Advances in kidney disease and health最新文献

Immunosuppression in Kidney Transplant Recipients: An Update for the General Nephrologist 肾移植受者的免疫抑制：普通肾科医生的最新进展

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.05.001

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Management of Failing Kidney and Pancreas Transplantations 肾脏和胰脏移植失败后的管理

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.07.001

{"title":"Management of Failing Kidney and Pancreas Transplantations","authors":"","doi":"10.1053/j.akdh.2024.07.001","DOIUrl":"10.1053/j.akdh.2024.07.001","url":null,"abstract":"<div><p>Survival rates for allografts have improved over the last 2 decades, yet failing allografts remains a challenge in the field of transplant. The risks of mortality and morbidity associated with failed allografts are compounded by infectious complications and metabolic abnormalities, emphasizing the need for a standardized approach to management. Management of failing allografts lacks consensus, highlighting the need for unified protocols to guide treatment protocols and minimize risks with postdialysis initiation. The decision to wean off immunosuppression depends on various factors, including living donor availability and infectious risks, necessitating improved coordination of care and a standard guideline. Treatment of failed pancreas focuses on glycemic control, with insulin as the mainstay, while considering surgical interventions such as graft pancreatectomy in advanced symptomatic cases. Navigating the complexities of failed allograft management demands a multidisciplinary approach and standardized stepwise protocol. Addressing the gaps in management plans for failing allografts and employing a systematic approach to transplant decisions will enhance patient outcomes and facilitate informed decision-making.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949813924001174/pdfft?md5=cc9ae1b071152b5c0a8da073841e8ff9&pid=1-s2.0-S2949813924001174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Electrolyte and Acid-Base Abnormalities After Kidney Transplantation 肾移植后的电解质和酸碱异常

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.03.007

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Reproductive Health in Kidney Transplant Recipients 肾移植受者的生殖健康

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.04.006

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Biomarkers in Kidney Transplantation 肾移植中的生物标记物

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.06.001

{"title":"Biomarkers in Kidney Transplantation","authors":"","doi":"10.1053/j.akdh.2024.06.001","DOIUrl":"10.1053/j.akdh.2024.06.001","url":null,"abstract":"<div><p>Currently in the United States, there are more than 250,000 patients with a functioning kidney allograft and over 100,000 waitlisted patients awaiting kidney transplant, with a burgeoning number added to the kidney transplant wait list every year. Although early post-transplant care is delivered at the transplant center, the increasing number of kidney transplant recipients requires general nephrologists to actively participate in the long-term care of these patients. Serum creatinine and proteinuria are imperfect traditional biomarkers of allograft dysfunction and lag behind subclinical allograft injury. This manuscript reviews the various clinically available biomarkers in the field of kidney transplantation for a general nephrologist with a focus on the utility of donor-derived cell-free DNA, as a marker of early allograft injury. Blood gene expression profiling, initially studied in the context of early identification of subclinical rejection, awaits validation in larger multicentric trials. Urinary cellular messenger ribonucleic acid and chemokine CXCL10 hold promising potential for early diagnosis of both subclinical and acute rejection. Torque tenovirus, a ubiquitous DNA virus is emerging as a biomarker of immunosuppression exposure as peripheral blood torque tenovirus copy numbers might mirror the intensity of host immunosuppression. Although high-quality evidence is still being generated, evidence and recommendations are provided to aid the general nephrologist in implementation of novel biomarkers in their clinical practice.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122565","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}

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The Kidney Transplant Journey: Passing the Baton From Transplant Nephrologists to Referring Nephrologist 肾移植之旅：移植肾科医生向转诊肾科医生传授经验

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.07.002

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Kidney Transplant Candidacy: Addressing Common Medical and Psychosocial Barriers to Transplant 肾移植候选者：解决移植常见的医疗和社会心理障碍

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.03.002

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Approach to Kidney Allograft Dysfunction: A Brief Review 治疗肾移植功能障碍的方法：简要回顾

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.06.002

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Coronavirus Disease 2019 in Kidney Transplantation – A 2024 Update 2019年肾移植中的冠状病毒疾病--2024年最新进展

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.03.004

{"title":"Coronavirus Disease 2019 in Kidney Transplantation – A 2024 Update","authors":"","doi":"10.1053/j.akdh.2024.03.004","DOIUrl":"10.1053/j.akdh.2024.03.004","url":null,"abstract":"<div><p>The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 has led to the death of about 7 million people worldwide. When infected, older individuals and those with diabetes, hypertension, cardiovascular disease, and compromised immune system are at higher risk for unfavorable outcomes. These comorbidities are prevalent in kidney transplant candidates and recipients making them inherently vulnerable to severe acute respiratory syndrome coronavirus 2 infection, hence, the significant burden the pandemic has exerted on kidney transplant programs. With the swift discovery and wide-scale availability of vaccines and therapeutics against severe acute respiratory syndrome coronavirus 2, the pandemic is currently behind us allowing transplant programs to relieve their restrictions and resume normal pre-COVID-19 operations. In the aftermath of the pandemic, we discuss the implications for immunosuppression and vaccination, COVID-19–induced kidney injury phenotypes and long COVID-19 symptoms. We also discuss some of the operational aspects the pandemic brought about – mainly the utilization of telemedicine – that are now here to stay.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122569","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}

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Approach to Late Noninfectious Post-Transplant Complications 处理移植后晚期非感染性并发症的方法

Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.05.005

{"title":"Approach to Late Noninfectious Post-Transplant Complications","authors":"","doi":"10.1053/j.akdh.2024.05.005","DOIUrl":"10.1053/j.akdh.2024.05.005","url":null,"abstract":"<div><p>The management of noninfectious complications in kidney transplant recipients includes a broad spectrum of conditions, including metabolic issues, cardiovascular diseases, and malignancies, each presenting unique challenges for nephrologists managing these patients. Unlike infectious complications, these noninfectious issues require nuanced, multidisciplinary approaches for prevention, diagnosis, and management, emphasizing the need for personalized care plans. Cardiovascular disease is particularly significant, standing as the primary cause of death post-transplantation, with recent data indicating an overtaking of cancer death rates over infections among kidney transplant recipients. The intricacies of managing these patients, influenced by the burden of kidney disease and immunosuppression, highlight the importance of a collaborative care model. Although nephrologists may not directly treat all these conditions, their understanding of the unique aspects of transplant recipients is crucial. They play a pivotal role in coordinating care with specialists such as cardiologists, endocrinologists, hematologists, and oncologists, ensuring comprehensive management that addresses these specific post-transplant complications. This review discusses the epidemiology, underlying mechanisms, clinical manifestations, and management strategies of various noninfectious complications post-kidney transplant, with a focus on cardiovascular, metabolic, oncologic, and hematologic complications.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122568","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