR, p=0.0067). Patients with over-the-range levels of IL-6 had significant higher levels of serum cholesterol and LDL-cholesterol respectively (p=0.0242 and p=0.0081). Serum Apo-B was also significant higher in Group A than Group B. Protein excretion was significant higher in patients from group A (p=0.0013). No statistical significant relationship could be proven between elevated levels of IL-6 and hbA1c, insulin and glycosuria disturbances in the two groups. Also, we found no statistical significant association between resistivity and pulsatility indices (both hilum and intragraft) or carotid intima media thickness. Conclusion: Serum interleukin 6 is related to lipid profile disorders and less to glucidic metabolism anomalies in non-diabetic kidney transplant recipients.

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Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation

Clinical and Developmental Immunology ◽

10.1155/2013/496974 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 20

Author(s):

Massimiliano Veroux ◽

Tiziano Tallarita ◽

Daniela Corona ◽

Nunziata Sinagra ◽

Alessia Giaquinta ◽

...

Keyword(s):

Diabetes Mellitus ◽

Serum Creatinine ◽

Kidney Transplant ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Reduced Dose ◽

Group A ◽

Group B ◽

New Onset Diabetes Mellitus ◽

New Onset

New-onset diabetes mellitus after transplantation (NODAT) may complicate 2–50% of kidney transplantation, and it is associated with reduced graft and patient survivals. In this retrospective study, we applied a conversion protocol to sirolimus in a cohort of kidney transplant recipients with NODAT. Among 344 kidney transplant recipients, 29 patients developed a NODAT (6.6%) and continued with a reduced dose of calcineurin inhibitors (CNI) (8 patients, Group A) or were converted to sirolimus (SIR) (21 patients, Group B). NODAT resolved in 37.5% and in 80% patients in Group A and Group B, respectively. In Group A, patient and graft survivals were 100% and 75%, respectively, not significantly different from Group B (83.4% and 68%, resp.,P=0.847). Graft function improved after conversion to sirolimus therapy: serum creatinine was 1.8 ± 0.7 mg/dL at the time of conversion and 1.6 ± 0.4 mg/dL five years after conversion to sirolimus therapy (P<0.05), while in the group of patients remaining with a reduced dose of CNI, serum creatinine was 1.7 ± 0.6 mg/dL at the time of conversion and 1.65 ± 0.6 mg/dL at five-year followup (P=0.732). This study demonstrated that the conversion from CNI to SIR in patients could improve significantly the metabolic parameters of patients with NODAT, without increasing the risk of acute graft rejection.

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Long-term follow-up of polyneuropathy in diabetic kidney transplant recipients

Diabetes ◽

10.2337/diabetes.37.9.1247 ◽

1988 ◽

Vol 37 (9) ◽

pp. 1247-1252 ◽

Cited By ~ 4

Author(s):

J. A. Van der Vliet ◽

X. Navarro ◽

W. R. Kennedy ◽

F. C. Goetz ◽

J. J. Barbosa ◽

...

Keyword(s):

Kidney Transplant ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Diabetic Kidney ◽

Long Term Follow Up

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Exhaled Hydrogen as a Marker of Intestinal Fermentation Is Associated with Diarrhea in Kidney Transplant Recipients

Journal of Clinical Medicine ◽

10.3390/jcm10132854 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2854

Author(s):

Fernanda Rodrigues ◽

J. Swarte ◽

Rianne Douwes ◽

Tim Knobbe ◽

Camilo Sotomayor ◽

...

Keyword(s):

Small Bowel ◽

Kidney Transplant ◽

Surrogate Marker ◽

Bacterial Overgrowth ◽

Dietary Factors ◽

Multivariable Logistic Regression Analysis ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Increased Risk ◽

The Relationship

Background: Diarrhea is common among kidney transplant recipients (KTR). Exhaled hydrogen (H2) is a surrogate marker of small bowel dysbiosis, which may drive diarrhea. We studied the relationship between exhaled H2 and diarrhea in KTR, and explored potential clinical and dietary determinants. Methods: Clinical, laboratory, and dietary data were analyzed from 424 KTR participating in the TransplantLines Biobank and Cohort Study (NCT03272841). Fasting exhaled H2 concentration was measured using a model DP Quintron Gas Chromatograph. Diarrhea was defined as fast transit time (types 6 and 7 according to the Bristol Stool Form Scale, BSFS) of 3 or more episodes per day. We studied the association between exhaled H2 and diarrhea with multivariable logistic regression analysis, and explored potential determinants using linear regression. Results: KTR (55.4 ± 13.2 years, 60.8% male, mean eGFR 49.8 ± 19.1 mL/min/1.73 m2) had a median exhaled H2 of 11 (5.0–25.0) ppm. Signs of small intestinal bacterial overgrowth (exhaled H2 ≥ 20 ppm) were present in 31.6% of the KTR, and 33.0% had diarrhea. Exhaled H2 was associated with an increased risk of diarrhea (odds ratio 1.51, 95% confidence interval 1.07–2.14 per log2 ppm, p = 0.02). Polysaccharide intake was independently associated with higher H2 (std. β 0.24, p = 0.01), and a trend for an association with proton-pump inhibitor use was observed (std. β 0.16 p = 0.05). Conclusion: Higher exhaled H2 is associated with an increased risk of diarrhea in KTR. Our findings set the stage for further studies investigating the relationship between dietary factors, small bowel dysbiosis, and diarrhea after kidney transplantation.

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Stromal Cell-Derived Factor 1 Gene Polymorphism Is Associated with Susceptibility to Adverse Long-Term Allograft Outcomes in Non-Diabetic Kidney Transplant Recipients

International Journal of Molecular Sciences ◽

10.3390/ijms150712495 ◽

2014 ◽

Vol 15 (7) ◽

pp. 12495-12506 ◽

Cited By ~ 2

Author(s):

Chung-Jieh Wang ◽

Jen-Pi Tsai ◽

Shun-Fa Yang ◽

Jong-Da Lian ◽

Horng-Rong Chang

Keyword(s):

Gene Polymorphism ◽

Kidney Transplant ◽

Stromal Cell ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Diabetic Kidney ◽

Stromal Cell Derived Factor

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Alendronate as an Effective Treatment for Bone Loss and Vascular Calcification in Kidney Transplant Recipients

Journal of Transplantation ◽

10.1155/2014/269613 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 14

Author(s):

Masanori Okamoto ◽

Shintaro Yamanaka ◽

Wataru Yoshimoto ◽

Takashi Shigematsu

Keyword(s):

Bone Loss ◽

Effective Treatment ◽

Kidney Transplant ◽

Vascular Calcification ◽

Secondary Osteoporosis ◽

Control Group ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Mineral Density ◽

Group A

Kidney transplant recipients develop secondary osteoporosis induced by immunosuppressive medication, with a high risk of fracture, and abdominal aortic calcification (AC) is a known predictor of cardiovascular mortality. In this study of 12 stable kidney recipients, we estimated the preventive effect of bisphosphonate treatment on bone loss and progression of AC. We randomly divided the subjects into a treatment group with alendronate (group A: 5 subjects) and a control group (group C: 7 subjects). Group A patients received 35 mg/week of alendronate over 24 months, while group C patients were not administered with any bisphosphonates. Two major endpoints were established: (1) the time-dependent change in bone mineral density (BMD) estimated with DEXA and (2) progression of abdominal AC, calculated twice as an index (ACI) using computed tomography data. Over the 2-year study period, group A patients showed significantly increased BMD of 1.86 ± 0.85% (P=0.015versus baseline), and almost complete inhibition of ACI progression (38.2 ± 24.2% to 39.6 ± 24.3%), but group C patients showed a decrease in BMD decline with bone loss and progression of ACI (32.8 ± 25.0% to 37.8 ± 29.2%,P=0.061). In conclusion, alendronate therapy was an effective treatment in kidney transplant recipients for secondary osteoporosis and vascular calcification as ectopic calcification. This clinical trial is registered with number JMA-IIA00155 of JMACCT CTR.

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