Propofol-based versus sevoflurane-based anaesthesia for deceased donor kidney transplantation: the VAPOR-2 study protocol for an international multicentre randomised controlled trial.

Introduction: Ischaemia reperfusion injury (IRI) is inevitable in kidney transplantation and negatively affects patient and graft outcomes. Anaesthetic conditioning (AC) refers to the use of anaesthetic agents to mitigate IRI. AC is particularly associated with volatile anaesthetic (VA) agents and to a lesser extent to intravenous agents like propofol.

Potential Health Benefits of Dietary Tree Nut and Peanut Enrichment in Kidney Transplant Recipients-An In-Depth Narrative Review and Considerations for Future Research.

Kidney transplant recipients face a substantial burden of premature mortality and morbidity, primarily due to persistent inflammation, cardiovascular risk, and nutritional deficiencies. Traditional nutritional interventions in this population have either focused on supplementing individual nutrients-often with limited efficacy-or required comprehensive dietary overhauls that compromise patient adherence. In this narrative review, we explore the rationale for dietary nut enrichment as a feasible, multi-nutrient strategy tailored to the needs of kidney transplant recipients.

Effect of Exercise or Combined Exercise and Diet Intervention on Sleep and Fatigue in Kidney Transplant Recipients.

Introduction: Physical functioning and diet may be promising targets to improve sleep and reduce fatigue among kidney transplant recipients (KTRs). We investigated whether a lifestyle intervention consisting of exercise or exercise combined with diet improve self-reported sleep and fatigue among KTRs.

Methods: A predefined analysis of the Dutch multicenter randomized controlled Active Care after Transplantation (ACT) study (NCT01047410) was performed.

Complement Activation is More Pronounced in the Kidneys of Critically Ill Patients With COVID-19 Than in Those With Bacterial Sepsis.

Introduction: Previous studies have shown that the complement system plays an important role in COVID-19 acute kidney injury (AKI). However, studies evaluating the activation pathways are scarce and have shown contradictory findings. It has also been suggested that COVID-19 AKI has a pathophysiology similar to that of bacterial sepsis AKI.

Family Planning in Patients With ADPKD-Results From the DIPAK Consortium.

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) can impact family planning because it can result in reduced fertility, increased risks of adverse pregnancy outcomes, and a 50% inheritance risk. This study explored considerations of people with ADPKD regarding family planning.

Methods: This prospective cohort study included patients from the "Developing Intervention Strategies to Halt Progression of ADPKD (DIPAK) observational study.

Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study.

During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this change on 1 year post-transplantation outcomes. Thirty-six adult patients who underwent SPK transplantation between June 2015 and June 2023 were included, of whom 21 before February 2020 (ALEM) and 15 after February 2020 (IL2R).

Plasma Versus Whole Blood Tacrolimus Concentrations and Health-Related Quality of Life in Kidney Transplant Recipients.

: Tacrolimus dosing traditionally relies on therapeutic drug monitoring in whole blood, while assessment in plasma may better reflect its effect and reveal overdosing impacting health-related quality of life (HRQoL). : In this cross-sectional study, 898 kidney transplant recipients (KTRs) who were at least 12 months post-transplantation were included. Plasma and whole blood tacrolimus concentrations were compared using Passing-Bablok regression analyses and Bland-Altman plots.

Insights Into Health-Related Quality of Life of Kidney Transplant Recipients: A Narrative Review of Associated Factors.

Life expectancy and graft survival continue to improve after transplantation. However, improved posttransplant clinical outcomes do not necessarily translate into improved health-related quality of life (HRQoL). Therefore, there is an increased focus on HRQoL in kidney transplant recipients (KTRs).

Insights into effective fatigue reducing interventions in kidney transplant candidates: a scoping review.

Background: Fatigue is a prevalent and debilitating symptom among kidney transplant candidates (KTCs), significantly affecting their quality of life and overall well-being. Its complexity necessitates a comprehensive approach to manage fatigue in this population.

Purpose: To explore the effectiveness of nonpharmacological interventions in reducing fatigue in KTCs.

Rationale and design of the Renal Lifecycle trial assessing the effect of dapagliflozin on cardiorenal outcomes in severe chronic kidney disease.

Background: Several clinical trials have shown beneficial effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on kidney disease progression and cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) with and without type 2 diabetes mellitus. However, some subgroups of patients with CKD have been excluded from participation in these trials, such as patients with severely impaired kidney function, patients on dialysis and kidney transplant recipients.

Methods: The Renal Lifecycle trial (NCT05374291) is a pragmatic, international, multicentre, investigator-initiated, randomized, placebo-controlled clinical trial planned to enrol ≈1500 patients with an estimated glomerular filtration rate (eGFR) ≤25 ml/min/1.

Effect of lifestyle intervention on systemic oxidative stress in kidney transplant recipients: A post-hoc analysis of the Active Care after Transplantation (ACT) randomized controlled trial.

Background: Oxidative stress is associated with adverse outcomes in kidney transplant recipients (KTR), including graft failure, morbidity, and mortality. Since both exercise training and dietary modifications have the potential to improve redox status, we aimed to investigate the potential mitigating effects of exercise or exercise plus diet intervention on circulating levels of free thiols (R-SH) as marker of systemic redox status in KTR.

Methods: We conducted a post-hoc analysis of the Active Care after Transplantation (ACT) study, a randomized controlled lifestyle intervention trial which proved to enhance physical functioning of KTR.

Early compensatory increase in single-kidney estimated GFR after unilateral nephrectomy is associated with a lower long-term risk of estimated GFR decline.

Background And Hypothesis: A more pronounced short-term increase in single-kidney GFR (ΔskGFR) has been associated with better long-term kidney function in living kidney donors. Whether this also applies to non-donors is unknown. We evaluated whether ΔskGFR is associated with long-term risk of eGFR decline in individuals undergoing unilateral nephrectomy.

Favorable Living Donor Kidney Transplantation Outcomes within a National Kidney Exchange Program: A Propensity Score-Matching Analysis.

Key Points: KEP recipients have comparable long-term graft survival to direct living donor kidney transplantation recipients, which underscores the need to prioritize KEP over other's therapies. Our outcomes can be achieved regardless of whether the donor travels or the graft is transported, offering flexibility in program implementation.

Background: KEPs (kidney exchange programs) facilitate living donor kidney transplantations (LDKTs) for patients with incompatible donors, who are typically at higher risk than non-KEP patients because of higher sensitization and longer dialysis vintage.

Urinary Endotrophin and Long-term Outcomes in Kidney Transplant Recipients.

Background: Kidney fibrosis is a suggested cause of kidney failure and premature mortality. Because collagen type VI is closely linked to kidney fibrosis, we aimed to evaluate whether urinary endotrophin, a collagen type VI fragment, is associated with graft failure and mortality among kidney transplant recipients (KTR).

Methods: In this prospective cohort study, KTR with a functioning graft ≥1-y posttransplantation were recruited; 24-h urinary endotrophin excretion was measured using an ELISA method.

Muscle Mass, Muscle Strength, and Health-Related Quality of Life in Kidney Transplant Recipients: Results of the TransplantLines Biobank and Cohort Study.

Introduction: Muscles are crucial for daily activities, and kidney transplant recipients (KTRs) often have reduced muscle mass and strength. We aimed to investigate the potential relationship of muscle mass and strength with physical health-related quality of life (HRQoL) in KTRs.

Methods: Data from the TransplantLines Biobank and Cohort Studies were used.

Multicenter, Real-World Clinical Evaluation of Alemtuzumab and Anti-Thymocyte Globulin for Severe Acute T Cell-Mediated Kidney Transplant Rejection.

Background: Alemtuzumab can be an alternative to rabbit anti-thymocyte globulin (rATG) to treat severe or glucocorticoid-resistant acute T cell-mediated kidney transplant rejection (TCMR). Yet, there are few reports in which these two treatments are evaluated let alone, compared. This study describes the real-world clinical experience of both therapies and compares their efficacy and toxicity.

Effect of an exercise intervention or combined exercise and diet intervention on health-related quality of life-physical functioning after kidney transplantation: the Active Care after Transplantation (ACT) multicentre randomised controlled trial.

Background: Robust evidence for interventions to improve health-related quality of life (HRQoL) in people who receive a kidney transplant is scarce. We aimed to assess the effects of a lifestyle intervention in this context.

Methods: We conducted a multicentre, open-label, parallel-group, randomised controlled trial among people who have received a kidney transplant.

Long-term maternal outcomes of pregnancy after orthotopic liver transplantation in the Netherlands: A retrospective multicenter cohort study.

Pregnancy after orthotopic liver transplantation (OLT) puts the mother, child, and transplanted organ at risk. Little is known about long-term outcomes. We performed a nationwide retrospective cohort study to evaluate short-term and long-term outcomes of post-OLT pregnancies.

Apical tubular complement activation and the loss of kidney function in proteinuric kidney diseases.

Many kidney diseases are associated with proteinuria. Since proteinuria is independently associated with kidney function loss, anti-proteinuric medication, often in combination with dietary salt restriction, comprises a major cornerstone in the prevention of progressive kidney failure. Nevertheless, complete remission of proteinuria is very difficult to achieve, and most patients with persistent proteinuria slowly progress toward kidney failure.

Kidney Transplantation Improves Health-Related Quality of Life in Older Recipients.

Kidney transplantation is the best treatment for kidney failure in older patients. However, little is known regarding changes in health-related quality of life (HRQoL) from before to after transplantation and determinants of HRQoL in older kidney transplant recipients (KTR). We studied both, using data of older (≥65 years) patients waitlisted for kidney transplantation and older KTR 1 year after transplantation from the TransplantLines Biobank and Cohort Study.

Memory B-cell derived donor-specific antibodies do not predict outcome in sensitized kidney transplant recipients: a retrospective single-center study.

Background: Repeated exposure to sensitizing events can activate HLA-specific memory B cells, leading to the production of donor-specific memory B cell antibodies (DSAm) that pose a risk for antibody-mediated rejection (ABMR) in kidney transplant recipients (KTRs). This single-center retrospective study aimed to identify DSAm and assess their association with outcomes in a cohort of KTRs with pretransplant serum donor-specific antibodies (DSA).

Methods: We polyclonally activated pretransplant peripheral blood mononuclear cells (PBMCs) from 60 KTRs in vitro, isolated and quantified IgG from the culture supernatant using ELISA, and analyzed the HLA antibodies of eluates with single antigen bead (SAB) assays, comparing them to the donor HLA typing for potential DSAm.

The association between hemoglobin levels and renal function parameters during normothermic machine perfusion: A retrospective cohort study using porcine kidneys.

Background: Ex vivo normothermic machine perfusion (NMP) is a promising tool for assessing an isolated kidney prior to transplantation. However, there is no consensus on the perfusate's optimal oxygen-carrying capacity to support renal function. To investigate the association of hemoglobin levels with renal function parameters, a retrospective analysis of isolated, normothermically, perfused porcine kidneys was performed.

Iron deficiency, anemia, and patient-reported outcomes in kidney transplant recipients.

Kidney transplant recipients (KTRs) experience more fatigue, anxiety, and depressive symptoms and lower concentration and health-related quality of life (HRQoL) compared with the general population. Anemia is a potential cause that is well-recognized and treated. Iron deficiency, however, is often unrecognized, despite its potential detrimental effects related to and unrelated to anemia.