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Simultaneous pancreas-kidney transplantation for end-stage renal failure in type 1 diabetes mellitus: Current perspectives

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World Journal of Transplantation 2023年第5期13卷 208-220页

作者： Lakshmi Nagendra Cornelius James Fernandez Joseph M Pappachan Department of endocrinology JSS Medical CollegeJSS Academy of Higher Education and ResearchMysore 570015India Department of endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

Type 1 diabetes mellitus(T1DM)is one of the important causes of chronic kidney disease(CKD)and end-stage renal failure(ESRF).Even with the best available treatment options,management of T1DM poses significant challenges for clinicians across the world,especially when associated with CKD and *** increases in morbidity and mortality along with marked rise in treatment costs and marked reduction of quality of life are the usual consequences of onset of CKD and progression to ESRF in patients with *** pancreas-kidney transplant(SPK)is an attractive and promising treatment option for patients with advanced CKD/ESRF and T1DM for potential cure of these diseases and possibly several ***,limited availability of the organs for transplantation,the need for long-term immunosuppression to prevent rejection,peri-and post-operative complications of SPK,lack of resources and the expertise for the procedure in many centers,and the cost implications related to the surgery and postoperative care of these patients are major issues faced by clinicians across the *** clinical update review compiles the latest evidence and current recommendations of SPK for patients with T1DM and advanced CKD/ESRF to enable clinicians to care for these diseases.

关键词： Type 1 diabetes mellitus Chronic kidney disease end-stage renal failure Simultaneous pancreas-kidney transplantation Perioperative complications Immunosuppression

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Efficacy and safety of Nafamostat mesylate in patients with endstage renal failure

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World Journal of Clinical Cases 2024年第1期12卷 68-75页

作者： Kun Liu Zhen-Hua Li Department of Critical Care Medicine The Third People's Hospital Of Hubei ProvinceWuhan 430030Hubei ProvinceChina Department of Critical Care Medicine General Hospital of The Yangtze River ShippingWuhan Brain HospitalWuhan 430015Hubei ProvinceChina

BACKGROUND Recent studies on dialysis anticoagulation therapy in patients with renal failure have shown that Nafamostat mesylate,a broad-spectrum potent serine protease inhibitor,has strong anticoagulation and anti-fiber *** To evaluate the efficacy and safety of Nafamostat mesylate in patients with end-stage renal *** Seventy-five patients with end-stage renal failure who received hemodialysis at our hospital between January 2020 and August 2021 were selected and divided into the observation group(Nafamostat mesylate for injection,n=33)and control group(heparin sodium injection,n=32).General patient data,indicators of clinical efficacy,dialyzer hemocoagulation parameters,coagulation function indices,and hemoglobin concentration and platelet count before and after treatment,and the occurrence of adverse reactions after treatment were compared between the two *** The two groups showed no significant differences in general patient data(P>0.05).The post-treatment effectiveness rate in the control group was lower than that in the observation group(P0.05),while the number of patients in grade 0 was lower in the control group,and the number of patients in grades II and III was higher in the control group(P0.05).The total number of post-treatment adverse reactions in the observation group was lower than that in the control group(Pend-stage renal failure with Nafamostat mesylate can s

关键词： end-stage renal failure Nafamostat mesylate Effectiveness Safety study Chronic kidney diseases

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Disease Progression, Response to ACEI/ATRA Therapy and Influence of ACE Gene in IgA Nephritis

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Cellular & Molecular Immunology 2007年第3期4卷 227-232页

作者： Keng-Thye Woo Yeow-Kok Lau Yi Zhao Fang-E Liu Hwee-Boon Tan Eng-Keng Tan Fook-Chong Stephanie Choong-Meng Chan Kok-Seng Wong Department of renal Medicine Singapore General Hospital Singapore Clinical Research Singapore General Hospital Singapore Department of Paediatrics The 2nd Hospital Shandong University Jinan Shandong China

Various studies have shown that angiotensin-converting enzyme （ACE） gene insertion/deletion （ID） polymorphism may play a role in the progression to end stage renal failure （ESRF） in patients with IgA nephritis （IgAN）. In this randomized controlled trial, patients were followed up for 5 years to determine their long-term renal outcome to ACEI/ATRA therapy and to ascertain if their ACE gene profile could play a role in determining their response to therapy. Seventy-five patients with IgAN were enlisted. Thirty-seven were on ACEI/ATRA therapy for 62 ± 5 months and thirty-eight were untreated and served as controls. All patients had their ACE gene ID polymorphism genotyped. Compared to controls, treated patients had lower serum creatinine （p 〈 0.001）, lower proteinuria （p 〈 0.002） and fewer numbers progressing to ESRF （p 〈 0.002）. Among patients with genotype II, there were less ESRF in the treatment group when compared to the untreated control group （p 〈 0.02）. The advantage of therapy was not seen in patients with ID or DD genotypes. ACEI/ATRA therapy was found to be effective in retarding disease progression in IgAN with years to ESRF significantly extended in patients at all levels of renal function, including patients whose outcome were ESRF. Genotyping showed better response to therapy only for those with genotype Ⅱ. The common mechanism is probably through lower levels of ACE, glomerular pressure and proteinuria resulting in reduced renal damage and retardation of progression to ESRF. Cellular ＆ Molecular Immunology.

关键词： ACE gene ID polymorphism ACEI/ATRA therapy end-stage renal failure

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