Derivation and external validation of the SIMPLICITY score as a simple immune-based risk score to predict infection in kidney transplant recipients.

Existing approaches for infection risk stratification in kidney transplant recipients are suboptimal. Here, we aimed to develop and validate a weighted score integrating non-pathogen-specific immune parameters and clinical variables to predict the occurrence of post-transplant infectious complications. To this end, we retrospectively analyzed a single-center derivation cohort of 410 patients undergoing kidney transplantation in 2008-2013 in Madrid.

Pretransplant IgA-Anti-Beta 2 Glycoprotein I Antibodies As a Predictor of Early Graft Thrombosis after Renal Transplantation in the Clinical Practice: A Multicenter and Prospective Study.

Background: Graft thrombosis is a devastating complication after renal transplantation. We recently described the association of anti-beta-2-glycoprotein-I (IgA-ab2GP1) antibodies with early graft loss mainly caused by thrombosis in a monocenter study.

Methods: Multicenter prospective observational cohort study.

Paricalcitol Versus Calcifediol for Treating Hyperparathyroidism in Kidney Transplant Recipients.

Introduction: Secondary hyperparathyroidism (SHPT) and vitamin D deficiency are common at kidney transplantation and are associated with some early and late complications. This study was designed to evaluate whether paricalcitol was more effective than nutritional vitamin D for controlling SHPT in kidney allograft recipients.

Methods: This was a 6-month, investigator-initiated, multicenter, open-label, randomized clinical trial.

Outcomes of Peritoneal Dialysis Catheter Left In Place after Kidney Transplantation.

No clear consensus has been reached regarding the optimal time to remove the peritoneal dialysis catheter (PDC) after kidney transplantation (KT). This retrospective observational study, conducted in a single peritoneal dialysis (PD) unit including all PD patients who received a KT between 1995 - 2015, was undertaken to evaluate the clinical outcomes and potential complications associated with a PDC left in place after KT. Of the 132 PD patients who received a KT, 20 were excluded from the study.

Preserved Renal Function in Kidney Transplantation over a Thrombosed Aortobifemoral Bypass Graft: The Role of Retrograde Flow and Early Thrombolysis.

Aortobifemoral bypass (ABFB) thrombosis is not uncommon, and when the artery of a renal graft is implanted on a bypass the risk of graft loss is high. We report the case of a 48-year-old woman with a previous history of ABFB under antiplatelet therapy and a kidney allograft implanted on the vascular prosthesis, who presented with acute limb ischemia and severe renal impairment. Imaging techniques revealed a complete thrombosis of the proximal left arm of the ABFB.

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: The role of gender (EMITRAL study).

Background And Objectives: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established.

Method: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally.

Efficacy and safety of tacrolimus compared with ciclosporin-A in renal transplantation: 7-year observational results.

The European Tacrolimus versus Ciclosporin-A Microemulsion (CsA-ME) Renal Transplantation Study demonstrated that tacrolimus decreased acute rejection rates at 6 months. Primary endpoints of this investigator-initiated, observational 7-year follow-up study were acute rejection rates, patient and graft survival rates, and a composite endpoint (BPAR, graft loss, and patient death). We analyzed data from the original intent-to-treat population (n = 557; 286 tacrolimus, 271 CsA-ME).

Bone fractures and lumbar mineral density after renal transplantation. A long-term cross-sectional study.

Background: The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD).

Patients And Methods: One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft function, biochemical mineral metabolism markers and body mass density (DEXA) were measured.

Development of urologic de novo malignancies after renal transplantation.

Objectives: The incidence of neoplasms in renal transplant recipients is higher than in general population. The increasing age of donors and recipients also increases the risk of developing malignancies, including genitourinary. The aim of this study is to analyze clinical aspects and management of this complication.

Glomerular filtration rate: utility for assessing long-term renal allograft outcomes in kidney allograft recipients.

Glomerular filtration rate (GFR) is the parameter currently used in renal transplantation to monitor renal function and to predict long-term survival of the graft. Due to practical difficulties in measuring GFR through inulin or creatinine clearance, formulas have been 
designed to estimate GFR from serum creatinine and indirect indices of creatinine production from muscles, i.e.

Are low levels of 25-hydroxyvitamin D a risk factor for cardiovascular diseases or malignancies in renal transplantation?

Background: Observational studies in healthy people suggest an inverse relationship between 25-hydroxy-vitamin D (25(OH)D levels) and cardiovascular diseases and malignancies. We performed an observational prospective study in renal transplant recipients to investigate the effects of vitamin D deficiency on cardiovascular and malignancy risks.

Methods: From 389 renal transplant recipients, 331 with a functioning graft at 12 months were included in the study.

Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study.

Background: To describe the causes of graft loss, patient death and survival figures in kidney transplant patients in Spain based on the recipient's age.

Methods: The results at 5 years of post-transplant cardiovascular disease (CVD) patients, taken from a database on CVD, were prospectively analysed, i.e.

Anemia at 1 year after kidney transplantation has a negative long-term impact on graft and patient outcomes.

Background: Anemia, a common complication after kidney transplantation, has a controversial impact on graft or patient survivals or the appearance of cardiovascular disease. The present study investigated the incidence and risk factors for anemia in the first year after transplantation and its effects on graft and patient outcomes.

Patients And Methods: Among 389 patients transplanted between January 2000 and June 2008, the 331 with functioning grafts at 1 year were included in the study.

The effects of mineral metabolism markers on renal transplant outcomes.

Background: Hyperparathyroidism is a common complication of chronic renal failure. A functioning kidney graft improves hyperparathyroidism but it can persist to some degree for years. Persistent hyperparathyroidism associated with hypercalcemia and hyperphosphatemia have been associated with poor graft and patient survivals.

Patients with a failed renal transplant.

Despite the advances in the care of recipients and in immunosuppression, long-term graft survival has experienced little improvement in the last 10 years. An important number of recipients present progressive loss of graft function and have to be readmitted on dialysis therapy. Before starting dialysis, these patients are re-exposed to the complications of chronic renal failure but there are no specific guidelines for their treatment.

Utilization of elderly kidney donors (>70 years) does not affect graft survival in the medium term.

Background: The need for organs for renal transplantation has encouraged the use of grafts from increasingly older donors. Earlier studies performed in Spain have shown the suitability of donors aged 60-65 years. In this single-center study, we evaluated our results using donors >70 years old.

[Treatment of uraemic anorexia with megestrol acetate].

Background: Anorexia is a common disorder in patients treated with regular haemodialysis and is a contributing factor to malnutrition. The aim of this study was to evaluate the effectiveness of megestrol acetate, an appetite stimulant used in cancer patients, as a treatment for anorexia in dialysis patients.

Material And Method: In 2009, 16 patients in our haemodialysis unit, three with diabetes mellitus, were treated with megestrol (160 mg/day single dose) for anorexia defined according to a Likert scale of appetite.

Effects of the new immunosuppressive agents on the occurrence of malignancies after renal transplantation.

Introduction: The risk of malignancies in renal transplant recipients is considerably greater than in the general population. The purpose of the present study was to investigate the effects on the appearance of malignancies of 3 immunosuppressive periods: azathioprine (AZA), cyclosporine (CsA), and tacrolimus (TAC).

Patients And Methods: This study included 1029 first renal transplant recipients of mean age at transplantation of 44.

Cholecalciferol supplements improve vitamin D deficiency in renal transplant recipients.

Most renal transplant recipients display vitamin D deficiency or insufficiency. The KDIGO guidelines suggest that this deficit should be treated as in the general population. Since there are few studies about the effects of cholecalciferol in de novo renal transplant recipients, we sought to assess these effects in long-term kidney graft recipients.

Renal transplantation in patients with hepatitis C virus antibody. A long national experience.

Background. Renal transplantation is the best therapy for patients with hepatitis C virus (HCV) infection with end-stage renal disease. Patient and graft survival are lower in the long term compared with HCV-negative patients.

Long-term graft function changes in kidney transplant recipients.

Background. Monitoring changes in glomerular filtration rate (GFR) is the recommended method for assessing the progression of kidney disease. The aim of this study was to assess the decline of graft function defined by the annualized change in GFR and the factors which affect it.

Open-label trial: effect of weekly risedronate immediately after transplantation in kidney recipients.

Background: Treatment with oral risedronate to prevent bone mineral density (BMD) loss in renal transplant recipients has been shown to be effective. There is no agreement on the optimum moment of introduction or how long it should be continued. The aim was to evaluate the effectiveness of risedronate at doses of 35 mg/week in renal transplant recipients who underwent treatment immediately after transplant.

Improvement in late renal allograft survival between 1990 and 2002 in Spain: results from a multicentre case-control study.

Epidemiological studies have failed to show an improvement in graft survival beyond 1 year after kidney transplantation possibly because of an increased number of expanded donors and older recipients. Thus, we performed a case-control study matching patients transplanted in different eras by donor and recipient characteristics. We considered renal transplant recipients included in the database of the Spanish Chronic Allograft Dysfunction Study Group in 1990, 1994, 1998 and 2002 (n = 4842).

Low toxicity regimens in renal transplantation: a country subset analysis of the Symphony study.

Regional transplant practices may affect clinical outcomes within multinational studies. This study evaluated whether the overall results from the Symphony study can be generalized to the participating countries. De novo adult renal transplant recipients (n = 1645) were randomized to receive standard-dose cyclosporine, or daclizumab induction plus low-dose cyclosporine, low-dose tacrolimus,or low-dose sirolimus, all in addition to mycophenolate mofetil and steroids.