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- Wramner, Lars, 1955, et al.
(författare)
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Impaired kidney graft survival is associated with the TNF-alpha genotype
- 2004
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Ingår i: Transplantation. - 0041-1337. ; 78:1, s. 117-21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The TNF2 allele at position -308 of the tumor necrosis factor (TNF)-alpha gene is associated with high TNF production. The purpose was to study the association of this gene polymorphism with rejection episodes and graft survival after kidney transplantation. METHODS: A retrospective analysis of transplant outcomes of patients who only had been treated with one single form of immunosuppression consisting of cyclosporine, azathioprine, and prednisolon was performed. RESULTS: We found that 115 (73%) patients had the TNF1/TNF1 genotype, whereas 42 (27%) were TNF2 positive. There was no difference in the overall acute rejection frequency between these two groups (50% in each), but our data showed a non-significant tendency towards a higher frequency of steroid resistant rejections in the TNF2 positive group (57% vs. 40%). There was no significant difference in graft survival between the two genotype groups, although an early tendency towards worse survival was seen in TNF2 recipients. However, the TNF2 positive recipients with rejection episodes had far worse graft survival compared with the TNF1/TNF1 recipients with rejection episodes (P<0.02). No difference was seen between the two genotype groups in patients without rejection episodes. CONCLUSION: Our data propose that potentially high TNF producers with the TNF2 allele do not have an increased risk for rejection episodes, but if rejection episodes occur, they have a significantly increased risk for early graft loss. TNF production may intensify rejection, but is not a primary factor for the induction of such acute immune activation.
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- Johannsson, Gudmundur, 1960, et al.
(författare)
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Double-blind, placebo-controlled study of growth hormone treatment in elderly patients undergoing chronic hemodialysis: anabolic effect and functional improvement.
- 1999
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Ingår i: American journal of kidney diseases : the official journal of the National Kidney Foundation. - 1523-6838. ; 33:4, s. 709-17
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Tidskriftsartikel (refereegranskat)abstract
- Elderly patients with end-stage renal disease often have protein and/or caloric malnutrition that severely affects general well-being and mortality. Uremia is associated with resistance to the action of growth hormone (GH). This resistance could be of clinical importance in elderly dialysis patients. In the present study, the effects of GH treatment were assessed in elderly patients receiving chronic hemodialysis. Twenty hemodialysis patients with a mean age of 71.7 years (range, 53 to 92 years) were included on a 6-month, randomized, double-blind, placebo-controlled trial of GH treatment. The dose of GH was 66.7 microgram/kg, administered subcutaneously three times weekly immediately after each dialysis session. Body composition was measured using total-body potassium levels, computed tomography of the lower leg, and bioelectrical impedance analysis. Serum albumin concentrations and handgrip strength were also measured. GH treatment increased the serum concentration of insulin-like growth factor-I (IGF-I), IGF-I/IGF-binding protein-3 ratio, fat-free mass, and the serum concentration of albumin compared with placebo. The number of patients with serum albumin levels less than 40 g/L was reduced by a factor of three in the GH-treated group. Handgrip strength increased in response to GH treatment compared with placebo. Six months of GH treatment in elderly hemodialysis patients produced anabolic effects, with improved muscle performance. Also, the number of patients with low albumin levels was markedly reduced, indicating improved nutritional status and/or attenuated catabolism. These are all important beneficial effects for individual patient outcomes.
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| 8. |
- Schön, S, et al.
(författare)
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Renal replacement therapy in Sweden.
- 2004
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 38:4, s. 332-9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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