Evolution of Native Kidney Function After Pancreas Transplantation Alone

in Transplantation Proceedings (2012), 44

Introduction. This study investigated changes in kidney function over time among a <br />cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to <br />December 2011. <br ... [more ▼]

Introduction. This study investigated changes in kidney function over time among a <br />cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to <br />December 2011. <br />Patients and Methods. Ten of eighteen PTA patients bearing functioning grafts for at <br />least 1 year were recruited for the analysis. Primary endpoints were changes in mean serum <br />creatinine (SCr, mg/L) and mean estimated glomerular filtration rate (eGFR) using the <br />4-variable Levey-MDRD equation (mL/min/1.73 m2) comparing baseline (pretransplantation) <br />to 6-month, 1-year, 3-year, and 5-year posttransplantation values. Mean follow-up <br />time was 75.7 20.5 months (range, 46–106.5). <br />Results. Baseline eGFR was 89.3 27.9 (range, 58–145). eGFR decreased to 75.7 <br />26.2, 71 20.6, 66.5 14.8, and 62.1 11.2 at 6 months, 1, 3, and 5 years representing <br /> 15.2%, 20.5%, 15.8%, and 22.6% percentage decreases respectively (P .05 for all <br />pairwise comparisons). The Baseline SCr was 8.6 2.3 mg/L (range, 5–13). SCr <br />progressively increased to 10.1 3, 10.5 3.1, 10.9 3.1, and 11.3 1.7 at 6 months, 1, <br />3, and 5 years a 17.1%, 22%, 16.6%, and 19.9% increase respectively (P .05 for all <br />pairwise comparisons). One of ten, 2/8, and 3/7 patients displayed an eGFR 60 at <br />transplantation versus 3 and 5 years thereafter, respectively. No patient developed a SCr <br /> 25 mg/L or eGFR 30 or needed dialysis or kidney transplantation. Five of ten patients <br />had micro-albuminuria or proteinuria before transplantation. Tacrolimus levels were <br />within recommended therapeutic ranges over time. <br />Conclusion. Kidney function deteriorated significantly after PTA. Understanding of risk <br />factors for the development of renal impairment is important to preserve kidney function <br />and to select appropriate candidates for PTA. [less ▲]

Allergie systémique à l’insuline: traitement médical ou chirurgical (greffe de pancréas vascularisé).

in Diabète & Métabolisme (2005), 31