Abstract:
BACKGROUND/AIMS:The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski's histological score on 3-year graft function in renal transplant. Ex-post classification using Nyberg's score was carried out to assess the reliability of a purely clinical score and its applicability for organ allocation. METHODS:We evaluated 407 deceased donors (251 optimal and 156 ECD) for renal transplants performed between 2001 and 2006. The differences in creatinine levels and MDRD-GFR at transplant and 1, 2 and 3 years post-transplant between optimal donors and ECD were recorded. Amongst ECD organs, the effect of different Karpinski score classes (0-1, 2, 3, 4, double transplants) on 3-year graft outcomes was analyzed. We then compared renal function over time across the Nyberg grades (A, B, C, and D). RESULTS:Karpinski scores 0-1 and 2 and double transplants were associated with improved graft function compared to scores 3 and 4. Nyberg's clinical score shows a good fit with medium-term outcome and Karpinski's score, but among the donors with a high Nyberg grade (C and D), it fails to differentiate between allocable or non-allocable organs (due to Karpinski's score ≥7). CONCLUSIONS:Our data demonstrate a correlation of histological damage at the time of transplant with 3-year graft function, but at present we are unable to provide any supposition on the possible outcome of the discarded kidneys.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
La Manna G,Comai G,Cappuccilli ML,Liviano D'Arcangelo G,Fabbrizio B,Valentini C,Carretta E,Ravaioli M,Scolari MP,Ridolfi L,Feliciangeli G,Grigioni FW,Pinna AD,Stefoni Sdoi
10.1159/000346257subject
Has Abstractpub_date
2013-01-01 00:00:00pages
158-66issue
2eissn
0250-8095issn
1421-9670pii
000346257journal_volume
37pub_type
杂志文章abstract:BACKGROUND:Despite the significant morbidity and mortality attributable to cardiovascular disease (CVD), risk stratification remains an important challenge in the chronic kidney disease (CKD) population. We examined the discriminative ability of noninvasive measures of atherosclerosis, including carotid intima-media th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000342794
更新日期:2012-01-01 00:00:00
abstract::We studied plasma, dialysate, and muscle carnitine levels in patients with stable chronic renal failure on hemodialysis, and intermittent peritoneal, or continuous ambulatory peritoneal dialysis (CAPD). In patients on hemodialysis, plasma carnitine levels fell from 46.2 +/- 4.5 mumol/l (mean +/- SEM) to 18.8 +/- 2.7 m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166711
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:Although there is a very high mortality rate (>50%) with acute renal failure (ARF) in the intensive care unit (ICU), there is no general consensus on the best dialysis treatment for this condition. METHODS:We surveyed by mail questionnaire, all adult academic and community registered Canadian nephrology cen...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046671
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Hemodialysis treatment requires a well-functioning vascular access. Access patency is limited by the development of venous intimal hyperplasia, which predisposes to fistula stenosis and subsequent thrombosis. In animal models, the renin-angiotensin system has a major role in the development of intimal h...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000080464
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:The impact of socioeconomic factors on arteriovenous fistula (AVF) creation in hemodialysis (HD) patients is not well understood. We assessed the association of area and individual-level indicators of poverty and health care insurance on AVF use among incident end-stage renal disease (ESRD) patients initiate...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000441804
更新日期:2015-01-01 00:00:00
abstract::A multicentre trial (11 nephrology centres) was carried out to test the effects of ibopamine, an orally active dopamine-like drug, on the progression of chronic renal failure. For a 2-year period 189 chronic renal failure patients (serum creatinine level 1.5-4.0 mg/dl) were observed. They were homogeneous for basic ne...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1159/000169049
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:End-stage renal disease (ESRD) is a disease with an aging population and a high prevalence of cognitive impairment affecting quality of life, health care costs and mortality. Structural changes in the brain with decreased white matter integrity have been observed in ESRD. Understanding the changes in cogniti...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000444334
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Hyperkalemia is common in patients receiving maintenance hemodialysis. However, few studies have examined the association between serum potassium level and mortality. METHODS:This study used annual cohorts of hemodialysis patients during 2007-2010. To determine hyperkalemia prevalence, monthly hyperkalemia ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000448341
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:A recent study suggests that inflammation and malnutrition are strongly associated with cardiovascular disease in dialysis patients. Endothelial lipase (EL) is a newly cloned physiological regulator of high-density lipoprotein cholesterol (HDL), which is associated with the progression of atherosclerosi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000144025
更新日期:2008-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065270
更新日期:2002-09-01 00:00:00
abstract::We describe a 78-year-old patient with nephrotic syndrome due to minimal-change glomerulopathy, associated with a renal adenocarcinoma. Oliguric acute renal failure requiring hemodialysis was also observed. Surgical removal of the tumor and corticosteroid therapy resulted in resolution of the nephrotic state and impro...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013365
更新日期:1998-01-01 00:00:00
abstract::In hypoaldosteronemic patients with chronic renal insufficiency, administration of a mineralocorticoid steroid such as fludrocortisone can ameliorate hyperkalemia and metabolic acidosis, but this therapy is not always safe owing to the deleterious consequences of extracellular fluid volume expansion resulting from min...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166827
更新日期:1984-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167443
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Treatment of metabolic acidosis to target the higher serum bicarbonate level than guideline recommendation may downregulate muscle protein degradation and improve renal function among chronic kidney disease (CKD) patients. We conducted a study to test the effects of increased serum bicarbonate level on muscl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000504557
更新日期:2020-01-01 00:00:00
abstract::Investigations of biopsy material from human kidneys with different forms of glomerulonephritis (n = 1,240) and with diabetic glomerulosclerosis (n = 406) performed in order to find changes caused by hyperperfusion of the kidney tissue gave the following results: (1) Hyperperfusion injury occurs in the different forms...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167579
更新日期:1988-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013326
更新日期:1998-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166815
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND/AIMS:Ischemia/reperfusion (I/R) injury is characterized by cytoskeletal reorganization and loss of polarity in proximal tubule epithelial cells. Previously, we showed that myofibrillogenesis regulator (MR)-1 promoted actin organization in cardiomyocytes. MR-1 is also expressed in the kidney. METHODS:In this...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000360141
更新日期:2014-01-01 00:00:00
abstract::We report the case of a 42-year-old woman with autosomal dominant polycystic kidney disease complicated by primary aldosteronism. She had a history of hypertension for 12 years and was found to have hypokalemia and polycystic renal and hepatic disease. Endocrinological tests revealed hyporeninemia and hyperaldosterone...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168725
更新日期:1994-01-01 00:00:00
abstract::Idiopathic diffuse crescentic glomerulonephritis without immune deposits is a variant of rapidly progressive glomerulonephritis which can account for up to 40% of crescentic nephritis. The prognosis may depend on both the severity of histological injury at presentation and the efficacy of treatment. Recent advances in...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167424
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK b...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000491552
更新日期:2018-01-01 00:00:00
abstract::The terminal complement-inhibitor eculizumab has dramatically changed the management of patients with atypical hemolytic uremic syndrome (aHUS), and has also shown promise for treating certain forms of secondary HUS (sHUS), including that caused by drugs and solid-organ/hematopoietic stem cell transplant. While effect...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000492033
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear. METHODS:This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from t...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000455388
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Elderly patients with cardiovascular comorbidities are more likely to die before progressing to the need for undergoing hemodialysis; so deferring their predialysis vascular access (VA) surgery has been suggested. However, recent declines in cardiovascular mortality in the US population may have changed this...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000446159
更新日期:2016-01-01 00:00:00
abstract::The development of new therapies for chronic diseases, such as diabetic kidney disease (DKD), will continue to be hampered by lack of sufficient biomarkers that will provide insights and will be responsive to treatment interventions. The recent application of metabolomic technologies, such as nuclear magnetic resonanc...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
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更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The optimal level of serum ferritin (s-ft) for anemia control and good survival in hemodialysis (HD) patients remains unclear. A 10-year survey was performed to clarify the appropriate quantities of s-ft and investigate the relationships among s-ft, transferrin saturation (TSAT), and mortality in HD patients...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000370317
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Used in a variety of approved and off-label indications, there are several intravenous immunoglobulin (IVIG) preparations available which differ in the excipients (e.g. sucrose, glucose, maltose, D-sorbitol, glycine or L-proline) used to stabilize the protein in the solution. A very rare, but severe adverse ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000354893
更新日期:2013-01-01 00:00:00
abstract::In order to evaluate the changes in causes and outcome of acute renal failure (ARF) during the years 1975-1989, 710 patients treated in our dialysis center were analyzed. We compared the etiology, the severity and catabolic state of ARF, the techniques of renal replacement therapy, which were employed and the ages and...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168466
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus (HCV) infection is highly prevalent among patients on hemodialysis (HD) and is associated with poor prognosis. Treatment with interferon and ribavirin is poorly tolerated, and few data are available on the impact of new direct-acting antivirals (DAAs). This study was intended to analyze the...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.1159/000454819
更新日期:2017-01-01 00:00:00
abstract::The medical history of salt begins in ancient times and is closely related to different aspects of human history. Salt may be extracted from sea water, mineral deposits, surface encrustations, saline lakes and brine springs. In many inland areas, wood was used as a fuel source for evaporation of brine and this practic...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000168759
更新日期:1994-01-01 00:00:00