scholarly journals Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation

2019 ◽  
Vol 20 (14) ◽  
pp. 3413 ◽  
Author(s):  
Mineaki Kitamura ◽  
Yasushi Mochizuki ◽  
Yasuyoshi Miyata ◽  
Yoko Obata ◽  
Kensuke Mitsunari ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Periodontal Disease ◽  
Immunosuppressive Therapy ◽  
Kidney Allograft ◽  
Periodontal Tissues ◽  
Pathological Conditions ◽  
Allograft Function ◽  
The Impact

Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.

CLINICAL ASPECTS OF RENAL TRANSPLANTATION

Vestnik ◽  
2021 ◽  
pp. 136-142
Author(s):  
Б.Г. Султанова ◽  
И.Б. Мансурова ◽  
С.Б. Бодесова ◽  
Н.С. Джуманов ◽  
Ш.А. Сарсенова ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Interdisciplinary Approach ◽  
Clinical Aspects ◽  
Graft Dysfunction ◽  
Donor Kidney ◽  
Donor Evaluation

В статье приведен литературный обзор, посвященный современным проблемам в трансплантологии почек. Нерешенными проблемами остаются оценка донора, низкая приверженность пациентов иммуносупрессивной терапии и развитие дисфункции трансплантата. Развивающиеся осложнения после трансплантации и иммуносупрессивной терапии требуют междисциплинарного подхода в лечении и наблюдении реципиентов донорской почки. Также необходимо широкое развитие трупного донорства для снижения числа потенциальных пациентов с хронической болезнью почек. The article presents a literature review of contemporary problems in kidney transplantation. Donor evaluation, low adherence of patients to immunosuppressive therapy and the development of graft dysfunction remain as unresolved problems. Developing complications after transplantation and immunosuppressive therapy require an interdisciplinary approach in the treatment and monitoring of recipients of donor kidney. It is also indispensable to the development of cadaveric donation to reduce the number of potential patients with chronic kidney disease.

From chronic kidney disease to kidney transplantation: The impact of obesity and its treatment modalities

2016 ◽  
Vol 30 (4) ◽  
pp. 203-211 ◽  
Author(s):  
Brian Camilleri ◽  
Julie M. Bridson ◽  
Ajay Sharma ◽  
Ahmed Halawa
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Treatment Modalities ◽  
The Impact

scholarly journals Uremic Toxins, Oxidative Stress, Atherosclerosis in Chronic Kidney Disease, and Kidney Transplantation

2021 ◽  
Vol 2021 ◽  
pp. 1-15 ◽  
Author(s):  
Ewa Wojtaszek ◽  
Urszula Oldakowska-Jedynak ◽  
Marlena Kwiatkowska ◽  
Tomasz Glogowski ◽  
Jolanta Malyszko
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Uremic Toxins ◽  
Transplant Recipients ◽  
Risk Of Death ◽  
The Impact

Patients with chronic kidney disease (CKD) are at a high risk for cardiovascular disease (CVD), and approximately half of all deaths among patients with CKD are a direct result of CVD. The premature cardiovascular disease extends from mild to moderate CKD stages, and the severity of CVD and the risk of death increase with a decline in kidney function. Successful kidney transplantation significantly decreases the risk of death relative to long-term dialysis treatment; nevertheless, the prevalence of CVD remains high and is responsible for approximately 20-35% of mortality in renal transplant recipients. The prevalence of traditional and nontraditional risk factors for CVD is higher in patients with CKD and transplant recipients compared with the general population; however, it can only partly explain the highly increased cardiovascular burden in CKD patients. Nontraditional risk factors, unique to CKD patients, include proteinuria, disturbed calcium, and phosphate metabolism, anemia, fluid overload, and accumulation of uremic toxins. This accumulation of uremic toxins is associated with systemic alterations including inflammation and oxidative stress which are considered crucial in CKD progression and CKD-related CVD. Kidney transplantation can mitigate the impact of some of these nontraditional factors, but they typically persist to some degree following transplantation. Taking into consideration the scarcity of data on uremic waste products, oxidative stress, and their relation to atherosclerosis in renal transplantation, in the review, we discussed the impact of uremic toxins on vascular dysfunction in CKD patients and kidney transplant recipients. Special attention was paid to the role of native and transplanted kidney function.

scholarly journals Pre-Transplant Obesity and Post-Transplant Chronic Kidney Disease: Time-Dependent Effect of Kidney Transplantation

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1251-1251
Author(s):  
Ekamol Tantisattamo ◽  
Natnicha Leelaviwat ◽  
Natsuki Eguchi ◽  
Natchaya Polpichai ◽  
Natsumon Udomkittivorakul ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Time Dependent ◽  
Obese Group ◽  
Dependent Effect ◽  
Post Transplant ◽  
Allograft Function ◽  
Time Dependent Effect

Abstract Objectives Obesity is associated with worsening kidney allograft function. Since kidney allograft function may rapidly change throughout the course of kidney transplantation, particularly during early post-transplant period, we aim to examine association between pre-transplant obesity and development of chronic kidney disease (CKD) over several time points during post-transplant periods. Methods A single center retrospective cohort study included kidney transplant recipients who received kidney transplantation, between 2012 and 2015. The study population were divided into non-obese and obese groups based on pre-transplant body mass index (BMI) of < 30 and ≥30 kg/m2, respectively. Association between the obesity status and post-transplant CKD defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 was examined by multivariable Cox proportional hazard regression analysis with a time-dependent effect at 12, 24, 36, and 48 weeks post-kidney transplantation. Results Of all 105 patients, mean age ± SD was 54 ± 12 and 61% was female. Non-obese and obese groups were account for 64% and 36%, respectively and their corresponding mean BMI were 24.34 ± 3.54 and 34.27 ± 3.53 kg/m2 (P < 0.001). The risk of developing CKD at 12, 36, and 48 weeks post-kidney transplantation, were not significantly difference. However, at 24-week post- kidney transplantation, obese group had 71% greater the risk for CKD compared to non-obese group (Hazard ratio (HR) 1.71, P 0.049, 95% confidence interval (95%CI) 1.002, 2.908). After adjusted for age, gender, type of kidney transplantation, systolic and diastolic blood pressure at 24 weeks post-kidney transplantation, the obese group remain at higher the risk for CKD (HR 1.74, P 0.044, 95% CI 1.014, 2.985). Conclusions Pre-kidney transplant obesity was associated with increased risk of CKD at the early, but not at the immediate or long-term post-transplant periods independent to the baseline characteristics and blood pressure. Pathophysiological changes during different post-transplant periods including immunological or non-immunological factors may contribute to this time-dependent effects of pre-transplant obesity and CKD. Additional studies are warranted to further examine possible mechanism. Funding Sources None.

scholarly journals Oral health in patients with chronic kidney disease

Praxis medica ◽  
2020 ◽  
Vol 49 (1-2) ◽  
pp. 35-40
Author(s):  
Radojica Stolić ◽  
Vekoslav Mitrović ◽  
Naja Suljković ◽  
Dušica Miljković-Jakšić ◽  
Aleksandra Balović ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Oral Health ◽  
Kidney Disease ◽  
Periodontal Disease ◽  
Patient Population ◽  
Periodontal Diseases ◽  
Oral Disease ◽  
Gingival Hyperplasia ◽  
Oral Diseases ◽  
The Impact

Objective: In the available literature data, there is not much information about problems of patients with end stage kidney disease in relation to oral health. Our objective was to show the importance of oral diseases for patients on hemodialysis. Data sources: In this review article, the sources of data are review articles and scientific articles in the English language published in MEDLINE database. The choice of studies was based on keywords: Chronic kidney disease, Hemodialysis, Oral health, Periodontal diseases. Results: It is assumed that almost 90% patients with chronic kidney disease manifest some symptoms of oral disease. Therefore, it is important to determine the impact of periodontal disease on the progression of kidney failure in these individuals, to evaluate inflammatory parameters in this patient population, to assess the degree of bone loss and periodontal disease index, to determine the presence of bacterial strains, paradontopathy of gingival fluid and antibody titers, to examine correlations of proinflammatory cytokines in the gingival sulcus and serum, as well as to determine the relationship between periodontal tissue and inflammatory mediators. Periodontal diseases can increase the possibility of developing chronic kidney disease by 1.5 to 2 times. These oral diseases include gingival hyperplasia, periodontitis, xerostomia, unpleasant breath, changes in the oral mucosa, malignancies, oral infections, dental abnormalities and bone lesions. Conclusion: This requires serious cooperation between nephrologists and dentists to make proper communication possible, in order to provide quality dental care for this growing patient population in accordance with new treatment strategies.

scholarly journals Our first experiences in applying an original method for removal of ABO-isoagglutinins in ABO-incompatible kidney recipients

2009 ◽  
Vol 66 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Ljiljana Ignjatovic ◽  
Zoran Kovacevic ◽  
Dragan Jovanovic ◽  
Neven Vavic ◽  
Zoran Paunic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Immunosuppressive Therapy ◽  
Blood Group ◽  
Original Method ◽  
Blood Type ◽  
Long Term Outcome ◽  
Kidney Allograft ◽  
Allograft Function

Background/Aim. Due to improved methods for removal of ABO isoagglutinins and novel immunosuppressive protocols, short and long term outcome in blood group incompatible is similar to blood group compatible kidney transplantation. The aim of this study was to determine the efficacy of our original method for removal of ABO isoagglutinins from the blood in ABO-incompatible kidney allograft recipients. Method. Between 2006 and 2008 twelve patients were transplanted from ABO incompatible living donors. Titers of ABO isoagglutinins were 4-128 (IgG). Immunosuppressive therapy started 14 days before kidney transplantation with rituximab, followed by a triple therapy (prednisone + tacrolimus + mycophenolate mofetil) and the first plasma exchange (PE) procedure, in which one plasma volume was substituted with albumin and saline on day 7 before transplantation. For selective extracorporeal immunoadsorption, the removed plasma was mixed with donor blood type filtered red blood cells, centrifuged and the supernatant separated and preserved. In the next PE procedure, the removed plasma was replaced with immunoadsorbed plasma, and so on. Titers of ABO agglutinins, renal allograft function and survival were followed-up. Results. The pre-transplant treatment consisting of 1-5 PE procedures and immunosuppressive therapy resulted in target ABO agglutinins titers below 4. During a 10-24 month follow-up three patients had an early acute rejection, one patient acute rejection and hemolytic anemia, two patients surgical complications and one of them lost his graft. In the post-transplant period, the titers of ABO antibodies remained below 4. All the patients had stable kidney allograft function with mean serum creatinine ?SD of 129 ? 45 ?mol/l at the end of the study. Conclusion. Our method for removal of ABO antibodies was effective in a limited series of patients and short-term follow-up.

scholarly journals The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD)

2021 ◽  
Vol 18 (7) ◽  
pp. 3838
Author(s):  
Denise Genereux ◽  
Lida Fan ◽  
Keith Brownlee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Indigenous Peoples ◽  
Health Care Professionals ◽  
Medical Condition ◽  
Geographical Location ◽  
Well Being ◽  
First Nation ◽  
Urban Centre ◽  
The Impact

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.

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