Pharmacokinetics of mycophenolate mofetil in kidney transplant patients with renal insufficiency.

Mycophenolate mofetil (MMF) is an immunosuppressant that is widely used for prophylaxis of rejection in solid organ transplantation. In this study, we examined the effect of renal insufficiency on the pharmacokinetics of MMF, particularly on the free fraction of drug in renal transplant patients. Our study was performed on 10 patients with severe renal insufficiency (creatinine clearance [CrCl] <30 mL/min), and 10 control patients with preserved renal function (CrCl >90 mL/min).

Plasmapheresis for the prophylaxis and treatment of recurrent focal segmental glomerulosclerosis following renal transplant.

We evaluated 10 patients with primary focal segmental glomerulosclerosis (FSGS) treated with plasmapheresis (PS) following renal transplantation. Three patients lost their first graft due to FSGS recurrence. In seven patients, PS was indicated as treatment for probable recurrence defined as the onset of proteinuria above 1 g/24 hours.

Alendronate in kidney transplant patients: a single-center experience.

Introduction: Osteoporosis following a renal transplant is an important cause of morbidity. Several studies have demonstrated the efficiency of diphosphonates for the prevention and treatment of osteoporosis.

Methods: We evaluated the effect of alendronate treatment on bone mineral density (BMD) in patients with osteoporosis (lumbar spine and/or hip t-scores < or = -2.

Minimal model analysis in nondiabetic renal transplant recipients with hepatitis C.

Introduction: Epidemiological data suggest that hepatitis C virus (HCV) infection may contribute to the development of posttransplantation diabetes mellitus (PTDM).

Methods: We investigated the glucose metabolism in 19 renal transplant recipients with antiHCV antibodies and without DM according to World Health Organization criteria before or after transplantation. We measured insulin sensitivity (SI), glucose effectiveness (SG), and pancreatic insulin response using the frequently sampled intravenous glucose tolerance test (FSIGTT).

Treatment of hepatitis C virus with interferon in hemodialysis patients awaiting kidney transplant.

Introduction: Hepatitis C virus (HCV) infection is associated with worsening disease progression after renal transplant, and to date there is no available treatment for use at this stage. It has therefore been recommended to treat HCV infection with interferon (IFN) during the dialysis period while the patient is on the waiting list for transplantation.

Methods: We analyzed data from 27 patients on hemodialysis awaiting transplant, who were under IFN treatment for chronic HCV infection (dominant genotype, 1b).

Osteoarticular pain and bone mineral density in renal transplantation.

Introduction: The reduction of bone mineral density (BMD) levels is an important complication after renal transplantation. The prevalence of nontraumatic lesions may reach 22%. Patients with lower osseous mass suffer the highest number of lesions.

Outcome of kidney transplant in chronic hepatitis C virus patients: effect of pretransplantation interferon-alpha2b monotherapy.

Hepatitis C virus (HCV) infection represents an important problem for hemodialysis patients especially following renal transplantation. We assessed the outcome of HCV-positive patients undergoing renal transplantation after treatment during the pretransplant period with alpha-interferon 2b (alpha-IFN2b). Data from all HCV-infected patients (n=38) undergoing renal transplantation from a cadaveric donor between January 1997 and June 2002 were retrospectively reviewed.

[Cost of maintenance immunosuppressive drugs in kidney transplantation].

Method: We calculated the cost of maintenance immunosuppression (ISM) in 405 kidney transplant patients under treatment for more than one year, classifying them according to the combination of drugs used and whether the ISM continued to be the same as initially indicated (primary ISM), or a later adaptation. Basic clinical data were also acquired on the through levels of drugs and the use and cost of the associated medication.

Results: The mean doses in mg/kg/day and the trough levels in ng/ml were: cyclosporin (Cs), 2.

Infections in renal transplant recipients receiving mycophenolate versus azathioprine-based immunosuppression.

Differences in the incidence, etiology, type, and outcome of infections occurring during the first 6 months after transplantation were evaluated in two consecutive cohorts of kidney recipients who received immunosuppressive regimens based on either azathioprine (plus antilymphocyte globulin, cyclosporine A, and prednisone) (ATG-AZA cohort) or mycophenolate-mofetil (plus cyclosporine A and prednisone) (MMF cohort). The overall incidence of infections in the two cohorts was similar (0.99+/-1.

Prospective study of renal transplant infections in 50 consecutive patients.

A prospective study of the frequency, timing, etiology and risk factors of infections in renal transplant recipients during the first year after transplantation was conducted in 50 consecutive patients. Neither prophylaxis with trimethoprim-sulfamethoxazole nor antiviral prophylaxis was administered. Two hundred twenty-eight episodes of infection were registered (4.

Comparison of survival in continuous ambulatory peritoneal dialysis and hospital haemodialysis: a multicentric study.

We compared the survival of 842 patients on centre haemodialysis to 272 patients on continuous ambulatory peritoneal dialysis (CAPD). All patients selected had begun treatment between 1 January 1984 and 30 June 1988 and were from six centres which participate in a regional renal patients registry. Patients on CAPD were older and had a greater proportion of diabetes and other associated diseases.