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2019, Number 1

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RCU 2019; 8 (1)

Acute tubular necrosis and acute rejection and its impact on renal graft function

Leyva TC, Hernández VLM, Muradas AM, Molina AS, Fernandez VGS

Language: Spanish
References: 20
Page: 45-53
PDF size: 723.18 Kb.


ABSTRACT

Introduction: Failure in the initial function of the renal graft due to acute tubular necrosis (ATN) and acute rejection (AR) or both continue to negatively influence the function and survival of the renal graft. Method: A retrospective descriptive study was carried out, in order to determine the frequency of ATN and RA, as well as its possible relationship with function and survival of the renal graft and patients per year. We reviewed the medical records of all patients transplanted in the Nephrology Institute between the years 2012-2015. For all hypothesis tests, an alpha significance level of 0.05 was set. Results: 140 transplants were performed, 103 of them (73.6 %) of cadaveric donation; 90 (94.3 %) of the male sex; 85 (60.7 %) whites and most adults under 60 years of age. There were no failure in the initial function 78 patients (55.7 %); ATN was presented in 34 cases (24.3 %) and associated with RA in 4 (2.9 %); the AR was presented in 4 cases (2.9 %). Conclusions: The frequency of ATN coincides with international reports. Isolated ATN did not significantly impact graft function or survival at 1th year. The association of ATN plus AR or isolated AR was associated with significant reduction in renal function and graft survival in the cadaveric donor.


REFERENCES

  1. Rocha MJ, Ferreira S, Martins LS, Almeida M, Dias L, Pedroso S, et al. Cost analysis of renal replacement therapy by transplant in a system of bundled payment of dialysis. Clin Transplant. 2012;26:529-31.

  2. Morariu AM, Schuurs TA, Leuvenink HGD, van Oeveren W, Rakhorst G, Ploeg RG. Early events in kidney donation: progression of endothelial activation, oxidative stress and tubular injury after brain death. Am J Transplant 2008;8:933- 41.

  3. Seija M, Nin M, Astesiano R, Coitiño R, Santiago J, Ferrari S, et al. Rechazo agudo del trasplante renal: diagnóstico y alternativas terapéuticas. Nefrol Latioam. 2017;14(4):119- 30.

  4. Shabir S, Halimi J-M, Cherukuri A, Ball S, Ferro C, Lipkin G, et al. Predicting 5-Year Risk of Kidney Transplant Failure: A Prediction Instrument Using Data Available at 1 Year Posttransplantation. Am J Kidney Dis. 2014;63:643-51.

  5. López V, Cabello M, Ruíz-Esteban P, Sola E, Gutiérrez C, Jironda C, et al. Impact of Early Low- Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients. Transplant Proc. 2015;47(9):2611-4.

  6. Nga HS, Andrade LGM, Contti MM, Valiatti MF, Silva MMD, Takase HM. Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years. J Bras Nefrol. 2018;40(2):162- 169. doi: 10.1590/2175-8239-JBN-3871.

  7. Ticona-Garrón AB, Álvarez-Rangel LE, Jiménez-Domínguez A, Cruz-Santiago J, Medina- Uicab C, Meza-Jiménez G, et al. Supervivencia del paciente e injerto renal al año de trasplante de donante fallecido; comparación con resultados de donante vivo. Rev Mex Urol. 2010;70(6):347-53.

  8. Cubillos J, Sandoval CL, Andrade E, Hermida NH. Factors contributing to the loss of deceased donor kidney at Fundación Surcolombiana de Trasplantes. February 2007 - November 2012, Neiva, Colombia. rev colomb anestesiol. 2014;42(2):83-9.

  9. Lamb KE, Lodhi S, Meier-Kriesche HU. Longterm renal allograft survival in the United States: a critical reappraisal. Am J Transplant. 2011;11:450-62.

  10. Borroto Díaz G, Barceló Acosta M, Guerrero Díaz C, Rodríguez Alonso H. Frecuencia y factores de riesgo de la necrosis tubular aguda en elpostrasplante renal inmediato. Rev cubana med. 2002 [citado 2018 Jul 02];41(6). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttex t&pid=S0034-75232002000600002&lng=es

  11. Hernández Fernández ME, Ramírez González T, Fernández Ruiz E, López Romero J, Cruz Abascal RE, Fariña Peláez RA. Comportamiento de la función inicial del injerto renal en receptores de donantes con criterios ampliados para la edad. Acta Médica del Centro. 2016 [citado 2018 Jul 2];5(2). Disponible en: http://www.revactamedicacentro.sld.cu/index. php/amc/article/view/565.

  12. Ávila Riopedre Francisco, Velazco Oiz Yadira, Triana del Toro Tomás, Pila Pérez Rafael. Pérdida del injerto renal: estudio en un trienio. AMC. 2007 [citado 2018 Jul 02];11(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttex t&pid=S1025-02552007000100008&lng=es

  13. Leyva C, Pumariaga M, Pérez A, Pérez de Padro JC, Gutierrez F. Comportamiento de la necrosis tubular aguda en el trasplante renal donante cadavérico. INEF 2012-2015. Revista Mexicana de trasplante. 2015;4(Suppl 1):S41.

  14. Domínguez-Gil B, Valentín M, Martin E, García M, Cruzado JM, Pascual J, et al. Situación actual del trasplante renal de donante vivo en España y otros países: pasado, presente y futuro de una excelente opción terapéutica. Nefrologia. 2010;30(Suppl 2):3-13.

  15. González-Bedat MC, Rosa-Diez G, Ferreiro A. El Registro Latinoamericano de Diálisis y Trasplante Renal: la importancia del desarrollo de los registros nacionales en Latinoamérica. nefrol latinoam. 2017;14(1):12-21.

  16. Lai Q, Pretagostini R, Poli L, Levi Sandri GB, Melandro F, Grieco M, et al. Early Urine Output Predicts Graft Survival After Kidney Transplantation. Transplant Proc. 2010;42(4):1090-2.

  17. Hassanain M, Tchervenkov JI, Cantarovich M, Metrakos P, Paraskevas S, Keith D, et al. Recovery of graft function early postransplantant determines long-term graft survival in deceased donor renal transplants. Transplant Proc. 2009;41:124-6.

  18. Opelz G, Wujciak T, Döhler B, Scherer S, Mytilineos J. HLA compatibility and organ transplant survival. Collaborative Transplant Study. Rev Immunogenet 1999;1(3):334-42.

  19. Nemati E, Einollahi B, Lesan Pezeshki M, Porfarziani V, Fattahi MR. Does kidney transplantation with deceased or living donor affect graft survival? Nephrourol Mon. 2014 Jul 5;6(4):e12182. doi: 10.5812/numonthly.12182. eCollection 2014 Jul.

  20. Solá R, Vela E, Cleries M, Guirado LI, Díaz JM, Facundo C, Deulofeu. R. Living donor kidney transplantation in Catalonia: comparison with cadaveric kidney donors. Transplant Proc. 2007;39(7):2208-9.




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