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Clotting of the Extracorporeal Circuit in Hemodialysis: Beyond Contact-Activated Coagulation 血液透析中体外循环的凝血：超越接触激活凝血
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2024-01-16 DOI: 10.1016/j.semnephrol.2023.151473
Matthias M. Engelen, Peter Verhamme, Thomas Vanassche
{"title":"Clotting of the Extracorporeal Circuit in Hemodialysis: Beyond Contact-Activated Coagulation","authors":"Matthias M. Engelen, Peter Verhamme, Thomas Vanassche","doi":"10.1016/j.semnephrol.2023.151473","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2023.151473","url":null,"abstract":"<p><span>Thrombotic complications in patients<span><span> with end-stage kidney disease are frequent. While being a lifesaving treatment for these patients, </span>hemodialysis<span> introduces a thromboinflammatory environment. Additionally, the extracorporeal hemodialysis circuit itself is prone to clotting because of an interaction between different activation mechanisms of the </span></span></span>coagulation system<span>, platelets, and the immune system. Anticoagulation of the patient and the machine is frequently complicated by bleeding. We discuss the factors important in this balancing act and touch on potential strategies that are on the horizon to target thromboinflammation.</span></p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"36 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139476243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of Cancer in Kidney Transplant Recipients 肾移植受者的癌症流行病学。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151494
David Massicotte-Azarniouch MD, MSc , J. Ariana Noel MD, MSc , Greg A. Knoll MD, MSc
{"title":"Epidemiology of Cancer in Kidney Transplant Recipients","authors":"David Massicotte-Azarniouch MD, MSc ,&nbsp;J. Ariana Noel MD, MSc ,&nbsp;Greg A. Knoll MD, MSc","doi":"10.1016/j.semnephrol.2024.151494","DOIUrl":"10.1016/j.semnephrol.2024.151494","url":null,"abstract":"<div><p>Kidney transplantation is the ideal treatment modality for patients with end-stage kidney disease, with excellent outcomes post-transplant compared with dialysis. However, kidney transplant recipients are at increased risk of infections and cancer because of the need for immunosuppression. Kidney transplant recipients have approximately two to three times greater risk of developing cancer than the general population, and cancer is a major contributor to morbidity and mortality. Most of the increased risk is driven by viral-mediated cancers such as post-transplant lymphoproliferative disorder, anogenital cancers, and Kaposi sarcoma. Nonmelanoma skin cancer is the most frequent type of cancer in kidney transplant recipients, likely due to an interaction between ultraviolet radiation exposure and decreased immune surveillance. Occurrence of the more common types of solid organ cancers seen in the general population, such as breast, prostate, lung, and colorectal cancers, is not, or is only mildly, increased post-transplant. Clinical care and future research should focus on prevention and on improving outcomes for important immunosuppression-related malignancies, and treatment options for other cancers occurring in the transplant setting.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151494"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0270929524000111/pdfft?md5=99b92dccff332e7ea4e7c242ea388063&pid=1-s2.0-S0270929524000111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systemic Amyloidosis and Kidney Transplantation: An Update 系统性淀粉样变性与肾移植：最新进展。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151496
Shankara K. Anand MS , Vaishali Sanchorawala MD , Ashish Verma MBBS
{"title":"Systemic Amyloidosis and Kidney Transplantation: An Update","authors":"Shankara K. Anand MS ,&nbsp;Vaishali Sanchorawala MD ,&nbsp;Ashish Verma MBBS","doi":"10.1016/j.semnephrol.2024.151496","DOIUrl":"10.1016/j.semnephrol.2024.151496","url":null,"abstract":"<div><p>Amyloidosis is a heterogeneous disorder characterized by abnormal protein aggregate deposition that often leads to kidney involvement and end-stage kidney disease. With advancements in diagnostic techniques and treatment options, the prevalence of patients with amyloidosis requiring chronic dialysis has increased. Kidney transplantation is a promising avenue for extending survival and enhancing quality of life in these patients. However, the complex and heterogeneous nature of amyloidosis presents challenges in determining optimal referral timing for transplantation and managing post-transplantation course. This review focuses on recent developments and outcomes of kidney transplantation for amyloidosis-related end-stage kidney disease. This review also aims to guide clinical decision-making and improve management of patients with amyloidosis-associated kidney disease, offering insights into optimizing patient selection and post-transplant care for favorable outcomes.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151496"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Premalignant Lesions in the Kidney Transplant Candidate 肾移植候选者的恶性前病变
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151495
Paul M. Schroder MD, PhD, Ben E. Biesterveld MD, David P. Al-Adra MD, PhD
{"title":"Premalignant Lesions in the Kidney Transplant Candidate","authors":"Paul M. Schroder MD, PhD,&nbsp;Ben E. Biesterveld MD,&nbsp;David P. Al-Adra MD, PhD","doi":"10.1016/j.semnephrol.2024.151495","DOIUrl":"10.1016/j.semnephrol.2024.151495","url":null,"abstract":"<div><p>End-stage kidney disease patients who are referred for transplant undergo an extensive evaluation process to ensure their health prior to transplant due in part to the shortage of available organs. Although management and surveillance guidelines exist for malignancies identified in the transplant and waitlist populations, less is written about the management of premalignant lesions in this population. This review covers the less common premalignant lesions (intraductal papillary mucinous neoplasm, gastrointestinal stromal tumor, thymoma, and pancreatic neuroendocrine tumor) that can be found in the transplant candidate population. High-level evidence for the management of these rarer premalignant lesions in the transplant population is lacking, and this review extrapolates evidence from the general population and should not be a substitute for a multidisciplinary discussion with medical and surgical oncologists.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151495"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-Transplant Lymphoproliferative Disorders 移植后淋巴细胞增生性疾病（肾脏病研讨会综述）。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151503
Vikas R. Dharnidharka MD, MPH , Marianna B. Ruzinova MD, PhD , Lianna J. Marks MD
{"title":"Post-Transplant Lymphoproliferative Disorders","authors":"Vikas R. Dharnidharka MD, MPH ,&nbsp;Marianna B. Ruzinova MD, PhD ,&nbsp;Lianna J. Marks MD","doi":"10.1016/j.semnephrol.2024.151503","DOIUrl":"10.1016/j.semnephrol.2024.151503","url":null,"abstract":"<div><p>Post-transplant lymphoproliferative disorders (PTLDs) are a heterogenous set of unregulated lymphoid cell proliferations after organ or tissue transplant. A majority of cases are associated with the Epstein-Barr virus and higher intensity of pharmacologic immunosuppression. The clinical presentations are numerous. The diagnosis is ideally by histology, except in cases where the tumor is inaccessible to biopsy. While some pre-emptive therapies and treatment strategies are available have reasonable success are available, they do not eliminate the high morbidity and significant mortality after PTLD.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151503"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient-Centered Research and Outcomes in Cancer and Kidney Transplantation 以患者为中心的癌症和肾移植研究与成果。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151499
Ellen Dobrijevic MD , Nicole Scholes-Robertson PhD , Chandana Guha MA , Martin Howell PhD , Allison Jauré PhD , Germaine Wong MD, PhD , Anita van Zwieten PhD
{"title":"Patient-Centered Research and Outcomes in Cancer and Kidney Transplantation","authors":"Ellen Dobrijevic MD ,&nbsp;Nicole Scholes-Robertson PhD ,&nbsp;Chandana Guha MA ,&nbsp;Martin Howell PhD ,&nbsp;Allison Jauré PhD ,&nbsp;Germaine Wong MD, PhD ,&nbsp;Anita van Zwieten PhD","doi":"10.1016/j.semnephrol.2024.151499","DOIUrl":"10.1016/j.semnephrol.2024.151499","url":null,"abstract":"<div><p>Cancer has been identified by kidney transplant recipients as a critically important outcome. The co-occurrence of cancer and kidney transplantation represents a complex intersection of diseases, symptoms, and competing priorities for treatments. Research that focuses on biochemical parameters and clinical events may not capture the priorities of patients. Patient-centered research can improve the relevance and efficiency of research and is particularly pertinent in the setting of cancer and kidney transplantation to facilitate shared decision-making in complex clinical situations. In addition, patient-reported outcomes can facilitate the assessment of patients’ experiences, symptom burden, treatment side effects, and quality of life. This review discusses patient-centered research in the context of kidney transplantation and cancer, including consumer involvement in research and patient-centered outcomes and their measures and inclusion in core outcome sets.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151499"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction: Clinical Innovations in Transplant Onconephrology 简介：移植肿瘤肾脏病学的临床创新。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151493
Naoka Murakami MD, PhD, Germaine Wong MD, PhD
{"title":"Introduction: Clinical Innovations in Transplant Onconephrology","authors":"Naoka Murakami MD, PhD,&nbsp;Germaine Wong MD, PhD","doi":"10.1016/j.semnephrol.2024.151493","DOIUrl":"10.1016/j.semnephrol.2024.151493","url":null,"abstract":"","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151493"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Access to Cancer Care: Prevention and Screening for Females Post Kidney Transplantation Around the World 获得癌症护理：世界各地肾移植后女性的预防和筛查。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151502
Nicole Scholes-Robertson PhD , Zibya Barday PhD , Bianca Davidson MBChB , Abirami Krishnan MBBS, MD, MRCP , Maleeka Ladhani MBBS, PhD , Louise Lerminiaux BBus, MBA , Ruth Sapir-Pichhadze MD, MSc, PhD , Amanda Vinson MD, MSc
{"title":"Access to Cancer Care: Prevention and Screening for Females Post Kidney Transplantation Around the World","authors":"Nicole Scholes-Robertson PhD ,&nbsp;Zibya Barday PhD ,&nbsp;Bianca Davidson MBChB ,&nbsp;Abirami Krishnan MBBS, MD, MRCP ,&nbsp;Maleeka Ladhani MBBS, PhD ,&nbsp;Louise Lerminiaux BBus, MBA ,&nbsp;Ruth Sapir-Pichhadze MD, MSc, PhD ,&nbsp;Amanda Vinson MD, MSc","doi":"10.1016/j.semnephrol.2024.151502","DOIUrl":"10.1016/j.semnephrol.2024.151502","url":null,"abstract":"<div><p>Kidney transplantation offers recipients superior outcomes and improved quality of life compared with dialysis. However, the need for ongoing immunosuppression places recipients at increased risk of certain forms of cancer. Screening and early detection of precancerous lesions are one of the few proven ways to lower the risk of cancer morbidity and mortality in the transplant population. Women have additional barriers to cancer screening services globally, especially in low- and middle-income countries as well as within certain disadvantaged groups in high-income countries. There is a dearth of published data on screening guidelines and policies on post-transplant malignancy in female recipients. It is vital that health care providers and patients are educated regarding the risks of cancer at all post-transplant stages and that the recommended screening policies are adhered to in order to reduce associated morbidity and mortality in this at-risk group.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151502"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kidney Transplantation in Multiple Myeloma and Monoclonal Gammopathy of Renal Significance 多发性骨髓瘤和单克隆肾病的肾移植。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151497
Nelson Leung MD , Cihan Heybeli MD
{"title":"Kidney Transplantation in Multiple Myeloma and Monoclonal Gammopathy of Renal Significance","authors":"Nelson Leung MD ,&nbsp;Cihan Heybeli MD","doi":"10.1016/j.semnephrol.2024.151497","DOIUrl":"10.1016/j.semnephrol.2024.151497","url":null,"abstract":"<div><p>Recent advances in the treatment of plasma cell disorders (PCDs) have provided a wealth of therapy alternatives and improved overall survival tremendously. Various types of PCDs are associated with kidney injury and end-stage kidney disease in a considerable number of patients. Kidney transplantation (KTx) is the best option for renal replacement therapy in select patients in terms of both quality of life parameters and overall survival. Even with modern therapies, all PCDs carry the risk of hematologic progression, whereas histologic recurrence and graft loss are other prevailing concerns in these patients. The risk of mortality is also higher in some of these disorders compared with KTx recipients who suffer from other causes of kidney disease. Unlike solid cancers, there is no well-defined “waiting time” after hematologic remission before proceeding to KTx. Thus, clinicians are usually reluctant to recommend KTx to patients who develop end-stage kidney disease due to PCDs. This review aims to provide the current evidence on KTx outcomes in patients with monoclonal gammopathy of renal significance and multiple myeloma. Although immunoglobulin light chain amyloidosis is a monoclonal gammopathy of renal significance subtype, KTx outcomes in this group are mentioned in another chapter of this issue.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151497"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune Checkpoint Inhibitors in Recipients of Renal Allografts 免疫检查点抑制剂在肾移植受者中的应用
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151500
Karthik Venkataraman MBBS , Tania Salehi MBBS , Robert P. Carroll MD, PhD, FRACP, A(ACHI)
{"title":"Immune Checkpoint Inhibitors in Recipients of Renal Allografts","authors":"Karthik Venkataraman MBBS ,&nbsp;Tania Salehi MBBS ,&nbsp;Robert P. Carroll MD, PhD, FRACP, A(ACHI)","doi":"10.1016/j.semnephrol.2024.151500","DOIUrl":"10.1016/j.semnephrol.2024.151500","url":null,"abstract":"<div><p>Kidney transplant recipients are at increased risk of malignancy as a result of immunosuppression and are increasingly exposed to checkpoint inhibitors (CPIs). However, CPI therapy can precipitate allograft rejection. This review aims to summarize the current literature describing the epidemiology, immunological mechanisms, diagnosis, and treatment of CPI-associated allograft rejection.Initial studies of CPIs suggested allograft rejection post commencement of CPIs occured commonly (40-60%), occurring between 2 and 6 weeks after CPI initiation, with a cancer response rate approaching 50%. More recent studies with predefined, structured immunosuppressive regimens have seen rejection rates of 0-12.5%, with rejection occurring later. Allograft biopsy remains the mainstay of diagnosis; however, noninvasive tools are emerging, including donor-derived cell-free DNA, urinary chemokine assessment, and defining alloreactive T-cell clones prior to or during CPI therapy.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 1","pages":"Article 151500"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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