Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute Rejection, Risk Factors, and Impact on Patient and Graft Outcome

Background. Although numerous risk factors for delayed graft function (DGF) have been identified, the role of ischemia-reperfusion injury and acute rejection episodes (ARE) occurring during the DGF period is ill-defined and DGF impact on patient and graft outcome remains controversial. Methods. From 1983 to 2014, 1784 kidney-only transplantations from deceased donors were studied. Classical risk factors for DGF along with two novel ones, recipient’s perioperative saline loading and residual diuresis, were analyzed by logistic regression and receiver operating characteristic (ROC) curves. Results. Along with other risk factors, absence of perioperative saline loading increases acute rejection incidence (OR = 1.9 [1.2–2.9]). Moreover, we observed two novel risk factors for DGF: patient’s residual diuresis ≤500 mL/d (OR = 2.3 [1.6–3.5]) and absence of perioperative saline loading (OR = 3.3 [2.0–5.4]). Area under the curve of the ROC curve (0.77 [0.74–0.81]) shows an excellent discriminant power of our model, irrespective of rejection. DGF does not influence patient survival (P=0.54). However, graft survival is decreased only when rejection was associated with DGF (P<0.001).  Conclusions. Perioperative saline loading efficiently prevents ischemia-reperfusion injury, which is the predominant factor inducing DGF. DGF per se has no influence on patient and graft outcome. Its incidence is currently close to 5% in our centre

Interest of diffusion-weighted magnetic resonance imaging in IgG4-related renal disease detection and follow-up

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The epidemiology of kidney stones in Belgium based on Daudon’s morpho-constitutional classification: a retrospective, single-center study

Background: Increasing evidence highlights the robust clinical value of morpho-constitutional classification proposed by Daudon. Methods: We retrospectively analyzed the data of 5480 samples submitted for Daudon’s classification between 2007 and 2013 to identify the main pro-lithogenic metabolic abnormalities involved in the formation of stones in Belgium. Results: Among 5027 stones submitted by 4975 patients, the distribution of stones steadily increased with age in both genders, reaching a maximum between 40 to 50 years and decreasing thereafter. Men submitted more stones (3549) than women (1426) with global men-to-women ratio at 2.4 (1.0 to 2.79). In the whole series, type Ia was a main morpho-constitutional presentation of whewellite (surface morphology), accounting for 41.9%; the types Ib, Ic, Id and Ie corresponded to 2.2%, 0.16%, 0.94% and 0.46%, respectively. Type IIa accounted for 16.4% and types IIb and IIc for 5.7% and 0.18% of weddellite stones. Types IIIa, IIIb, IIIc and IIId accounted for 4.4%, 3.8%, 0.1% and 0.3%, of uric acid and urate stones respectively. The frequency of calcium phosphate type IVa was 4.7% followed by type IVb (3.5%), IVc (1.3%), IVd (1.4%) and IVa2 (0.3%). Type Va (cystine stones) accounted only for 1.1% and Vb for only 0.1%. The rare, but very specific types Ic, Ie, Id, IIId, IVa2 and V pointed to precise entities such as primary hyperoxaluria type 1, enteric hyperoxaluria, urinary tract abnormalities, hyperuricosuria with diarrhoea, distal tubular acidosis and cystinuria respectively. In terms of the major physico-chimical component, 75.4% of stones contained calcium oxalate (whewellite (52%) and weddellite (22.7%)), 12% calcium phosphate (carbapatite (6.7%)), and 9.8% uric acid, mainly anhydrous (9.1%). The struvite stones accounted for 106 (2.1%) and predominated in women. Conclusions: High frequency of types Ia and IIa suggest that diet related hyperoxaluria and idiopathic hypercalciuria are the leading lithogenic disorders in Belgian kidney stone formers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Mycobactrium fortuitum peritonitis associated with automated peritoneal dialysis

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Donor Cancer Transmission in Kidney Transplantation

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Etude histologique et analyse des calcifications vasculaires au sein de biopsies peritonéales: nouvelles pistes physiopathologiques de la sclérose péritonéale

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Analysis of peritoneal biopsies in patients with encapsulating peritoneal sclerosis.

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Investigation by infrared microspectroscopy of hydroxyapatite microcrystal deposits in peritoneal membrane biopsies

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Interest of circulating (CD19+IgD-CD28+CD38+) plasmablasts in monitoring B cell depletion after rituximab in relapsing PLA2r membranous nephropathy

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