Journals / Cukurova Medical Journal / 2020 / Cilt: 45 - Sayı: 1

Risk factors for development of rejection in kidney transplant patients

Böbrek nakilli hastalarda rejeksiyon gelişimi için risk faktörler

Pages
215–222
Publication Date
2020-03-31
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

By logistic regression analysis, uric acid and glucose elevation were defined as independent risk determinants for the development of rejection.Conclusion: Hyperuricemia and hyperglycemia may predict the development of rejection after renal transplantation.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Purpose: The aim of this study was to evaluate the parameters that may be a risk factor for the development of rejection in our patient population.Materials and Methods: The results of the biopsies performed in our organ transplantation unit were evaluated retrospectively.
📊
Key Findings & Data:Forty-nine biopsies made for 45 patients and the results were compared.Results: The most common cause of kidney biopsy was acute renal injury (34 biopsies, 69.4%).
💡
Conclusion & Impact:By logistic regression analysis, uric acid and glucose elevation were defined as independent risk determinants for the development of rejection.Conclusion: Hyperuricemia and hyperglycemia may predict the development of rejection after renal transplantation.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:kidney transplantation · rejection · uric acid

Abstract

Purpose: The aim of this study was to evaluate the parameters that may be a risk factor for the development of rejection in our patient population.Materials and Methods: The results of the biopsies performed in our organ transplantation unit were evaluated retrospectively. Demographic data of the patients about primary renal disease, concomitant disease and laboratory data in the time of biopsy were recorded. Forty-nine biopsies made for 45 patients and the results were compared.Results: The most common cause of kidney biopsy was acute renal injury (34 biopsies, 69.4%). Histopathological examination revealed rejection in 23 (46.7%) biopsies. BK nephropathy was detected in 4 patients (8,1%), while the calcineurin inhibitor toxicity was found in 10 patients (20.5%). Chronic allograft nephropathy was observed in 11 biopsies (22.6%) and recurrent glomerulonephritis was detected in 1 biopsy (2.1%). Serum glucose, uric acid and total cholesterol levels were higher and hemoglobin levels were lower in the rejection group. By logistic regression analysis, uric acid and glucose elevation were defined as independent risk determinants for the development of rejection.Conclusion: Hyperuricemia and hyperglycemia may predict the development of rejection after renal transplantation.

Özet

Amaç: Bu çalışmada, kendi hasta populasyonumuzda böbrek nakil rejeksiyonu gelişimi için risk faktörü olabilecek parametrelerin değerlendirilmesini amaçladık.Gereç ve Yöntem: Organ nakli ünitemizde yapılan nakil böbrek biyopsilerin sonuçları retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, primer böbrek hastalıkları, eşlik eden hastalıkları ve perkütan iğne biyopsisi anındaki laboratuar verileri kaydedildi. 45 hastaya yapılan 49 adet biyopsi verileri karşılaştırıldı.Bulgular: Böbrek nakilli 45 hastaya yapılan toplam 49 biyopsi incelendiğinde biyopsi yapılma endikasyon sıklığı en sık olarak 34 biyopsi (%69.4) ile akut böbrek hasarı idi. Histopatolojik inceleme ile 23 (% 46.7) biyopside rejeksiyon saptandı. BK nefropati saptanan biyopsi sayısı 4 iken (%8.1), ilaç toksisitesi olarak kalsinörin inhibitörü toksisitesi 10 biyopside (%20.5) ve kronik allograft nefropatisi de 11 biyopside (%22.6) görüldü. 1 biyopside (%2.1) tekrarlayan glomerulonefrit saptandı. Rejeksiyon saptanan grup rejeksiyon saptanmayan grupla karşılaştırıldığında biyopsi anında serum glukoz, ürik asit ve total kolesterol düzeylerinin yüksek, hemoglobin değerlerinin daha düşük olduğu belirlenmiştir (hepsi için. Lojistik regresyon analizi ile, ürik asit ve glukoz yüksekliği rejeksiyon gelişimi için bağımsız risk belirleyicileri olarak tanımlanmıştır.Sonuç: Hiperürisemi ve hipergliseminin böbrek nakli sonrası rejeksiyon gelişimini öngörebileceği düşünülmüştür.

🔖

Cite This Article

ERGİN, M., OGUZ, E. G., YAYAR, O., ATİLGAN, K. G., OZTEKİN, S., AYLİ, M. D. (2020). Risk factors for development of rejection in kidney transplant patients. Cukurova Medical Journal, Cilt: 45 - Sayı: 1, 215–222. https://ajindex.com/articles/56229

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. Meier-Kriesche HU, Ojo AO, Hanson JA, Cibrik DM, Punch JD, Leichtman AB et al. Increased impact of acute rejection on chronic allograft failure in recent era. Transplantation. 2000;70:1098-100
  2. Sellarés J, de Freitas DG, Mengel M, Reeve J, Einecke G, Sis B et al. Understanding the causes of kidney transplant failure: the dominant role of antibodymediated rejection and nonadherence. Am J Transplant. 2012;12:388-99
  3. Roberts DM, Jiang SH, Chadban SJ. The treatment of acute antibody-mediated rejection in kidney transplant recipients a systematic review. Transplantation. 2012;94:775-83
  4. Nankivell, BJ, Alexander SI. Rejection of the kidney allograft. N Engl J Med. 2010;7;363:1451-462
  5. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9:1-155
  6. Rush D, Arlen D, Boucher A, Busque S, Cockfield SM, Girardin C te al. Lack of benefit of early protocol biopsies in renal transplant patients receiving TAC and MMF: a randomized study. Am J Transplant. 2007;7:2538-545
  7. Mehta R, Cherikh W, Sood P, Hariharan S. Kidney allograft surveillance biopsy practices across US transplant centers: A UNOS survey. Clin Transplant. 2017;31(5)
  8. Leal R, Pinto H, Galvao A, Santos L, Romaozinho C, Macario F et al. Nephrotic range proteinuria in renal transplantation: Clinical and histologic correlates in a 10 year retrospective study. Elsevier Inc. 2017;7929
  9. Sellarés J, de Freitas DG, Mengel M, Reeve J, Einecke G, Sis B et al. Understanding the causes of kidney transplant failure: The dominant role of antibody‐ mediated rejection and nonadherence. Am J Transplant. 2012;12:388-99
  10. Seyahi N, Ateş K, Süleymanlar G: Current status of renal replacement therapies in Turkey: Turkish Society of Nephrology Registry 2015 Summary Report. Turk Neph Dial Transpl. 2017;26:154-160
  11. First MR. Renal function as a predictor of long‐term graft survival in renal transplant patients. Nephrol Dial Transplant. 2003,18:3-6
  12. Almond PS, Matas A, Gillingham K, Dunn DL, Payne WD, Gores P et al. Risk factors for chronic rejection in renal allograft recipients. Transplantation. 1993;55:752-56
  13. Maury CP. Comparative study of serum amyloidrelated protein SAA, C- reactive protein, and beta 2- microglobulin as markers of renal allograft rejection. Clin Nephrol. 1984;22:284-92
  14. Fink JC, Onuigbo MA, Blahut SA, Christenson RH, Mann D, Bartlett ST et al. Pretra