Publications by authors named "Kai Krupka"
Background: A pre-transplant prediction model using commonly available factors is valuable for optimizing donor selection, communication, and counseling for pediatric kidney transplant (PKT) recipients. This study aims to externally validate a Dutch PKT prediction model and assess its international applicability.
Materials And Methods: Data from the Dutch-, CERTAIN-, and CRISTAL registries, covering PKT from 2005 to 2021, were used.
Background: We investigated factors associated with post-transplant growth in pediatric kidney transplant (KTx) recipients with a focus on plasma bicarbonate (HCO3) and estimated the effect of alkali treatment on growth.
Methods: In this study of the CERTAIN Registry, data were collected up to 5 years post-transplant. Generalized Additive Mixed Models were applied to assess the association between post-transplant growth and covariates.
Introduction: Data on age-related differences in rejection rates, infectious episodes, and tacrolimus exposure in pediatric kidney transplant recipients (pKTRs) on a tacrolimus-based immunosuppressive regimen are scarce.
Methods: We performed a large-scale analysis of 802 pKTRs from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry from 40 centers in 14 countries. The inclusion criteria were a tacrolimus-based immunosuppressive regimen and at least 2 years of follow-up.
Article Synopsis
- In kidney transplant recipients, BK polyomavirus-associated nephropathy (BKPyVAN) is a significant risk for transplant loss, and reducing immunosuppression to manage BKPyV-DNAemia can also heighten the risk of graft rejection.
- The CERTAIN study, involving 195 pediatric kidney transplant recipients, found that BKPyV-DNAemia significantly increased the risk of T cell-mediated rejection, development of donor-specific antibodies, and overall decline in graft function.
- The findings suggest that careful monitoring and regular screening for donor-specific antibodies are essential when adjusting immunosuppressive therapy in patients with BKPyV-DNAemia to mitigate rejection risks.
Background: This study by the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) was designed to determine the incidence, risk factors, current management strategies, and outcomes of antibody-mediated rejection (ABMR) in pediatric kidney transplant recipients (pKTR).
Methods: We performed an international, multicenter, longitudinal cohort study of data reported to the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry. Three hundred thirty-seven pKTR from 21 European centers were analyzed.
Background: Complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) are ultra-rare chronic kidney diseases with an overall poor prognosis, with approximately 40-50% of patients progressing to kidney failure within 10 years of diagnosis. C3G is characterized by a high rate of disease recurrence in the transplanted kidney. However, there is a lack of published data on clinical outcomes in the pediatric population following transplantation.
View Article and Find Full Text PDFIntroduction: We investigated the relationship between metabolic acidosis over time and allograft outcome in pediatric kidney transplantation (KTx).
Methods: This registry study collected data up to 10 years posttransplant. Survival analysis for a composite end point of graft loss or estimated glomerular filtration rate (eGFR) ≤ 30 ml/min per 1.
Background: Kidney transplantation (KTx) from small donors is associated with inferior graft survival in registry studies, whereas single-center studies show favorable results.
Methods: We compared 175 pediatric KTx from small donors ≤20 kg (SDKTx) with 170 age-matched recipients from adult donors (ADKTx) from 20 centers within the Cooperative European Paediatric Renal Transplant Initiative registry. Graft survival and estimated glomerular filtration rate (eGFR) were analyzed by Cox regression and mixed models.
Background: Little is known about the time-varying determinants of kidney graft failure in children.
Methods: We performed a retrospective study of primary pediatric kidney transplant recipients (younger than 18 years) from the Eurotransplant registry (1990-2020). Piece-wise exponential additive mixed models were applied to analyze time-varying recipient, donor, and transplant risk factors.
Article Synopsis
- The article discusses the correction of previous findings related to a specific DOI, ensuring accuracy in scientific reporting.
- It emphasizes the importance of updating published research to reflect new insights or rectify errors.
- The corrected article aims to maintain integrity and trust in the scientific community by providing reliable information.
Introduction: Rejection remains the main cause of allograft failure in paediatric kidney transplantation and is driven by donor-recipient HLA mismatching. Modern computational algorithms enable assessment of HLA mismatch immunogenicity at the molecular level (molecular-mismatch, molMM). Whilst molMM has been shown to correlate with alloimmune outcomes, evidence demonstrating improved prediction performance against traditional antigen mismatching (antMM) is lacking.
View Article and Find Full Text PDFArticle Synopsis
- Researchers are looking at European kidney transplant registries to see how well they collect patient data for kids with kidney problems.
- They found 109 kidney transplant centers in 27 EU countries, but 39% of them don't share their data in the available registries.
- The study shows that while these registries are important, they collect different types of information, making it hard to get a complete picture of kidney health care.
Article Synopsis
- This study explores how chronic kidney disease-mineral and bone disorder (CKD-MBD) parameters affect kidney transplant outcomes in children, highlighting a lack of information in this area.
- Data was collected from 1210 pediatric patients across Europe, analyzing the impact of parathyroid hormone, calcium, phosphate, and vitamin D levels on kidney function over 5 years post-transplant.
- The findings indicate that hyperparathyroidism may independently increase the risk of kidney transplant dysfunction, while hyperphosphatemia's impact appears related to declines in kidney function rather than being an independent factor.
Article Synopsis
- Researchers found that using real health data from patient registries can help run better tests for treating kids who get kidney transplants.
- They compared two groups: one from a controlled trial and one from a patient registry, and found that they were similar in important ways.
- The results showed that using this registry data could be a good way to make clinical trials easier and more effective for kids with kidney issues.
Renal outcome and plasma methylmalonic acid levels after isolated or combined liver or kidney transplantation in patients with methylmalonic acidemia: A multicenter analysis.
Mol Genet Metab
November 2022
Background: Methylmalonic acidemia (MMAemia) is characterized by accumulation of methylmalonic acid (MMA) in all body tissues. To minimize disease-related complications, isolated kidney (KTx), liver (LTx) or combined liver-kidney transplantation (LKTx) have been suggested. However, the impact of these different transplant strategies on outcome are unclear.
View Article and Find Full Text PDFBackground: Preexistent LUTD are considered a hostile environment, which might negatively impact KTx survival. In such cases, surgical reconstruction of the bladder is required. However, there is still disagreement on the optimal timing of the reconstruction procedure.
View Article and Find Full Text PDFHospitalization following pediatric kidney transplantation: An international comparison among a Canadian pediatric transplant center, North American Pediatric Renal Trials and Collaborative Studies, and Cooperative European Pediatric Renal Transplant Initiative registry data.
Pediatr Transplant
August 2022
Background: There are several databases across the world that collect pediatric KT data. We compare the hospitalization outcomes for pediatric KT recipients from a large Canadian transplant center (SickKids database; The Hospital for Sick Children Kidney Transplantation Institutional Database), United States (NAPRTCS), and Europe (CERTAIN registry).
Methods: An institutional retrospective review of KT was performed between 2000 and 2015.
Background: Asymptomatic hyperuricemia is frequently observed in pediatric kidney transplant recipients; symptomatic hyperuricemia, however, is a rare complication. Only few data are available in this patient population. We, therefore, investigated the prevalence of hyperuricemia and its association with kidney transplant function and blood pressure in a multicenter cohort of pediatric kidney transplant recipients.
View Article and Find Full Text PDFBackground: Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce.
Methods: In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx.
Article Synopsis
- - The study analyzed blood pressure control in 336 pediatric renal transplant patients, revealing a high prevalence of hypertension post-transplant, with 84% affected at discharge and 77% at three years later, despite substantial use of antihypertensive medications.
- - Younger patients, especially those transplanted before age 5, showed consistently high systolic blood pressure but received less treatment over time, while factors like male sex, higher BMI, and high cyclosporine A levels were linked to elevated blood pressure.
- - The findings highlight inadequate blood pressure management in this cohort and suggest that specific groups, like young children and older girls, may require targeted monitoring and treatment strategies to improve outcomes.
Chronic antibody-mediated rejection (cABMR) is the main cause of long-term renal graft loss. Late-stage diagnosis is made by detecting donor-specific antibodies (DSA) in blood combined with typical histomorphological lesions in renal allografts. There is a need for noninvasive biomarkers for cABMR that might permit screening and earlier diagnosis.
View Article and Find Full Text PDFBackground: BK polyomavirus-associated nephropathy (BKPyVAN) constitutes a serious cause of kidney allograft failure, but large-scale data in pediatric renal transplant recipients and a comprehensive analysis of specific risk factors are lacking.
Methods: We analyzed the data of 313 patients in the Cooperative European Pediatric Renal Transplant Initiative Registry, with an observation period of 3.3 years (range, 1-5).
Background: JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) is a severe, but rare complication in adult renal transplant (RTx) recipients. Related data in pediatric patients are scarce.
Methods: Based on the CERTAIN Registry, we therefore performed a multi-center, retrospective study on the JCPyV antibody status, prevalence of JCPyV replication, and its associated disease in 139 pediatric RTx recipients (mean age, 8.
Background: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx.
Methods: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry.
Background: Avoidance of vaccine-preventable infections in paediatric renal allograft recipients is of utmost importance. However, the development and maintenance of protective vaccination titres may be impaired in this patient population owing to their need for immunosuppressive medication.
Methods: In the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), we therefore performed a multi-centre, multi-national study and analysed vaccination titres pre- and post-transplant in 155 patients with serial titre measurements in comparison with published data in healthy children.