توجه: محتویات این صفحه به صورت خودکار پردازش شده و مقاله‌های نویسندگانی با تشابه اسمی، همگی در بخش یکسان نمایش داده می‌شوند.
۱Hepatitis C virus infection in nephrology patients
نویسنده(ها): ، ،
اطلاعات انتشار: Journal of nephropathology، دوم،شماره۴، oct ۲۰۱۳، سال
تعداد صفحات: ۱۷
Context: Hepatitis C virus (HCV) infection leads to chronic liver disease, but also to extra–hepatic manifestations..Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched..Results: Herein, we provide an overview of renal diseases related to HCV and their therapies, as well as the treatment options available for HCV (+)\RNA (+) dialysis patients. We will not mention, however, HCV infection–related complications in the post–kidney transplantation setting..Conclusions: Extra–hepatic manifestations of HCV infection include mixed cryoglobulinemia, lymphoproliferative disorders, and renal disease. HCV infection has been reported in association with distinct histological patterns of glomerulonephritis in native kidneys..

۲Epidemiology of chronic kidney diseases in the Republic of Guinea; future dialysis needs
اطلاعات انتشار: Journal of nephropathology، چهارم،شماره۴، Oct ۲۰۱۵، سال
تعداد صفحات: ۷
Background: Chronic kidney disease (CKD) is increasing worldwide and can lead to end–stage renal disease (ESRD). Objectives: Because few patients with ESRD in the Republic of Guinea have access to haemodialysis, we retrospectively evaluated the prevalence of CKD, ESRD and access to supportive therapies.Patients and Methods: 579 CKD patients (304 males; mean age: 44 ± 16 years) were admitted into Conakry nephrology department, the only centre in the Republic of Guinea, between 2009 and 2013. Most patients (63%) resided within Conakry (the capital), 12.5% came from lower Guinea, 11.7% from middle Guinea, 7.9% from upper Guinea and 4.8% from forest Guinea. Results: Reasons for referral were increased serum creatinine (49.5%), hypertension (27%) and diffuse edema (17%). Also, 11% were diabetic, 12.5% were smokers, 17% were HIV–positive, 8.3% were HBV–positive and 15% were HCV–positive. The most frequent symptom at admission was nausea\vomiting (56%). Upon admission, 70.5% of patients already had ESRD. Although no kidney biopsies were performed it was assumed that 34% and 27% of patients had vascular nephropathy and chronic glomerulonephritis, respectively. Of the 385 ESRD patients, only 140 (36.3%) had access to haemodialysis (two sessions\week, 4 hours each). Most patients that received haemodialysis resided within the Conakry region (P 0.0001). There were significant associations between mortality and (i) terminal stage of CKD (P = 0.0005), (ii) vascular nephropathy (P = 0.002), and (iii) nephropathies of unknown origin (P = 0.0001). Conclusions: A fourfold increase in haemodialysis machines is needed in Conakry, plus four new nephrology\haemodialysis centres within the Republic of Guinea, each holding ≥30 haemodialysis machines.

۳Place of mTOR inhibitors in management of BKV infection after kidney transplantation
نویسنده(ها): ، ،
اطلاعات انتشار: Journal of nephropathology، پنجم،شماره۱، Jan ۲۰۱۶، سال
تعداد صفحات: ۷
Context: BK virus (BKV) viremia and BKV–associated nephropathy (BKVAN) have become a serious nuisance to kidney transplant (KT) patients since the mid–nineties, when the incidence of this disease has increased significantly. Evidence Acquisition: Directory of open access journals (DOAJ), EMBASE, Google Scholar, PubMed, EBSCO, and Web of Science have been searched. Results: Many hypothesis have been made as to why this phenomenon has developed; it is of general opinion that a more potent immunosuppression is at the core of the problem. The use of the association of tacrolimus (TAC) with mycophenolic acid (MPA) has gained momentum in the same years as the increase in BKV viremia incidence making it seem to be the most likely culprit. m–TOR inhibitors (m–TORIs) have been shown to have antiviral properties in vitro and this fact has encouraged different transplant teams to use these agents when confronted with BKV infection (viremia or nephropathy). However, the results are mitigated. There had been conflicting results for example when converting from TAC–to sirolimus–based immunosuppression in the setting of established BKVAN. Conclusions: In order to prevent BKV infection we have to minimize to some extent immunosuppression, but it is not always possible, e.g. in high immunological risk patients. Conversely, we could use m–TORIs associated with low–dose calcineurin inhibitors (CNIs). This could be actually the key to a safe immunosuppression regimen both from the immunological stand point and from the viral one.

۴Early post–transplant complications following ABO–incompatible kidney transplantation
اطلاعات انتشار: Journal of nephropathology، پنجم،شماره۱، Jan ۲۰۱۶، سال
تعداد صفحات: ۹
Background: Living–kidney transplantation is increasing because of the scarcity of kidneys from deceased donors and the increasing numbers of patients on waiting lists for a kidney transplant. Living–kidney transplantation is now associated with increased long–term patient– and allograft–survival rates. Objectives: The purpose of this retrospective study was to identify, in a cohort of 44 ABO–incompatible (ABOi) live–kidney transplant patients, the main complications that occurred within 6 months post–transplantation, and to compare these findings with those from 44 matched ABO–compatible (ABOc) live–kidney transplant patients who were also from our center.Patients and Methods: This single–center retrospective study assessed post–transplantation complications in 44 ABO–i versus 44 matched ABO–c patients. All patients were comparable at baseline except that ABO–i patients had greater immunological risks. Results: During the 6–month post–transplant period, more ABO–i patients presented with postoperative bleeds, thus requiring significantly more blood transfusions. Bleeds were associated with significantly lower values of fibrinogen, platelets, prothrombin time, and hemoglobin levels. Surgical complications, patient– and graft–survival rates, and kidney–function statuses were similar between both groups at 6 months post–transplantation. Conclusions: We conclude that impairment of hemostatic factors at pre–transplant explained the increased risk of a post–transplant bleed in ABO–i patients.

۵Treatment of large plasma volumes using specific immunoadsorption to desensitize ABO–incompatible kidney–transplant candidates
اطلاعات انتشار: Journal of nephropathology، پنجم،شماره۳، Jul ۲۰۱۶، سال
تعداد صفحات: ۸
Background: ABO–incompatible (ABOi) kidney–transplantation has very good long–term results, i.e. similar to those observed for living–kidney ABO–compatible transplantation. This is because patients are desensitized at pretransplant using apheresis and rituximab therapy, with tacrolimus–based immunosuppression. Objectives: To assess the efficacy of a single, pretransplant (Day –1), specific immunoadsorption session using Glycosorb® columns (anti–A or anti–B; Glycorex Sweden) to treat large volumes of plasma (up to 18 L). Patients and Methods: Prospective single–center study evaluating 12 consecutive patients (6 males), aged 40 (23–59) years. Incompatibilities were A into 0 (8), B into 0 (3), and AB into 0 (1). Pretransplant desensitization relied on rituximab (D–30), tacrolimus, mycophenolic acid, and steroids (all started on D–13), and a single session of specific immunoadsorption on D–1. Immunoadsorption was coupled in tandem with a hemodialysis session. Results: Overall, 15 L (11–18) of plasma were treated per patient, i.e., 0.2 (0.11–0.36 L\kg). Isoagglutinin titers were 1\16 (1\5–1\64) before the procedure, decreasing after 6 hours to 1\5 (1\1–1\16 P = 0.008), and to 1\2 (1\1–1\8; P = 0.05) at completion of the session. The next day, i.e., the day of transplantation, there was no rebound of isoagglutinins [1\4 (1\1–1\5); P = ns]. The procedure was well tolerated with no side–effects and no significant changes in hemoglobin level, platelet counts, fibrinogen, or albumin levels.Conclusions: For ABOi kidney–transplantation, a single, longer, specific immunoadsorption session was very efficient at 1–day pre–transplantation with no rebound. These results should be confirmed when isoagglutinin titers are higher (≥120).
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