Hemodialysis access monitoring and surveillance, how and why?

Hemodialysis access is the 'life line' for patients on renal replacement therapy. Vascular access failure and complications are the second leading cause for hospitalization of patients on hemodialysis. The concept of access monitoring is based on the basic tenet that identification of patients at risk of developing future access failure, coupled with elective intervention will decrease the incidence of hemodialysis access failure and improve patient outcomes.

Effect of prednisone versus no prednisone as part of maintenance immunosuppression on long-term renal transplant function.

Corticosteroids have been a component of maintenance immunosuppression for renal transplant since the 1960s and have helped to reduce the rate of acute rejection. Corticosteroids, however, have many adverse effects, and with the development of new immunosuppressive medications, many transplant centers have adopted protocols that eliminate or completely avoid the use of corticosteroids. Despite promising short-term results, the impact of corticosteroid elimination on long-term kidney function still is unclear.

Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus.

Background: It is not known how different steroid-free immunosuppressive combinations affect long-term kidney transplant function in recipients of simultaneous kidney and pancreas transplant (SPK). Here, we sought to evaluate, in SPK recipients, the impact on long-term renal allograft function of two Tac-based prednisone-free maintenance immunosuppressive protocols: tacrolimus (Tac)/mycophonelate mofetil (MMF) versus Tac/ sirolimus (SRL).

Methods: In this single-center, retrospective, sequential study, we analyzed 59 SPK transplant patients with at median follow up of 5 years.