Università degli Studi di Brescia, Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Brescia, Italia; ASST Spedali Civili di Brescia, Unità Operativa di Nefrologia, Brescia, Italia.
Published: April 2020
AI Article Synopsis
Article Abstract
We are in the midst of a health emergency that is totally new for us all and that requires a concerted effort, especially when it comes to safeguarding patients on hemodialysis, and kidney transplant recipients. Brescia is currently a very active cluster of infections (2918 cases on the 17/03/2020), second only to Bergamo. The way our structure is organised has allowed us to treat nephropathic patients directly within the Nephrology Unit, following of course a great deal of reshuffling; at the moment, we are treating 21 transplanted patients and 17 on hemodialysis. This has led us to adopt a systematic approach to handling this emergency, not only in managing inpatients, but also in researching the new disease. Our approach is mirrored in the guidelines attached to this article, originally intended for internal use only but potentially very useful to our colleagues, as they face the same exact problems. We have also started collecting data on our positive patients with the aim of understanding better the functioning of this disease and how best to manage it. If anyone is interested, we ask you to please get in touch with us, so we can coordinate our efforts.
Background: Metagenomic next-generation sequencing (mNGS) is increasingly being used for microbial detection in various infectious syndromes. However, data regarding the use of mNGS in solid organ transplant recipients (SOTR) are lacking.
Objectives: To describe and analyze real-world clinical impact of mNGS using plasma microbial cell-free DNA (mcfDNA) in SOTR.
Intraoperative hyperkalemia is particularly common in patients with chronic kidney disease (CKD). We report two cases of intraoperative hyperkalemia occurring under general anesthesia, while potassium levels remained stable with regional anesthesia alone. Case 1 involved a 69-year-old male with CKD who underwent total thyroidectomy under general anesthesia and developed intraoperative hyperkalemia, requiring glucose-insulin (GI) therapy.
Purpose: To determine the predictive value of the atherogenic index of plasma before transplant for delayed graft function.
Patients And Methods: A cross-sectional, longitudinal, non-interventional, non-controlled study of 167 patients undergoing kidney transplantation from living donors, with a mean age of 39.34 ± 11.
Repeat HLA mismatches (RMM) have been historically associated with an increased risk of graft loss after repeat kidney transplantation, in particular HLA-DR RMM in sensitized recipients. As routine use of sensitive assays can at present prevent the transplantation of RMM in hosts with donor-specific antibodies, we hypothesized that RMM would no longer be associated with graft loss. We performed a registry analysis of the Collaborative Transplant Study database including 6711 patients who received a second kidney transplant (2 KT) between 2010 and 2021, with at least one HLA-A, -B or -DR mismatch.
Introduction: Cytomegalovirus (CMV) is a virus of the herpesviridae family. CMV infection is associated with increased morbidity and mortality in immunocompromised subjects such as hemodialysis patients and transplant recipients. The aim of our study was to determine the serological status of potential kidney recipients and donors in order to assess the risk of post-transplant CMV infection and disease.
