Nephrology Times最新文献_第10页

For African-American Kidney Donors, Genetic Variants Linked to Graft Survival 对于非裔美国肾脏捐赠者，基因变异与移植物存活有关

Nephrology Times Pub Date : 2011-06-01 DOI: 10.1097/01.nep.0000399779.93032.76

M. Hogan

{"title":"For African-American Kidney Donors, Genetic Variants Linked to Graft Survival","authors":"M. Hogan","doi":"10.1097/01.nep.0000399779.93032.76","DOIUrl":"https://doi.org/10.1097/01.nep.0000399779.93032.76","url":null,"abstract":"Deceased-donor kidneys from African-Americans with two particular gene variants failed much more quickly than those from African-Americans without the two variants, found a single-center study published in the American Journal of Transplantation (2011;11:1025-1030). These results extend to transplantation the previously reported relationship between the apolipoprotein L1 (APOL1) gene and nondiabetic nephropathy risk in this population. “The APOL1 genetic association with nondiabetic kidney failure in African-Americans is among—if not the—most powerful genetic association in any common disease,” said senior author Barry I. Freedman, MD, Professor and Chief of the Section on Nephrology at Wake Forest School of Medicine, in a phone interview. “It fully explains the excess risk of nondiabetic kidney failure in blacks compared with whites in the United States and accounts for 40 percent or so of all African-Americans on dialysis. That’s very impressive, and there are no other genes in the renal literature of this effect. “If a kidney is donated by an African-American, it does not statistically function for as long as a kidney donated by a white, so one of the questions we had was, could this have anything to do with APOL1?” Finding this relationship between APOL1 risk variants in the donor and graft survival in the recipient could mean big changes for kidney transplantation, but not just yet. “These results have to be For African-American Kidney Donors, Genetic Variants Linked to Graft Survival","PeriodicalId":380758,"journal":{"name":"Nephrology Times","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116065019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alemtuzumab Rivals Conventional Induction Agents in Multicenter Trial 阿仑单抗在多中心试验中与传统诱导药物竞争

Nephrology Times Pub Date : 2011-06-01 DOI: 10.1097/01.NEP.0000399780.93032.10

F. Lowry

引用次数: 0

The Long and Short of Posttransplant Care 移植后护理的长与短

Nephrology Times Pub Date : 2011-06-01 DOI: 10.1097/01.NEP.0000399781.70161.DD

T. Bunchman

引用次数: 0

BK Virus Allograft Nephropathy: Unresolved Issues Complicate Diagnosis and Management BK病毒异体移植肾病:未解决的问题使诊断和管理复杂化

Nephrology Times Pub Date : 2011-06-01 DOI: 10.1097/01.NEP.0000399784.15904.40

G. Gupta, M. Atta

{"title":"BK Virus Allograft Nephropathy: Unresolved Issues Complicate Diagnosis and Management","authors":"G. Gupta, M. Atta","doi":"10.1097/01.NEP.0000399784.15904.40","DOIUrl":"https://doi.org/10.1097/01.NEP.0000399784.15904.40","url":null,"abstract":"BK virus has emerged as an important cause of graft loss in kidney transplant recipients. While surveillance strategies have increased early detection and, consequently, reduced graft loss, achieving a delicate balance in the use of potent immunosuppression remains key to preventing acute rejection and BK virus reactivation. In the kidney transplant population, BK virus, a polyomavirus, fi rst emerged as a clinical concern only in the mid1990s, after the introduction of more potent immunosuppressive medications. A signifi cant correlation was observed between the emergence of the infection and of the immunosuppressive regimen containing lymphocytedepleting agents for induction therapy followed by maintenance with calcineurin inhibitors (CNIs) and antiproliferative agents (mycophenolate mofetil, or MMF). At the current time, though, it seems more likely that the risk of BK virus reactivation relates to the total burden of immunosuppression, not to any one drug. Although the majority of reactivation occurs in the fi rst year posttransplant, BK virus nephropathy is a well-known cause of late allograft dysfunction. Risk factors for the condition include male gender, history of acute rejection, prolonged cold ischemia time, and degree of HLA mismatch. A robust association has been demonstrated between BK virus nephropathy and recipient seronegativity at the time of transplantation, similar to the epidemiology of other opportunistic viruses— e.g., herpes viruses, Epstein-Barr virus, and cytomegalovirus. Despite this known risk, testing for BK virus serostatus is not routinely performed, probably because seropositive renal transplant recipients can also develop BK virus nephropathy. Thus, although the precise etiopathogenesis remains unclear, BK virus nephropathy likely arises from complementary determinants in the host, the allograft, and the virus, in the setting of immunosuppression. When BK virus nephropathy does occur, reported rates of graft loss have ranged from 10% to 80%.","PeriodicalId":380758,"journal":{"name":"Nephrology Times","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116008133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tolerance Protocol Safe and Effective in HLA-Matched Kidney Transplant Recipients hla匹配肾移植受者耐受方案安全有效

Nephrology Times Pub Date : 2011-06-01 DOI: 10.1097/01.NEP.0000399782.77785.20

M. Hogan

引用次数: 0

B Cell-Targeted Therapy in Membranous Nephropathy: Time for a Randomized Trial 膜性肾病的B细胞靶向治疗:随机试验的时间

Nephrology Times Pub Date : 2011-05-01 DOI: 10.1097/01.NEP.0000398887.83065.5B

F. Fervenza

{"title":"B Cell-Targeted Therapy in Membranous Nephropathy: Time for a Randomized Trial","authors":"F. Fervenza","doi":"10.1097/01.NEP.0000398887.83065.5B","DOIUrl":"https://doi.org/10.1097/01.NEP.0000398887.83065.5B","url":null,"abstract":"Membranous nephropathy is a common immune-mediated glomerular disease and remains the leading cause of nephrotic syndrome in Caucasian adults.1 Although the disease progresses relatively slowly in most patients, approximately 40% eventually develop end-stage renal disease (ESRD).2 Despite this risk, there has been little progress in the treatment of this condition over the last 30 years. While available immunosuppressive therapies, including corticosteroids, alkylating agents, and calcineurin inhibitors, are at least partially successful in reducing proteinuria in membranous nephropathy, their use is controversial, and they all are associated with signifi cant adverse effects and a high relapse rate.3 This set of circumstances holds particularly true in the case of cyclophosphamide, where side effects include risk of infertility and the long-term increased chance of malignancy. Since membranous nephropathy is a disease with remissions and relapses, repeated use of cyclophosphamide results in a progressive increase in long-term risks. There is a need to evaluate new treatments for patients with membranous nephropathy that result in a higher response rate, lower relapse rate, and fewer adverse effects.","PeriodicalId":380758,"journal":{"name":"Nephrology Times","volume":"51 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113959954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accountable Care Model: Fit for Nephrology, but Room for Improvement in CMS Proposal 问责医疗模式:适合肾病学，但CMS提案有待改进

Nephrology Times Pub Date : 2011-05-01 DOI: 10.1097/01.NEP.0000398885.75442.23

L. Butcher

{"title":"Accountable Care Model: Fit for Nephrology, but Room for Improvement in CMS Proposal","authors":"L. Butcher","doi":"10.1097/01.NEP.0000398885.75442.23","DOIUrl":"https://doi.org/10.1097/01.NEP.0000398885.75442.23","url":null,"abstract":"The concepts of “accountable care”—by which health care providers are fi nancially rewarded if they improve patient care while lowering costs—offer great potential for nephrology. “The basic principles of accountable care are very attractive to me as a nephrologist and as somebody who recognizes that the renal industry is a collaboration of many different players and parts,” said Franklin W. Maddux, MD, Senior Vice President and Chief Medical Information Offi cer of Fresenius Medical Care. “When you look at the fundamental value proposition of accountable care, it fi ts renal disease quite well.” While Robert Provenzano, MD, Vice President of Medical Affairs for DaVita, shares Dr. Maddux’s enthusiasm for the concept, he considers the regulations proposed by the Centers for Medicare & Medicaid Services (CMS) to be “almost heartbreaking” because they put too much risk and expense on physicians. “They could have made this easier,” he said. He and others interviewed for this article are optimistic that, while CMS may have paid little attention to nephrology in the proposed rule for accountable care organizations (ACOs) issued March 31, the agency will eventually fi nd a way to apply accountable care concepts to kidney care. After a comment period that ends June 6, CMS will consider feedback and issue its fi nal rule in time for ACOs to begin contracting with the Medicare program as of Jan. 1, 2012. “I’ve never seen a rule from CMS with so many requests for the community to make open comments about particular areas of it,” Dr. Maddux said. “Everything from who can be an ACO to how patients are attributed to an ACO to how the payment and risk work is open for substantial comment.”","PeriodicalId":380758,"journal":{"name":"Nephrology Times","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125875752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

JAK Inhibitor Shows Potential for CNI-Free Immunosuppression, but Regimen Needs Refining JAK抑制剂显示无cni免疫抑制的潜力，但方案需要改进

Nephrology Times Pub Date : 2011-05-01 DOI: 10.1097/01.NEP.0000398886.75442.F8

M. Hogan

引用次数: 1

Transplantation of HIV-Infected Organs: The Time Has Come 感染hiv的器官移植:时机已到

Nephrology Times Pub Date : 2011-05-01 DOI: 10.1097/01.NEP.0000398884.81279.E2

D. Segev

引用次数: 0

Belatacept: Positive Outcomes Persist Over Time, and Safety Profile Improves belataccept:随着时间的推移，积极的结果持续存在，安全性得到改善

Nephrology Times Pub Date : 2011-05-01 DOI: 10.1097/01.NEP.0000398882.73656.A7

M. Hogan

引用次数: 0