bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO953PREVALENCE AND FACTORS ASSOCIATED WITH HYPERKALAEMIA IN STABLE KIDNEY TRANSPLANT RECIPIENTS WITH PRESERVED RENAL FUNCTION
Authors: Smyrli Maria , Sarafidis Pantelis , Loutradis Charalampos , Korogiannou Maria , Boletis Ioannis , Marinaki Smaragdi 
Published: May 2021

Abstract

Background and Aims
Hyperkalaemia is a frequent and potentially life-threatening condition in patients with CKD. Even after successful kidney transplantation, kidney transplant recipients have mild to severe CKD. Moreover, they share co-morbid conditions and frequently use medications that predispose to hyperkalaemia. This study aimed to examine the prevalence and factors associated with hyperkalaemia in this population.

Method
Over a pre-specified period of 6 months (September 1st 2019 to March 31st 2020), we recorded in a cross-sectional fashion information on serum potassium and relevant demographics, co-morbidities, medications, laboratory and transplant-associated variables in clinically stable kidney transplant recipients attending the Transplant Outpatient Clinic of our Department. Ηyperkalaemia was classified as follows: serum potassium level &gt;5 mEq/L or &gt;5 with concomitant use of sodium polystyrene sulfonate; ≥5.2; and ≥5.5 mEq/L. Univariate and multiple logistic regression analyses were used to identify factors associated with increased serum potassium &gt;5.0 mEq/L.

Results
The study population consisted of 582 stable kidney transplant recipients, 369 (63.4%) males, aged 52.4±13.5 years, with eGFR of 55.8±20.1 ml/min/1.73m2 transplanted for more than one year. The prevalence of hyperkalaemia defined as potassium &gt;5, &gt;5 and use of sodium polystyrene sulfonate, ≥ 5.2 or ≥5.5, was 22.7%, 22.7%, 14.4% and 4.1% (132, 132, 84 and 24 patients), respectively. In multivariate analysis, male gender (OR 2.020, 95% CI 1.264-3.227) and use of renin-angiotensin-aldosterone-system blockers (OR 1.628, 95% CI 1.045-2.536), were independently associated with hyperkalaemia, while higher eGFR (OR 0.967, 95% CI 0.955-0.979) and diuretic use (OR 0.140, 95% CI 0.046-0.430) were associated with lower odds of the disorder.

Conclusion
The prevalence of mild hyperkalaemia in stable kidney transplant recipients is common but that of moderate or severe hyperkalemia is relatively uncommon. Male gender and low eGFR are the most potent factors associated with hyperkalaemia. Among a wide range of factors only male gender, RAAS blockade and low eGFR increased the odds of hyperkalemia.
MO955RENAL TRANSPLANTATION IN PATIENTS WITH LOW URINARY TRACT ABNORMALITIES
Authors: Ladhari Narjes , Awatef Azzabi , Wissal Sahtout , Yosra Guedri , Sanda Mrabet , Narjes Ben Aicha , Dorsaf Zellama , Abdellatif Achour 
Published: May 2021

Abstract

Background and Aims
Kidney transplantation is the only curative treatment for chronic kidney failure that allows to restaure a normal quality of life for patients. In case of abnormalities of the lower urinary tract, there is a risk of recurrence of renal failure due to urodynamic disturbances. The objective of our study is to analyze the profile of transplanted patients with urodynamic abnormalities and to study their impact on the graft.

Method
Our study was conducted within our Nephrology Department, including renal transplant patients during the period from 2007 to 2020 and who underwent a pre-transplant urodynamic evaluation. Patients with vesical or sphincteral abnormalities were selected, their demographic characteristics, graft survival and infectious complications compared to patients without vesico-sphincteral abnormalities were studied.

Results
Of 209 kidney transplant patients during the period 2007-2020, 54 had undergone a pre-transplant urodynamic assay, which resulted in 32 patients having an abnormality: 12 cases of vesical hypertonia or hypotonia, 12 cases of sphincteral hypertonia and 9 patients had vesico-sphincteral dyssynergy. In this group with vesical abnormalities, the average age was 24 years, with extremes of 7 and 49 years, 19 were male versus 13 females. Initial nephropathy was tubulointerstitial in 75% of cases with reflux nephropathy in 17 patients. Comparing this group (G1) to the group of patients with no vesico-sphincteral abnormalities (G2), there was more graft reflux 34.4% in G1 compared to 18.2% in G2 (p= 0.16), more urological complications (p=0.2), more urinary tract infections, 0.55 episodes per patient per year in G1 versus 0.98 in G2 (p=0.21). For the graft function, there was no statistically significant difference between the 5-year creatinine post-transplant averages.

Conclusion
Vesico-sphincteral abnormalities are frequently found in young patients with pre-transplant NIC, they are not responsible for more post-transplant complications or significant graft failure
MO956APPRAISAL OF PSYCHO-SOCIAL BURDEN AND QUALITY OF LIFE OF KIDNEY DONORS- IS THERE A DEEP ROOTEDAPPREHENSION ?
Authors: Kaul Anupma , Behera Manas 
Published: May 2021

Abstract

Background and Aims
Living kidney donation is a very complex psychological experience for donor candidates as well as the recipients improving self-esteem and donor-recipient relationships on one hand while may add on to emotional stresses increasing psychic vulnerability and predisposition to the development of mental disorder. The present study aimed to look into psychosocial outcome among donor characteristics and quantification of the psychological impact of kidney donation.

Method
This was a retrospective random study conducted among 506 renal transplant donors from 2010 till 2018 at Department of nephrology and transplantation at a tertiary care centre in northern part of India.

Results
Majority of donors were females ie mothers (38.1%) and wife (35.5%). A total of 18.6% developed one or more co morbid illness following transplantation. Most of the donors (98.9%) were motivated by affection and love for the recipient and out of them (89.1%) felt that there were the first choice among the available donors. A majority of them (94.5%) felt that donation had positively affected their relationship and were respected. These donors showed lesser degree of both depressive and anxiety (HAD score 3.5) and depressive score (BDI II 4.8). Donation had upgraded the stature of the donor in the family and recipient which proved statically significant predictor on donor related outcome. Donors well being was dependant on recepients wellbeing and 20% of the donors felt or were made to feel the guilt of the graft failure or a poor outcome.

Conclusion
The study showed a positive acknowledgement for the donors from the recipients and society thus giving a meaning to life Need of the hours is greater post donation monitoring as well as due recognition among donors which can improve long term donor outcomes.
MO961KIDNEY TRANSPLANTATION AS A TREATMENT OF CHOICE FOR AA AMYLOIDOSIS DUE TO PERIODIC FEVER SYNDROME
Authors: Dedinska Ivana , Graňák Karol , Vnučák Matej 
Published: May 2021

Abstract

Background and Aims
Renal AA amyloidosis is the most serious complication of periodic fever syndrome, which, inadequate suppression, due to persistent inflammation, leads to nephrotic syndrome and renal failure over several years. In most cases, periodic fever syndromes begin to manifest clinically in early childhood. Occurrence in adulthood is considered rare and is associated with a poorer clinical course. Kidney transplantation is an effective and safe treatment for end-stage chronic kidney disease (CKD) based on AA amyloidosis.

Method
We present cases of two patients after deceased donor kidney transplantation, who have been diagnosed with adult periodic fever syndrome.

Conclusion
Periodic fever syndromes are diseases beginning to manifest clinically in early childhood in 60–90% of cases, most often in the case of familial Mediterranean fever around 4 years of age, in the case of CAPS usually only a few months after birth. Occurrence in adulthood is considered rare and is associated with a poorer clinical course. Kidney transplantation is an effective and safe treatment of end-stage CKD based on AA amyloidosis associated with periodic fever syndrome. Adequate targeted treatment against IL-1 or TNF is important and appears to be safe during the post-transplant period, with regular monitoring of renal function, acute phase inflammatory reactants, and histological findings by protocol graft biopsies. It will be important and necessary to assess the development of diseases in the post-transplant period in the long term.
MO964DEATH WITH GRAFT FUNCTION AMONG EGYPTIAN KIDNEY TRANSPLANT RECIPIENTS: A SINGLE CENTER EXPERIENCE
Authors: Gamal Mostafa , Salah Ahmed Mohamed , Hendy Yasser , Refaie Ayman 
Published: May 2021

Abstract

Background and Aims
Kidney transplantation is the optimal treatment of end stage renal disease (ESRD). Despite improvements in patient selection and management, every transplant carries risk of graft loss. Death with graft function (DWGF) is an important cause of long-term loss of grafts and patients. In this study, we investigated clinical characteristics and causes of DWGF among a cohort of 2953 Egyptian kidney transplant recipients.

Method
A total of 291 recipients who died with graft function (DWGF) were evaluated regarding causes and timing of death. Causes of death were investigated in different eras of immunosuppression; era 1 (1976-1995): steroid and azathioprine, era 2 (1996-2005): cyclosporine-based and era 3 (2006-2018): tacrolimus-based. Demographic data, original kidney disease, pre- and post-transplant co-morbidities, immunosuppression regimens, biopsy proven acute rejection episodes and graft function at last follow up were analyzed.

Results
Proportion of DWGF in total graft loss had changed over time. In our retrospective study, it decreases from 29.5% in era 1 to 13.7% in the most recent era of kidney transplantation. Most patients in DWGF group had diabetes mellitus, hypertension, frequently experienced more infections and more rejection episodes. cyclosporine-based immunosuppression was more prevalent. A total of 291 patients (9.9%) died with graft function. DWGF was responsible for 58.3% of a total of 499 deaths (figure 1). For this group of patients, median serum creatinine at last follow up was 1.7 mg/dl (range: 0.2 - 7 mg/dl). Out of 291 recipients who died with functioning graft, 53 patients (18.2%) died within the first year, 55 (18.9%) died within 1-5 years, 75 (25.8%) died within 5-10 years while 108 patients (37.1%) died after 10 years post transplantation. The majority of DWGF was secondary to cardio-vascular diseases (CVD) (30.9%) and serious infections (29.2%) (figure 2). Death due to malignancy was lowest within the ﬁrst year (1.9%), increased thereafter but unexpectedly malignancy (22.2%) was the third main cause of death in the late period after transplantation (figure 3).

Conclusion
DWGF accounts for 24.5% of total graft loss. The most common cause is cardiovascular disease followed by serious infections. Pre-transplant diabetes mellitus, steroid dose and infections had most significant association with DWGF. Understanding different causes of death according to the time after transplantation is mandatory in order to improve the long-term outcomes.
MO966COGNITIVE FUNCTIONING AMONG VARIOUS MODALITIES OF RENAL REPLACEMENT THERAPY- ROLE OF RENAL TRANSPLANT
Authors: Kaul Anupma , Behera Manas 
Published: May 2021

Abstract

Background and Aims
Evidences have shown diverse responses on thedescription of cognitive function in patients who have undergone renaltransplantation. The present study examined the changes in cognitive functionamong ESRD patients on maintenance haemodialysis or on CAPD and followingthey post renal transplant. We also looked into the ccognitive status among frailand non frail ESRD patients and their performance in the post transplant period

Method
67 patients who were stable ESRD on thrice a week haemodialysis or onCAPD were investigated 6 months pre and post transplant using a battery ofneurophysiologic testing. Transplant function was assessed on regular interval andfollowing a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant.

Results
CAPD compared to HD had better preservation of cognitive functionsassessed 6 months after initiation of dialysis. There was statistically significantimprovement in general cognitive status performance (P &lt; 0.001), motor speed,spatial reasoning, verbal memory and visual memory post transplant compared tothe pre transplant state. However, non-significant improvements were observed indomains of attention, executive functioning, language and verbal fluency. Theanxiety and depression scores did not show significant improvement despitetransplant. On the basis of fraility, frail individuals experienced less improvement in cognitive function as compared to non frail recipients in our study.

Conclusion
The data demonstrate improvements in cognition following kidneytransplant and emphasize the reversibility of the memory problems evidencedamong patients on dialysis.Focus should be made for interventions in terms ofprevention of cognitive decline among frail patients very early in pre-end stage thus helping in overall outcomes post transplant.
MO967A STUDY OF ACUTE KIDNEY INJURY IN RENAL ALLOGRAFT RECIPIENTS AND ITS IMPACT ON SHORT-TERM OUTCOME OF GRAFT FUNCTION
Authors: Parry Manzoor 
Published: May 2021

Abstract

Background and Aims
Acute kidney injury (AKI) in renal allograft recipients (RAR) is an important factor for short and long-term allograft function and survival. RAR are at high risk of AKI. The etiology, risk factors, and outcomes of AKI in RAR differ from that of AKI in the community setting. This study aimed to evaluate the spectrum and impact of AKI episodes on RAR outcome.

Method
This was a single-centre, prospective observational study on 84 live RAR patients who developed 105 AKI episodes as per Kidney Disease Improving Global Outcome (KDIGO) criteria between January 2018 to December 2019. The severity of AKI was categorized as per KDIGO guidelines. Acute rejection, recurrence of native kidney disease, and de nova glomerulonephritis were diagnosed by graft biopsy. These patients were followed for 3 months after AKI episodes.

Results
The mean age of our study populations was 38.1 ± 13.2 years. Mean serum creatinine at the time of AKI episode was 2.63 ± 0.95 mg/dL. The causes of AKI in our study population were infections (n 48, 45.7% ), dehydration (n 25, 23.8%), biopsy-proven rejection (n 9,8.6%) calcineurin inhibitor toxicity (n 10, 9.5%), biopsy-proven acute tubular necrosis (n 4, 3.8%), recurrence of native kidney disease (n 4, 3.8%), and miscellaneous causes (n 5, 4.8%). Most of the AKI episodes (62.9%) developed in the first year of the transplant, while as 29 (27.6%) cases developed between 1st and 2nd post-transplant year and 10 (9.5%) cases developed AKI beyond 2 years post-transplant. Sixty-four cases (60.9%) of AKI were in KDIGO stage 1, 30 cases (28.6%) were in AKI stage 2 and 11 cases (10.5%) were in AKI stage 3. Previous episodes of AKI (p&lt;0.0001), need for dialysis at the time of AKI (p=0.0016), and higher stage of AKI (p&lt;0.0001) were the factors associated with nonrecovery of graft functions at 3 months follow-up. At 3 months of follow up, AKI had a significant impact on allograft function.

Conclusion
In our study, AKI in RAR had a significant impact on allograft function. Multiple episodes of AKI, need for dialysis, and higher stage of AKI appear to affect the renal recovery at 3 months post-AKI.
MO969IMPACT OF COVID-19 IN KIDNEY REPLACEMENT THERAPY IN AN EPICENTER TERTIARY HOSPITAL IN SOUTHERN BRAZIL
Authors: Teichman Pedro do Valle , Rosa Viccari Alessandra , Fontanive Franco Rodrigo , Budel da Silva Maria Luiza , Da Silva Oliveira Carla Elisabete , Bauer Andrea Carla , Santos Gonçalves Luiz Felipe , Ceratti Manfro Roberto 
Published: May 2021

Abstract

Background and Aims
Patients on renal replacement therapy (RRT) pose multiple risk factors that may increase the risk of death from coronavirus disease 2019 (COVID-19). Currently, evidence of incidence, management, and prognosis of COVID-19 in this population are scarce.

Method
Between May and December 2020, we followed two RRT populations that have the same tertiary hospital in Southern Brazil as its reference hospital for transplantation. Firstly, we monitored eight affiliated dialysis clinics keeping track of COVID-19 incidence and fatality rate in dialysis patients and those on the kidney transplant waiting list. In the same period, we also monitor COVID-19 incidence and mortality among our prevalent population of kidney transplant recipients.

Results
We evaluated 1049 patients in RRT in the dialysis centers. COVID-19 occurred in 89 of such patients (8.5%), and 31 died from such condition (35.8% death rate). Fifteen patients (5.45%), among 275 on the kidney transplant waiting list, contracted the virus, with one death (6.6%).
Within our prevalent population of 1348 kidney transplant recipients, 113 were diagnosed with COVID19 (incidence: 8.4%), and 17 of them died (mortality rate: 15%). Finally, the number of kidney transplants decreased by 60.4% compared with the same period in the previous year.

Conclusion
COVID-19 determined a substantial impact on RRT. A high frequency of chronic dialysis patients expired from the disease. The impact on the patients on the transplant waiting list seems to be less pronounced probably due to their better health conditions. The fatality rate in kidney transplant recipients is elevated and probably mostly related to comorbidities. Brazil is currently entering the second wave of the disease and it is crucial to find and provide means to protect such vulnerable populations.
MO970GRAFT OUTCOME AFTER ACUTE REJECTION: A CASE CONTROL STUDY
Authors: Fattoum Safa , Bacha Mohamed Mongi , Mosbahhi Tasnim , Braiek Nesrine , Abderrahim Ezzedine , Ben Hmida Fethi , Ben Abdallah Taieb 
Published: May 2021

Abstract

Background and Aims
Although Acute rejection (AR) is a complication associated with the early period after kidney transplantation (KT), its complications are mostly seen after a long term. The aim of this study was to evaluate graft outcome after AR.

Method
It was a longitudinal, retrospective, analytical study including kidney transplant patients followed up in our department between 1986 and 2019. Our population was divided in 2 groups: group A (129 KT complicated by at least one episode of AR) and group B (491 KT not complicated by AR).

Results
AR was responsible of immediate loss of 2 grafts. Chronic graft dyfonction was more frequent in group A (44,1% versus 17,4%, p&lt;0,0001). Creatininemia levels were significantly higher at 3, 6 months, 1 year and 2 years (respectively p =0,0113 ; &lt;0,0001 ; 0,0003 and 0,0172) after KT. The percentage of patients having creatinine levels &gt; 130 µmol/l was higher in group A at 3, 6 months, 1 year, 2 years, 3 years and 5 years (respectively p =0,0186 ; 0,001 ; &lt;0,0001 ; 0,0115 ; 0,0073 and 0,0255).
Graft survival was better in group B (p&lt;0,0001). In group A, AR recurrence was responsible of a worser survival (p&lt;0,0001). Over time, graft survival improved in the 2 groups. Complete functional recovery survival was similar to graft with no rejection but with impared graft function. The worst graft survival was noted if the functional recovery was absent.

Conclusion
Even if graft outcome after AR has improved over time, its deleterious effect is still inevitable. So AR must be prevented in order to enhance graft outcome.
MO971LYMPHOPROLIFERATIVE DISEASE AFTER KIDNEY TRANSPLANTATION: DESCRIBING OUR EXPERIENCE
Authors: Berzal Rico Raquel , Sevillano Angel , Frías González Aida , Yuste Claudia , Aubert Lucia , Sandino Pérez Justo , Rivero Martínez Marta , Cordero García-Galán Lucía , Andrés Belmonte Amado , Praga Manuel 
Published: May 2021

Abstract

Background and Aims
Post-transplant lymphoproliferative disorders (PTLD) are one of the most common malignancies in kidney transplant (KT) recipients. Immunosuppressive therapy and Epstein Barr Virus (EBV) play a main role in their pathogenesis.

Method
In this study we retrospectively analyze the characteristics, clinical evolution and treatments of a group of KT recipients performed between 1986 and 2020 in a single center.

Results
We included 31 patients (64.5% males). Polycystic kidney disease was the most frequent cause of renal failure. Before KT a 6.5% of the patients presented another malignancy, 10% were EBV seronegative and one received immunosuppressive therapy secondary to his primary disease.
Mean age at KT was 43±12 years. 68% of the KT came from brain-dead donors. The most frequent immunosuppressive regime consisted in tacrolimus, mycophenolic acid and prednisone (61.3%). Basiliximab and Timoglobulin were used in the same proportion for the induction therapy (22.6%). Before PTLD appearance the immunosuppressive therapy was reduced in the 54.8% of the recipients. 13% of them presented acute allograft rejection.
The majority of PTLD were diagnosticated between 2016 and 2020. Median time to develop PTLD was 13 years. 54.3% of the patients presented with extranodal involvement. Although all the patients positivized EBV serology, 60% of them had undetectable EBV viral load.
The main therapeutical strategy after PTLD consisted in a reduction of the immunosuppressive therapy. In this way, 28.6% of the recipients was treated with monotherapy with a calcineurin inhibitors and 21.5% with monotherapy with a mTOR inhibitor. In other hand 16.7% received a combination of tacrolimus with a mTOR inhibitor. Rejections were not observed in our group and all the patients presented a preserved kidney function at the end of follow up. Four recipients died because of PTLD. The remaining 27 presented a complete response or stabilization of the disease.

Conclusion
Most of the PTLD were detected between 2016-2020. The time from transplantation to PTLD appearance was long, being EBV viral load negative in the majority of the cases. Graft survival after chemotherapy and reduction of immunosuppressive therapy was excellent, with a low risk of rejection and a good prognosis for hematologic disease. It is possible that a reduction in immunosuppression in selected patients could prevent the development of PTLD.