Kidney Failure, Kidney Transplant After Lung Transplant
Long-Term Renal Outcome After Lung Transplantation is Predicted by the 1-Month Postoperative Renal Function Loss - The severity of this problem appears to vary with type of transplant; heart and heart-lung recipients being the most effected and liver transplant recipients the least effected. Significant renal function loss has also been previously reported in lung transplant recipients, with problems ranging from slight impairment to rapid and total loss of kidney function. In a 57 patient study several characteristics varied across diagnostic groups. Patients in the cystic fibrosis group were younger and had higher pretransplant glomerular filtration rates (GFR). Three members of this group were diabetic prior to transplant. The cystic fibrosis group also required larger oral doses of cyclosporine to maintain the required trough levels. The majority of patients in 2 groups, cystic fibrosis and emphysema, were bilateral lung transplant recipients whereas all but 2 patients in the pulmonary hypertension group were transplantted with a single lung. This article from Transplantation. 2000; 69:1624-1628
Kidney Resources
Renal Net : http://www.renalnet.org/
Kidney Directions : http://www.kidneydirections.com/
National Kidney Foundation : http://www.kidney.org/
A Photojournalist's Journey Through Kidney Failure : http://www.johnfmartin.net/
ENEPH. com - The Official Site of the Journal Dialysis and Transplantation : http://www.eneph.com/
The American Kidney Fund : http://www.akfinc.org/
Chronic Renal Dysfunction in Nonrenal Organ Transplant Recipients (ADDED 9/2/04)
Of the 24,000 solid organ transplants performed in the United States in 003, more than 10,000 were non-renal -- that is, heart, heart-lung, lung, liver, or intestinal transplantation. The reported incidence of CRD varies widely from 5% to 80%.[4,6-8] This range of the rates of CRD reflects a number of methodologic and substantive issues. Among these are: (1) non-uniform definition of CRD; (2) risk factors intrinsic to each type of organ transplant; (3) methods to measure renal function; (4) age group of the study population; (5) posttransplant time frame in which renal function was assessed; (6) criteria used to include patients in study; and (7) study design typology. End-stage Renal Disease (ESRD) in Nonrenal Organ Transplant Recipients The cumulative incidence of ESRD ranges from 1.6% to 8.5%.CNI toxicity accounts for approximately two thirds of cases while other renal diseases account for the remainder. Risk Factors for CRF in Nonrenal Organ Recipient: Prevalence of Hypertension, Diabetes Mellitus, and Hyperlipidemia. CNI- induced CRD in Nonrenal Organ Recipients: Comparison of TAC with CsA. In a study of 95 heart transplant recipients, there was no difference in renal function between CsA and TAC treated patients. This and other studies suggest that there is no difference in the nephrotoxic potential between the 2 CNIs. Potential Therapies for CRF After Nonrenal Organ Transplantation. A number of experimental therapies have been shown to ameliorate chronic CNI induced nephrotoxicity. These include antioxidant nutrients, aldosterone receptor blockade, nitric oxide enhancement, melatonin and pentoxifylline.(Source: CME 2004)
