Maksims Čistjakovs, Alina Sultanova, Olga Jermakova, Svetlana Čapenko, Baiba Lesiņa-Korne, Rafails Rozentāls, Modra Murovska and Ieva Ziediņa
Kidney transplant recipients have higher incidence of human papillomavirus (HPV)-related malignancies, but studies on the natural history of HPV infection are insufficient, especially regarding in male recipients. The aim of this study was to evaluate the course of high-risk HPV (HR-HPV) infection after kidney allograft transplantation in male recipients: to estimate frequency and activity of HR-HPV infection under immune system suppression. Twenty male renal recipients (age 20 - 68) were enrolled in this investigation and examined in dynamics. Peripheral EDTA-blood samples and urine samples were collected from each patient 2 weeks, 6 months and 12 months after transplantation. Polymerase chain reaction (PCR) with consensus primers was used for initial detection of high range HPV types, a commercial qPCR kit for detection of HR-HPV load in urine samples and ELISA for detection of serum IgG class antibodies to HR-HPV L1-capsid protein. Overall, combining molecular (HR-HPV genomic sequences detected by real-time PCR) and serological studies (IgG class antibodies to HR-HPV L1-capsids’ protein), high frequency of HRHPV infection among male kidney transplant recipients (9/20; 45%) was showed. However, the majority of HR-HPV positive recipients (7/9; 78%) showed signs of infection clearance. It means that, despite the applied immune suppressive therapy, the host’s immune system is capable of dealing with HR-HPV infection up to the 12th month after transplantation. However, the sample size should be increased to enable through statistical analysis before final conclusions are made.
Sibel Ersan, Senem Ertilav, Ali Celik, Aykut Sifil, Caner Cavdar, Mehtat Unlu, Sulen Sarioglu, Huseyin Gulay and Taner Camsari
1. Shamseddin MK, Knoll GA. Posttransplantation proteinuria: an approach to diagnosis and management. Clin J Am Soc Nephrol 2011; 6: 1786-1793.
2. Ruiz JC, Sanchez-Fructuoso A, Zarraga S. Management of proteinuria in clinical practice after kidney transplantation. Transplant Rev 2012; 26: 36-43.
3. Knoll GA. Proteinuria in kidneytransplantrecipients: prevalence, prognosis, and evidence-based management. Am J Kidney Dis 2009; 54: 1131-1144.
4. KDIGO clinical practice guideline for the
Borelli Zlatkov, Jean Filipov, Emil Paskalev, Boyka Markova, Yuliya Marteva-Proevska and Alexandar Kolevski
antibiotic therapy on asymptomatic bacteriuria in kidneytransplantrecipients. J Urol 2005; 2: 32-35.
16. Clinical and Laboratory Standards Institute. 2010. Performance Standards for Antimicrobial Susceptibility Testing. Sixteenth Informational Supplement. Approve standard M100-S20. CLSI, Wayne, Pennsylvania, USA.
17. Dummer JS. Pneumocystis carinii infections in transplant recipients. Semin Respir Infect 1990; 3: 50-57.
18. Nicolle LE. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin North Am 2003; 17: 367-394.
antibodies in kidney transplantation: An algorithm based on pretransplant single-antigen flow bead techniques. Amer. J. Transplant ., 11 , 1592-1598.
Loupy, A., Suberbielle-Boissel, C., Hill, G., Nochy, D. (2009). Outcome of subclinical antibody-mediated rejection in kidneytransplantrecipients with preformed donor-specific antibodies. Amer. J. Transplant., 9 , 2561-2570.
Loupy, A., Hill, G., Suberbielle, C. (2011). Significance of C4d Banff scores in early protocol biopsies of kidneytransplantrecipients with performed donor
I.D. Tarța, Carmen Denise Căldăraru, Mirela Gliga, Adina Huțanu, Z. Bajko, E. Carașca and G.A. Dogaru
Introduction: 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.
DI Tarta, Căldăraru Carmen Denise, Tarta Cristina, A Frigy, E Caraşca, Carlan Otilia and AG Dogaru
Age for Patients with Chronic Kidney Disease? Am J Nephrol, 2012;35:238–241.
7. Wang J, Guo R, Liu S, et al - Molecular mechanisms of FK506-induced hypertension in solid organ transplantation patients, 2014;127:3645-3650.
8. Xue W, Zhang Q, Xu Y, Wang W, Zhang X, Hu X - Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis. Chin Med J (Engl), 2014;127:2376-2381.
9. Ponticelli C, Cucchiari D, Graziani G. - Hypertension in kidneytransplantrecipients
BK virus (BKV) infection was studied prospectively in 50 unselected consecutive patients who had undergone kidney transplantation. Infection was monitored for one year after transplantation. Viral DNA in urine (viruria) and plasma (viremia) samples was detected by nested, qualitative polymerase chain reaction. BKV screening data was available for 92% (n = 46) of patients enrolled in the study. Four groups of patients were distinguished: uninfected patients (group 1, n = 30), patients with viruria (group 2, n = 3), patients with viremia (group 3, n = 6) and patients with developed BKV nephropathy (group 4, n = 7). Infection was observed starting form the first month, and the maximum number of patients with active BKV infection occurred at six months after transplantation. Five-year graft survival was 69% for patients with any evidence of BKV infection, compared with 80.0% (P = NS) for patients without BKV infection. The best graft function was observed in group one patient (mean serum creatinine 130 mkmol/l and glomerular filtration rate (GFR) 60.9 ml/min) and the worst in group 4 (mean serum creatinine 180 mkmol/l and GFR 52.31 ml/min) at five years after transplantation. Five-year patient survival was 82.6% and was not affected by presence of BKV infection.
Amin R. Soliman, Hoda A. Maamoun, Mahmoud A. Soliman, Hatem Darwish and Esam Elbanna
., MENGEL M., et al. Early calcification of renal allografts detected by protocol biopsies: causes and clinical implications. American Journal of Transplantation. 2005; 5(8): 1934-1941.
4. Cohen JB., Gordon CE., Balk EM., Francis JM., et al. Cinacalcet for the treatment of hyperparathyroidism in kidneytransplantrecipients: A systematic review and meta-analysis. Transplantation. 2012; 94(10): 1041-1048.
5. PASCHOALIN RP., TORREGROSA JV., SÁNCHEZ-ESCUREDO A., BARROS X., DURÁN CE., CAMPISTOL JM., et al Cinacalcet treatment for stable kidney
Kreetachon Veerakikosol, Pajaree Chariyavilaskul, Natavudh Townamchai and Supeecha Wittayalertpanya
Tacrolimus, a calcineurin inhibitor, was approved in 1997 to prevent acute rejection of kidney transplants, and its role remains crucial as an effective immunosuppressant in kidneytransplantrecipients [ 1 ]. Tacrolimus is characterized by its narrow therapeutic index. Therefore, close drug monitoring of plasma tacrolimus levels is essential to optimize efficacy and minimize toxicity. Achieving therapeutic trough levels (C 0 ) is important, especially in the initial period after transplantation during which the highest risk of organ rejection occurs. Large
Ana Belazelkovska, Mirjana Popovska, Goce Spasovski, Jelka Masin-Spasovska, Svetlana Cekovska, Aneta Atanasovska-Stojanovska, Kristina Mitic and Vera Radojkova-Nikolovska
Introduction. Kidney disease is associated with many abnormalities in the oral health status as well as with alterations in salivary flow and composition. The aim of this study was to evaluate and to correlate oral clinical findings, salivary flow (SF) and salivary pH values in patients with chronic kidney disease (CKD) not yet on hemodyalisis treatment, those undergoing hemodialysis and in kidney transplant recipients.
Methods. In a cross-sectional study 90 patients were included. The cohort was composed of three groups: 30 patients with CKD (serum creatinine values under 120 μmol/L-group 1), 30 patients with CKD on hemodialysis (group 2) and 30 kidney transplanted patients (group 3). The control group consisted of 20 healthy individuals. Oral symptoms, signs and lesions: salivary volume, salivary pH and SF of stimulated and unstimulated saliva were evaluated.
Results. Among patients with CKD without dialysis treatment inverse relationship was found between uremic fetor, unpleasant taste and unstimulated SF and also between xerostomia and stimulated SF. Negative correlation between thirst and unstimulated salivary flow was found in both groups, patients with CKD on dialysis and kidney transplant group. Furthermore, in kidney-transplant patients a negative correlation was found between petechiae and SF, while in group of patients with CKD on hemodialysis the same negative correlation was registered between uremic fetor and stimulated SF.
Conclusions. Salivary flow was significantly lower in hemodialysis patients, while the highest was in the kidney-transplant recipients accompanied with improvement in the other oral clinical findings observed in our study.