Studying Risk Factors Association with Osteoporosis in Post Kidney Transplantation Patients

Osteoporosis that associate with kidney transplantation is an important cause of ‎morbidity to ‎the patients that warranted extensive study about possible causes of ‎osteoporosis in order to ‎implement several steps to reduce this risk. The current work aimed to investigate possible association between post kidney ‎transplant ‎immunosuppression therapy type and developing the ‎osteoporosis and evaluate the bone mass by using dual X-ray absorptiometry (DXA) post-renalal transplant. A case-control, conducted in kidney transplant center – medical city complex for ‎one year period (‎from October ‎‏2018‏‎ till April 2019), Seventy - five kidney ‎transplant patients were participated in the present study ‎including (21 females & ‎‎54 males). All ‎patients were examined for their bone density using DEXA scan (T – score) and ‎those with cut – point ≤- 2.5 were diagnosed as having osteoporosis (lumber and ‎hip bones were examined). The prevalence of osteoporosis and osteopenia was significantly higher in ‎transplant patients compared to control for bone lumber and hip bone (for ‎lumber bones: 33.3% vs 2.7%l for hip bones: 60% vs. 14.7%). T score was ‎significantly lower in the transplant patients compared to control for both lumber ‎‎(-1.9‎±0.8 vs. -1.1‎±0.7) and hip bones (-2.3‎±0.9 vs -1.3‎±0.8).‎ In logistic regression analysis; only gender and BMI were the predictors of ‎osteoporosis for spinal bone, while; the BMI and calcium were the predictors ‎of osteoporosis for hip bones. In ‏conclusion, Osteoporosis in post-renal transplant patients have a high rate of ‎osteoporosis compared to the general population, post-renal transplant drugs (Cyclosporine, MMF, etc.) did not increase the ‎risk of osteoporosis, and body mass index and female gender were risk factors for osteoporosis

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Human BK Polyomavirus Nephropathy (BKVN) In Non- Kidney-Transplant Patients

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.258 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S118-S118

Author(s):

Y Chen Wongworawat ◽

C Zuppan

Keyword(s):

Renal Transplant ◽

Kidney Transplant ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Transplant Patients ◽

Bk Polyomavirus ◽

Pathologic Features ◽

Renal Biopsies ◽

Renal Transplant Patients

Abstract Introduction/Objective Human BK polyomavirus nephropathy (BKVN) occurs in up to 10% of renal transplant recipients, and can result in graft loss. Transplant biopsy is the gold standard to diagnose BKVN, and SV40 immunohistochemical (IHC) staining is helpful in confirming the diagnosis. BKVN is uncommon outside the setting of renal transplantation. To understand more about its occurrence in other contexts, we reviewed our renal biopsies files for cases of BKVN. Methods Our renal biopsy files for the past 20 years were reviewed for all cases with a diagnosis of BKVN or polyoma virus infection, and the clinical characteristics of the affected patients noted. Results Evidence of BKVN was found in 44 renal biopsies, of which 39 (86%) were renal transplant patients. Of the remaining five patients (14%), two had undergone heart transplantation, one lung transplantation, one was undergoing chemotherapy for acute lymphoblastic leukemia, and one patient had active HIV infection. All patients had elevated serum creatinine, and four out of five patients had documented BK viremia. Four of the five biopsies showed typical tubular injury with viral nuclear cytopathic changes (inclusions). In the lung transplant patient, the biopsy showed advanced chronic tubulointerstitial injury without distinct viral inclusions, but SV40 staining confirmed the presence of BK virus antigen. Conclusion The BKVN is distinctly uncommon outside the context of kidney transplantation. In our series, 14% of patients with BKVN were not kidney transplant recipients, but all were immune compromised in some fashion. The pathologic features of BKVN appear similar, regardless of whether the host is a renal transplant recipient or not. Although uncommon, it is important to consider the possibility of BKVN in non-renal transplant patients with persistent or progressive renal dysfunction.

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Transplantation: Polyomavirus Nephropathy and the Risk of Specific Immunosuppression Regimens

The Scientific World JOURNAL ◽

10.1100/tsw.2006.93 ◽

2006 ◽

Vol 6 ◽

pp. 412-528 ◽

Cited By ~ 1

Author(s):

Christine Wu ◽

Parmjeet Randhawa ◽

Jerry McCauley

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Kidney Transplant ◽

Transplant Patient ◽

Graft Loss ◽

Bk Virus ◽

Therapeutic Monitoring ◽

Kidney Transplant Patient ◽

Bk Polyomavirus ◽

Specific Immunosuppression

BK virus is ubiquitously present in the latent state in humans, and awareness of the importance of BK polyomavirus is emerging among the kidney transplant community. First discovered in 1971 in the urine of a renal transplant recipient, BK virus nephropathy (BKVN) has come to be recognized as a significant cause of genitourinary disease and potential graft loss in the kidney transplant patient. In this review, we discuss the risk factors, available methods of diagnosis and therapeutic monitoring, and current approaches to therapy of BKVN.

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Prevalence and Risk Factors of Non-Adherence with Immunosuppressive Medication in Kidney Transplant Patients

American Journal of Transplantation ◽

10.1111/j.1600-6143.2006.01611.x ◽

2007 ◽

Vol 7 (1) ◽

pp. 108-116 ◽

Cited By ~ 123

Author(s):

K. Denhaerynck ◽

J. Steiger ◽

A. Bock ◽

P. Schäfer-Keller ◽

S. Köfer ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplant ◽

Transplant Patients ◽

Immunosuppressive Medication ◽

Kidney Transplant Patients

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Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis

BMC Cardiovascular Disorders ◽

10.1186/s12872-017-0505-6 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 19

Author(s):

María Teresa Seoane-Pillado ◽

Salvador Pita-Fernández ◽

Francisco Valdés-Cañedo ◽

Rocio Seijo-Bestilleiro ◽

Sonia Pértega-Díaz ◽

...

Keyword(s):

Risk Factors ◽

Survival Analysis ◽

Kidney Transplant ◽

Competing Risks ◽

Cardiovascular Events ◽

Transplant Patients ◽

Kidney Transplant Patients ◽

Associated Risk Factors

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Artificial Intelligence in Kidney Transplantation: A Scoping Review (Preprint)

10.2196/preprints.29983 ◽

2021 ◽

Author(s):

Mowafa Househ ◽

Asma Alamgir ◽

Yasmin Abdelaal ◽

Hagar Hussein

Keyword(s):

Artificial Intelligence ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Data Extraction ◽

Care Plan ◽

Reference List ◽

Potential Candidate ◽

Transplant Patients ◽

Study Selection ◽

Standardized Practice

BACKGROUND Artificial Intelligence technologies and big data have been increasingly used to enhance kidney transplant experts’ ability to make critical decisions and manage the care plan for their patients. OBJECTIVE To explore the use of AI technologies in the field of kidney transplantation as reported in the literature. METHODS Embase, CINAHL, PubMed and Google Scholar were used in the search. Backward reference list checking of included studies was also conducted. Study selection and data extraction was done independently by three reviewers. Data extracted was synthesized in a narrative approach. RESULTS Of 505 citations retrieved from the databases, 33 unique studies are included in this review. Artificial intelligence (AI) technologies in the included studies were used to help with diagnosis (n= 16), used as a prediction tool (n=15) and, also for supporting appropriate prescription for kidney transplant patients (n = 2). The population who benefited from the technique included patients who underwent kidney transplantation procedure (n = 24) and those who are potential candidate (n=6). The most prominent AI branch used in kidney transplantation care was machine learning with Random Forest (n=11) being the most used AI model, followed by Linear Regression (n=6). CONCLUSIONS Conclusion: AI is extensively being used in the field of kidney transplant. However, there is a gap in research on the limitation and obstacles associated with implementing AI technologies in kidney transplant. There is a need for more research to identify educational needs and standardized practice for clinicians who wish to apply AI technologies in critical transplantation-related decisions.

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Evaluation of Quality of Life among Kidney Transplant Patients- A Cross Sectional Study

10.53350/pjmhs2115113087 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3087-3089

Author(s):

Rashida Jabeen ◽

Kousar Perveen ◽

Muhammad Afzal ◽

Sadia Khan

Keyword(s):

Quality Of Life ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Transplant Patients ◽

Kidney Transplant Patients

Kidney transplantation is the famous and most important choice of treatment of renal replacement therapies (RRTs) because of its positive impact on morbidity, survival and cost. The health related quality of life is becoming important outcome. Quality of life is usually impaired in patients who have renal transplant because of renal transplant patients have anxiety, lack of social, physical and emotional support and diminished ability to take care of themselves. The basic purpose of renal transplantation is to achieve maximum quality of life with minimum side effects. Methods: A cross sectional study was conducted at Rukhsana Akhtar Bahria International Orchard Hospital Lahore after approval from institution board of university of Lahore. 36 patients were enrolled in study by using purposive sampling technique. After taking informed consent all Kidney transplant patients aged between 18 years to 60 years, visited the post-transplantation OPD and continuously in follow-up sessions were included in study. A validated and standard WHO questionnaire of “Kidney Disease and Quality of Life (KDQOL-36™)” was used for data collection. Data was entered and analyzed in SPSS version.21.Chi-square test was applied to find out significant association between qualitative variables. P -Value < 0.05will be considered as statistically significant. Results: Majority of patients were from 40-49 years 10(27.0%). Females were more as compared to men (20(55.6) vs 16(44.4%)). 10(27.8) patients can read and write and 8(22.2%) have done matriculation. More patients live in Urban area as compared to rural area(19(52.8%) vs 17(47.2%)).8(22.2%) patients have less than 1 year of post kidney transplantation time and 19(52.8%) have 1 to 3 years. All the seven domains of KDQOL show poor QOL. General Health, Physical function and physical and emotional function shows average QOL and Emotional, social, daily activities and overall KDQOL shows poor QOL. There was insignificant association with age, gender, education; residential area and Post kidney transplantation length of time (years)(p-value > 0.05). Conclusions: After renal transplantation HRQOL becomes very important factor. After kidney transplantation HRQOL depends on many factors. It was concluded from current study that the HRQOL was not as good as it should be. Over the period of transplantation time patient’s quality of life remain same. The society, government, family, and medical staff need to support patients so they can also improve their QOL. Key word: Renal Diseases, Kidney transplant, Quality of life, KDQOL-36

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Epidemiology, Risk Factors, and Outcomes After Early Posttransplant Clostridiodes difficile Infection in Renal Transplant Recipients

Annals of Pharmacotherapy ◽

10.1177/1060028019845003 ◽

2019 ◽

Vol 53 (10) ◽

pp. 1020-1025

Author(s):

Margaret R. Jorgenson ◽

Jillian L. Descourouez ◽

Dou-Yan Yang ◽

Glen E. Leverson ◽

Christopher M. Saddler ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Female Gender ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Secondary Outcome ◽

Induction Agent ◽

Renal Transplant Recipients

Background: Modifiable risk-factors associated with Clostridioides difficile infection (CDI) in renal-transplant (RTX) have not been clearly established and peri-transplant risk has not been described. Objective: Evaluate epidemiology, risk-factors and outcomes after CDI occurring in the first 90 days after RTX (CDI-90).Methods: Observational cohort study/survival analysis of adult RTX recipients from 1/1/2012-12/31/2015. Primary outcome was CDI-90 incidence/risk-factors. Secondary outcome was evaluation of post-90 day transplant outcomes. Results: 982 patients met inclusion criteria; 46 with CDI-90 and 936 without (comparator). CDI incidence in the total population was 4.7% at 90 days, 6.3% at 1 year, and 6.4% at 3 years. Incidence of CDI-90 was 5%; time to diagnosis was 19.4±25 days (median 7). Risk-factors for CDI-90 were alemtuzumab induction (Hazard ratio [HR] 1.5, 95% CI(1.1-2.0), p = 0.005) and age at transplant (HR 1.007/year, 95% CI (1.002-1.012), p= 0.007). However, risk-factors for CDI at any time were different; donation-after-circulatory-death (DCD) donor (HR 2.5 95% CI (1.3-4.9), p = 0.008) and female gender (HR 1.6 95% CI (1.0-2.7), p = 0.049). On Kaplan-Meier, CDI-90 appeared to have an impact on patient/graft survival, however when analyzed in a multivariable stepwise Cox proportional hazards model, only age was significantly associated with survival ( p = 0.002). Conclusion and Relevance: Incidence of CDI-90 is low, mostly occurring in the first post-operative month. Risk-factors vary temporally based on time from transplant. In the early post-op period induction agent and age at transplant are significant, but not after. Associations between CDI and negative graft outcomes appear to be largely driven by age. Future studies validating these risk-factors as well as targeted prophylaxis strategies and their effect on long term graft outcomes and the host microbiome are needed.

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