Risk analysis for deterioration of renal function after pancreas alone transplant
Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant. Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x. © 2011 John Wiley & Sons A/S. : The risk of progression t...
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| Veröffentlicht in: | Clinical transplantation 2012-05, Vol.26 (3), p.387-392 |
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| creator | Chatzizacharias, Nikolaos A. Vaidya, Anil Sinha, Sanjay Sharples, Edward Smith, Richard Jones, Gareth Brockmann, Jens Friend, Peter J. |
| description | Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x.
© 2011 John Wiley & Sons A/S.
: The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre‐transplant estimated glomerular filtration rate (eGFR) 12 mg/dL) at six months post‐transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271–160.907, p = 0.031). The presence of severe pre‐transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m2) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life‐threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured. |
| doi_str_mv | 10.1111/j.1399-0012.2011.01534.x |
| format | Article |
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Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x.
© 2011 John Wiley & Sons A/S.
: The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre‐transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m2. This is a retrospective, single‐center risk analysis of potential factors affecting renal function after PTA. Twenty‐four patients, transplanted over a three‐yr period, with functioning pancreatic grafts at the study’s end point were included. High tacrolimus levels (>12 mg/dL) at six months post‐transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271–160.907, p = 0.031). The presence of severe pre‐transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m2) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life‐threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/j.1399-0012.2011.01534.x</identifier><identifier>PMID: 21980989</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Biological and medical sciences ; estimated glomerular filtration rate ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Glomerular Filtration Rate ; Humans ; Male ; Medical sciences ; Nephrology. Urinary tract diseases ; pancreas alone transplant ; pancreas transplant alone ; Pancreas Transplantation - adverse effects ; Pancreas Transplantation - mortality ; Prognosis ; proteinuria ; renal function ; Renal Insufficiency - diagnosis ; Renal Insufficiency - etiology ; Renal Insufficiency - mortality ; Retrospective Studies ; Risk Assessment ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Rate ; Tissue, organ and graft immunology ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract. Prostate gland</subject><ispartof>Clinical transplantation, 2012-05, Vol.26 (3), p.387-392</ispartof><rights>2011 John Wiley & Sons A/S</rights><rights>2015 INIST-CNRS</rights><rights>2011 John Wiley & Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4374-8e900fb51661a75b6a49efc3897d9d009112aa88bd786751ffc5091cb3fdfb1a3</citedby><cites>FETCH-LOGICAL-c4374-8e900fb51661a75b6a49efc3897d9d009112aa88bd786751ffc5091cb3fdfb1a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1399-0012.2011.01534.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1399-0012.2011.01534.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25986410$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21980989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chatzizacharias, Nikolaos A.</creatorcontrib><creatorcontrib>Vaidya, Anil</creatorcontrib><creatorcontrib>Sinha, Sanjay</creatorcontrib><creatorcontrib>Sharples, Edward</creatorcontrib><creatorcontrib>Smith, Richard</creatorcontrib><creatorcontrib>Jones, Gareth</creatorcontrib><creatorcontrib>Brockmann, Jens</creatorcontrib><creatorcontrib>Friend, Peter J.</creatorcontrib><title>Risk analysis for deterioration of renal function after pancreas alone transplant</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x.
© 2011 John Wiley & Sons A/S.
: The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre‐transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m2. This is a retrospective, single‐center risk analysis of potential factors affecting renal function after PTA. Twenty‐four patients, transplanted over a three‐yr period, with functioning pancreatic grafts at the study’s end point were included. High tacrolimus levels (>12 mg/dL) at six months post‐transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271–160.907, p = 0.031). The presence of severe pre‐transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m2) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life‐threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>estimated glomerular filtration rate</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>pancreas alone transplant</subject><subject>pancreas transplant alone</subject><subject>Pancreas Transplantation - adverse effects</subject><subject>Pancreas Transplantation - mortality</subject><subject>Prognosis</subject><subject>proteinuria</subject><subject>renal function</subject><subject>Renal Insufficiency - diagnosis</subject><subject>Renal Insufficiency - etiology</subject><subject>Renal Insufficiency - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Rate</subject><subject>Tissue, organ and graft immunology</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract. Prostate gland</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEFv0zAUxy00xMrgKyBfJu2S4Bcnjn3gMFXQIlUgpqEdrRfHltylSWenov32OG3prvhi673f__npRwgFlkM6n9c5cKUyxqDICwaQM6h4me_fkNmlcUVmTLEivQW_Ju9jXKeqAFG9I9cFKMmUVDPy68HHZ4o9dofoI3VDoK0dbfBDwNEPPR0cDTa1qdv15lhBl_p0i70JFiPFbugtHQP2cdthP34gbx120X483zfk97evj_Nltvq5-D6_X2Wm5HWZSasYc00FQgDWVSOwVNYZLlXdqpYxBVAgStm0tRR1Bc6ZKhVNw13rGkB-Q-5Oc7dheNnZOOqNj8Z2aQc77KIGlsykKUomVJ5QE4YYg3V6G_wGwyFBehKq13rypidvehKqj0L1PkU_nX_ZNRvbXoL_DCbg9gxgNNi55MH4-MpVSooSWOK-nLg_vrOH_15Azx8fplfKZ6e8j6PdX_IYnrWoeV3ppx8LXawWS-DySS_5X5OdoF0</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Chatzizacharias, Nikolaos A.</creator><creator>Vaidya, Anil</creator><creator>Sinha, Sanjay</creator><creator>Sharples, Edward</creator><creator>Smith, Richard</creator><creator>Jones, Gareth</creator><creator>Brockmann, Jens</creator><creator>Friend, Peter J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201205</creationdate><title>Risk analysis for deterioration of renal function after pancreas alone transplant</title><author>Chatzizacharias, Nikolaos A. ; Vaidya, Anil ; Sinha, Sanjay ; Sharples, Edward ; Smith, Richard ; Jones, Gareth ; Brockmann, Jens ; Friend, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4374-8e900fb51661a75b6a49efc3897d9d009112aa88bd786751ffc5091cb3fdfb1a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>estimated glomerular filtration rate</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>pancreas alone transplant</topic><topic>pancreas transplant alone</topic><topic>Pancreas Transplantation - adverse effects</topic><topic>Pancreas Transplantation - mortality</topic><topic>Prognosis</topic><topic>proteinuria</topic><topic>renal function</topic><topic>Renal Insufficiency - diagnosis</topic><topic>Renal Insufficiency - etiology</topic><topic>Renal Insufficiency - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Rate</topic><topic>Tissue, organ and graft immunology</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chatzizacharias, Nikolaos A.</creatorcontrib><creatorcontrib>Vaidya, Anil</creatorcontrib><creatorcontrib>Sinha, Sanjay</creatorcontrib><creatorcontrib>Sharples, Edward</creatorcontrib><creatorcontrib>Smith, Richard</creatorcontrib><creatorcontrib>Jones, Gareth</creatorcontrib><creatorcontrib>Brockmann, Jens</creatorcontrib><creatorcontrib>Friend, Peter J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chatzizacharias, Nikolaos A.</au><au>Vaidya, Anil</au><au>Sinha, Sanjay</au><au>Sharples, Edward</au><au>Smith, Richard</au><au>Jones, Gareth</au><au>Brockmann, Jens</au><au>Friend, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk analysis for deterioration of renal function after pancreas alone transplant</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2012-05</date><risdate>2012</risdate><volume>26</volume><issue>3</issue><spage>387</spage><epage>392</epage><pages>387-392</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Chatzizacharias NA, Vaidya A, Sinha S, Sharples E, Smith R, Jones G, Brockmann J, Friend PJ. Risk analysis for deterioration of renal function after pancreas alone transplant.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01534.x.
© 2011 John Wiley & Sons A/S.
: The risk of progression to renal replacement after pancreas transplant alone (PTA) is a concern in patients with pre‐transplant estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m2. This is a retrospective, single‐center risk analysis of potential factors affecting renal function after PTA. Twenty‐four patients, transplanted over a three‐yr period, with functioning pancreatic grafts at the study’s end point were included. High tacrolimus levels (>12 mg/dL) at six months post‐transplant was the only independent risk factor identifying a substantial decline in native renal function by Cox regression analysis (HR = 14.300, CI = 1.271–160.907, p = 0.031). The presence of severe pre‐transplant proteinuria (urine Pr/Cr ≥100 mg/mmol) marginally failed to reach significance (p = 0.056). Low eGFR levels alone (≤45 and ≤40 mL/min/1.73 m2) at the time of transplant did not correlate with substantial decline in renal function. Our data suggest that PTA is a justifiable therapy for patients with hypoglycemia unawareness or other life‐threatening diabetic complications, even in those with borderline renal function, provided that they do not suffer from severe proteinuria and appropriate monitoring and tailoring of immunosuppression is ensured.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21980989</pmid><doi>10.1111/j.1399-0012.2011.01534.x</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences estimated glomerular filtration rate Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Glomerular Filtration Rate Humans Male Medical sciences Nephrology. Urinary tract diseases pancreas alone transplant pancreas transplant alone Pancreas Transplantation - adverse effects Pancreas Transplantation - mortality Prognosis proteinuria renal function Renal Insufficiency - diagnosis Renal Insufficiency - etiology Renal Insufficiency - mortality Retrospective Studies Risk Assessment Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate Tissue, organ and graft immunology Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland |
| title | Risk analysis for deterioration of renal function after pancreas alone transplant |
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