I'm sharing "Belatacept for kidney transplant recipients."

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Cochrane Database of Systematic Reviews 2014 Nov 24; 11 : CD010699. Belatacept for kidney transplant recipients. Philip Masson, Lorna Henderson, Jeremy R Chapman, Jonathan C Craig, Angela C Webster PMID: 25416857

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Alberto Reino Buelvas

I'm sharing "Multitarget Therapy for Induction Treatment of Lupus Nephritis: A Randomized, Controlled Trial."

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Annals of Internal Medicine 2014 Nov 11; Multitarget Therapy for Induction Treatment of Lupus Nephritis: A Randomized, Controlled Trial. Zhihong Liu, Haitao Zhang, Zhangsuo Liu, Changying Xing, Ping Fu, Zhaohui Ni, Jianghua Chen, Hongli Lin, Fuyou Liu, Yongcheng He, Yani He, Lining Miao, Nan Chen, Ying Li, Yong Gu, Wei Shi, Weixin Hu, Zhengzhao Liu, Hao Bao, Caihong Zeng, Minlin Zhou PMID: 25383558

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Alberto Reino Buelvas

Evaluating the Safety and Rationale for Cinacalcet Posttransplant Hyperparathyroidism and Hypercalcemia.

unboundmedicine.com Evaluating the Safety and Rationale for Cinacalcet Posttransplant Hyperparathyroidism and Hypercalcemia.

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Publisher Full Text

Authors

Coyne DW, Santos RD

Source

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons : 2014 Sep 15 pg

Pub Type(s)

EDITORIAL

Language

ENG

PubMed ID

25223316

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http://www.unboundmedicine.com/medline/citation/25223316/Evaluating_the_Safety_and_Rationale_for_Cinacalcet_Posttransplant_Hyperparathyroidism_and_Hypercalcemia_

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Alberto Reino Buelvas

A Randomized Study Evaluating Cinacalcet to Treat Hypercalcemia in Renal Transplant Recipients With Persistent Hyperparathyroidism.

unboundmedicine.com A Randomized Study Evaluating Cinacalcet to Treat Hypercalcemia in Renal Transplant Recipients With Persistent Hyperparathyroidism.

Abstract

Persistent hyperparathyroidism (HPT) after kidney transplantation (KTx) is associated with hypercalcemia, hypophosphatemia and abnormally high levels of parathyroid hormone (PTH). In this randomized trial, cinacalcet was compared to placebo for the treatment of hypercalcemia in adult patients with persistent HPT after KTx. Subjects were randomized 1:1 to cinacalcet or placebo with randomization stratified by baseline corrected total serum calcium levels (≤11.2 mg/dL [2.80 mmol/L] or >11.2 mg/dL [2.80 mmol/L]). The primary end point was achievement of a mean corrected total serum calcium value <10.2 mg/dL (2.55 mmol/L) during the efficacy period. The two key secondary end points were percent change in bone mineral density (BMD) at the femoral neck and absolute change in phosphorus; 78.9% cinacalcet- versus 3.5% placebo-treated subjects achieved the primary end point with a difference of 75.4% (95% confidence interval [CI]: 63.8, 87.1), p < 0.001. There was no statistical difference in the percent change in BMD at the femoral neck between cinacalcet and placebo groups, p = 0.266. The difference in the change in phosphorus between the two arms was 0.45 mg/dL (95% CI: 0.26, 0.64), p < 0.001 (nominal). No new safety signals were detected. In conclusion, hypercalcemia and hypophosphatemia were effectively corrected after treatment with cinacalcet in patients with persistent HPT after KTx.

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Authors

Evenepoel P, Cooper K, Holdaas H, Messa P, Mourad G, Olgaard K, Rutkowski B, Schaefer H, Deng H, Torregrosa JV, Wuthrich RP, Yue S

Source

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons : 2014 Sep 15 pg

Pub Type(s)

JOURNAL ARTICLE

Language

ENG

PubMed ID

25225081

http://www.unboundmedicine.com/medline/citation/25225081/A_Randomized_Study_Evaluating_Cinacalcet_to_Treat_Hypercalcemia_in_Renal_Transplant_Recipients_With_Persistent_Hyperparathyroidism_

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Alberto Reino Buelvas

Prevalence and Risk Factors of Noncontrolled and Resistant Arterial Hypertension in Renal Transplant Recipients.

Transplantation - Published Ahead-of-Print Prevalence and Risk Factors of Noncontrolled and Resistant Arterial Hypertension in Renal Transplant Recipients.

Background: Arterial hypertension (HT) is common in renal transplant recipients (RTRs). Control of HT is not optimal in this high-risk population despite recommendations for target blood pressure levels under 130/80 mm Hg. Methods: We performed a cross-sectional analysis of the prevalence of uncontrolled HT, and using a Cox regression model, we identified the risk factors associated with resistant HT. Results: Eight hundred eleven RTRs (>1 year after transplantation) were included. A total of 10.5% were normotensive (<130/80 mm Hg without treatment), 41% had controlled HT, 32.5% uncontrolled HT, and 16% resistant HT. In univariate analysis, compared to controlled HT, the RH group had significantly higher body mass index and older donors, delayed graft function, prevalence of metabolic syndrome (69.2 vs. 51.9%), fast glycemia and glycated hemoglobin, albuminuria, triglycerides and uric acid levels, and worse measured glomerular filtration rate (mGFR). In multivariate analysis, recipient age (P<0,001), mGFR (P=0.037), albuminuria (P<0.001), and metabolic syndrome (P=0.007) were significantly associated with RH. Association of metabolic syndrome with RH was much stronger than each of its components. Conclusion: Our data show that despite the recommendations issued by scientific societies, blood pressure control in RTRs is far from the recommended targets. At least a third of our patients (uncontrolled HT) did not receive optimal treatment and suffered therapeutic inertia. Decreased mGFR, metabolic syndrome, and urinary albumin excretion emerged as strong predictors of poor HT control. Whether prevention and management of the metabolic syndrome and reduction of albuminuria could help to more consistently reach the blood pressure recommended targets deserves further investigation. (C) 2014 by Lippincott Williams & Wilkins


http://pdfs.journals.lww.com/transplantjournal/9000/00000/Prevalence_and_Risk_Factors_of_Noncontrolled_and.97957.pdf

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