Abstract:
PURPOSE:Five-year kidney graft loss currently stands at about 30%. We evaluate the clinical utility of a blood test measuring donor-derived cell-free DNA that detects rejection earlier and, potentially, improves diagnostic and therapeutic accuracy. METHODS:In a randomized controlled experiment, we measured the clinical practice of 175 practicing nephrologists, both with and without the use of dd-cfDNA testing. Providers cared for six simulated post-renal transplant patient cases whose ages ranged from 30 to 75 years and were 3-24 months post-transplant with typical presentations. RESULTS:154 nephrologists completed two rounds of simulated cases. At baseline, the study arms performed similarly, demonstrating no significant differences either in primary diagnosis (p = 0.853), decisions to biopsy or refer to transplant center (p = 1.000), or therapeutic management (p = 0.488). After introduction of the dd-cfDNA test, intervention nephrologists were more likely to arrive at the diagnosis of rejection (OR 4.00, 95% CI 1.93-8.30), make a correct decision on biopsy/transplant center referral (OR 11.07, 95% CI 4.87-25.16), and properly adjust therapeutic management (OR 2.37, 95% CI 1.07-5.24). CONCLUSION:A sample of nationally representative, practicing nephrologists given dd-cfDNA to evaluate post-transplant patients were more likely to correctly diagnose early and subclinical allograft rejection, to send for biopsy or refer to transplant center, and to appropriately change treatment than those nephrologists without dd-cfDNA access.
journal_name
Int Urol Nephroljournal_title
International urology and nephrologyauthors
Peabody J,Billings P,Valdenor C,Demko Z,Moshkevich S,Tran M,Paculdo Ddoi
10.1007/s11255-020-02491-1subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1593-1601issue
8eissn
0301-1623issn
1573-2584pii
10.1007/s11255-020-02491-1journal_volume
52pub_type
杂志文章abstract::Intraglomerular embolization by tubular epithelial cell is a rare artefact found in needle biopsy specimens. The authors have observed this phenomenon in five out of 300 renal biopsy cases. Tubular epithelial cells, were present in the glomerular capillaries (in two cases) or in the capillaries and within the glomerul...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02559622
更新日期:1989-01-01 00:00:00
abstract::The paper deals with the authors' own experience in endoscopic treatment of urethrostenosis in males. Since 1980, 86 patients have been treated in this manner. Good results were obtained in 60 (70%) after one surgical procedure and in 18 (21%) after two operations. Two patients were operated upon by routine methods. W...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550611
更新日期:1988-01-01 00:00:00
abstract:UNLABELLED:Furosemide test is a simple and useful test of renal physiology used to evaluate the capability of the collecting ducts to secrete potassium under the effect of serum aldosterone. Its behaviour pattern has been established in children and young adults but not described in very old healthy people, which we ex...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-009-9547-8
更新日期:2010-03-01 00:00:00
abstract::Fifty-eight patients with urate calculi and 31 patients with other (non-urate) calculi were examined for total-body potassium by means of a total-body counter. The patients with urate calculosis were found to differ significantly in their total-body K from patients with other calculi as well as from normal subjects. T...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082228
更新日期:1979-01-01 00:00:00
abstract::The article "Interleukin 6 is a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in hemodialysis patients using reused low-fux dialyzers". ...
journal_title:International urology and nephrology
pub_type: 杂志文章,已发布勘误
doi:10.1007/s11255-020-02513-y
更新日期:2020-08-01 00:00:00
abstract::Bilateral vasovasostomies were performed in 7 previously vasectomized patients. The method employed was a modification of a one-layer anastomotic technique. There was no correlation between the presence of absence of sperm in the vas fluid, presence or absence of sperm granuloma, and site of vasectomy. No correlation ...
journal_title:International urology and nephrology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02550083
更新日期:1995-01-01 00:00:00
abstract:AIM:The aim of this study is to assess whether the haemostatic markers D-dimer, factor VIII (FVIII) and von Willebrand factor (VWF) are predictive of non-dipping status in treated hypertensive patients; so, as easy available laboratory data can predict non-dipping pattern and help with the selection of the patients who...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0288-8
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:It is controversial whether chromophobe renal cell carcinoma (chRCC) or clear cell renal cell carcinoma (ccRCC) is associated with better survival. We conducted a clinical-based cohort study and meta-analysis to evaluate the prognostic role of histology between chRCC and ccRCC. METHODS:A cohort of 1540 pati...
journal_title:International urology and nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11255-015-1161-3
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:It is unclear whether any significant changes in the epidemiology of chronic kidney disease (CKD), possibly resulting from the exceedingly rapid economic development and the aggressive prevention and treatment of kidney diseases in the Chinese population, have occurred over the past two decades. METHODS:The...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0194-0
更新日期:2012-08-01 00:00:00
abstract::The first time in Scandinavia we present a case report of a pure primary low-grade neuroendocrine carcinoma (carcinoid tumor) of the prostate. Our patient is a 34-year-old male with a long history of symptomatic chronic prostatitis/prostatodynia. After developing severe obstructive uropathy, a transurethral resection ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-009-9660-8
更新日期:2010-09-01 00:00:00
abstract::A clinical study was designed to investigate whether extracorporeal shock waves altered the urinary excretion of glycosaminoglycans and if they have a diagnostic value in determining the extent of the renal tissue damage. A total of 25 consecutive patients were treated for renal stone by extracorporeal shock wave lith...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:According to current guidelines, radical cystectomy (RC) should be combined with an extended pelvic lymphadenectomy (PLND) as therapeutic and staging instrument. Objective of this study was to analyze the influence of PLND on survival rates and complication rates in a selected group of elderly patients with ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1699-3
更新日期:2017-12-01 00:00:00
abstract::The results of treatment by means of modified RLND in 52 patients with clinical stage I non-seminomatous testicular cancer are presented. Retroperitoneal lymph node metastases were found in 15 patients (28.8%) with clinical stage I (CS-I) diagnosed prior to surgery. They received chemotherapy according to PVB schedule...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02768020
更新日期:1994-01-01 00:00:00
abstract::A review of 71 cases of horseshoe kidney accounting for 0.12% of the total number of patients seen at the Department of Urology, Semmelweis University Medical School, Budapest, over 25 years is presented. The incidence of the abnormality has been found twice as high in males as in females. The proportion of surgical c...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082128
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVES:To study the impact of radical tumour surgery in prostate and renal cell cancer patients on quality of life (QOL). METHODS:In 38 male patients suffering from organ-confined prostate or renal cell cancer, a prospective study was performed. For the evaluation of QOL, we used the EMPK (Erfassung multipler psyc...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02552179
更新日期:1997-01-01 00:00:00
abstract:PURPOSE:The impact of radical surgery for urothelial carcinoma is significant on patient's quality of life. Organ-sparing surgery (OSS) can provide comparable oncological outcomes and with improved quality of life. In this review, we summarize the indications, techniques and outcomes of OSS for these tumors. METHODS:P...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-019-02232-z
更新日期:2019-11-01 00:00:00
abstract::This prospective study was undertaken to study the spectrum of renal failure and the outcome in elderly patients. Patients included in the study group were elderly (age>60 years) who either attended outpatient renal clinic and or were hospitalized. Renal failure was classified as acute renal failure (ARF), rapidly pro...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-0089-z
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:To compare the long-term effects of the interleukin-2 receptor antagonist basiliximab versus rabbit antithymocyte globulin as an induction therapy for living-related renal transplantation. METHODS:This is a prospective, open-label, nonrandomized, controlled study including 213 cases of renal transplant. Immuno...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-016-1307-y
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Brown tumor, a non-neoplastic process resulting from excess osteoclast activity, is found in primary hyperparathyroidism (HPTP) and secondary hyperparathyroidism (HPTS). We report a rare case of multiple spinal cord compression by brown tumors. CASE REPORT:A 47-year-old male with end-stage renal disease cau...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0123-2
更新日期:2013-06-01 00:00:00
abstract::Transitional cell carcinoma (TCC) of ureteral stump after radical nephrectomy is rare. Following nephrectomy patients with a prior history of bladder cancer must have their ureteral stumps evaluated. Furthermore, the presence of hematuria should alert the urologist to a possible TCC in the ureteral stump. We present a...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-0745-0
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:We aimed to describe our experience in administering an innovative surgical technique to treat pediatric cases of exstrophy-epispadias complex. MATERIAL AND METHODS:Between 1995 and 2004, seven consecutive patients (six males) with exstrophy-epispadias complex were treated using ileocecal segment for bladder...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-9143-0
更新日期:2007-01-01 00:00:00
abstract::Measuring calcium (Ca) absorption, Ca balance and Ca level in serum,feces and urine during HK (hypokinesia) with and without Ca loading, the aim of this study was to disclose if prolonged HK could reduce Ca deposition more with or without Ca load contributing to greater Ca imbalance. Studies were conducted during 30-d...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-0929-7
更新日期:2004-01-01 00:00:00
abstract::Considering the aging dialysis population of today, increasing our knowledge about the nature, diagnosis and the treatment of bone mineral density (BMD) problems in end-stage renal disease (ESRD) patients deserves more attention. Osteoporosis is basicly defined as a decrease in bone mass. Large epidemiological studies...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-006-9109-2
更新日期:2007-01-01 00:00:00
abstract::Gleason score has been identified as an important variable to predict disease extent and biologic behaviour of prostate cancer. However, the correlation between Gleason score of needle biopsy and surgical specimen is often poor. We studied 72 patients who underwent needle biopsy and radical prostatectomy to correlate ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550548
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical value of detected prostate-specific antigen (PSA) mRNA expression levels in circulating cells in patients with prostate cancer by quantitative real-time polymerase chain reaction (qRT-PCR) and to determine the effect of surgical manipulation on hematogenous dissemination. METHODS:Blo...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-008-9416-x
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To determine the prostate specific antigen (PSA) population standards of a cluster of Turkish men with no clinical evidence of prostate cancer. PATIENTS AND METHODS:We evaluated PSA values of the men who were living in a well-defined, rural district of Western Anatolia. Two hundred fifty-seven men agreed to ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-7976-y
更新日期:2005-01-01 00:00:00
abstract::To enlarge bladder capacity after extensive segmental bladder resection, the authors sutered bladder margins to the serosal aspect of intact sigmoid (Heeg's method). Experimental data and two clinical cases have proved this technique to be of practical value. ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082674
更新日期:1975-01-01 00:00:00
abstract:AIM:Laparoscopic pyeloplasty (LP) is a minimally invasive approach that is becoming a standard treatment of ureteropelvic junction obstruction (UPJO). It is providing similar results when compared with open surgery. We here present our technique and analyses of experience of our first 100 cases. PATIENTS AND METHODS:W...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-010-9753-4
更新日期:2011-03-01 00:00:00
abstract::Among 104 patients with urethral strictures treated over a period of 3 years, sixty-five (63%) had complications such as inflammatory periurethral mass, watering-can perineum with discharging sinuses and fistulas, associated urethral calculi, periurethral abscesses and urethral diverticula. Seventy-four per cent of th...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02549587
更新日期:1989-01-01 00:00:00
abstract::The authors present four cases of operatively confirmed anorchism. The plasma levels of testosterone and 11-deoxy-17-ketosteroids and dehydroisoandrosterone in urine were low in all cases. After stimulation with HCG, plasma testosterone levels increased in two cases and did not change in another two. The levels of 11-...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082812
更新日期:1979-01-01 00:00:00