This might have occurred because the vasculitis that was observed in the first transplant kidney biopsy was not detected in the second biopsy, and the acute rejection persisted. In conclusion, we report a case of acute vascular rejection occurring during antituberculosis therapy in a kidney transplant patient. Diagnosis and treatment of LTBI should be routinely performed check details in kidney
transplant recipients during the pre-transplant period. Also, physicians must pay close attention to the trough TAC level if RFP is prescribed. The use of a quinolone or rifabutin instead of RFP should be considered if the trough CNI level decreases despite a large increase in the CNI dose prescribed. “
“Optimal treatment of atrial fibrillation (AF) in the haemodialysis population is uncertain due to the exclusion of this group from Doxorubicin cell line randomized trials. The risk-benefit profile for anticoagulation and anti-platelet therapy in haemodialysis differs from the general population due to platelet dysfunction from uraemia, altered pharmacokinetics and increased falls risk. This decision analysis used a Markov-state transition model that took a patient perspective over a 5 year timeframe. The Markov model compared life-years gained and quality-adjusted life-years gained (QALY) for three AF treatment strategies: warfarin, aspirin and no treatment. The base case was a 70-year-old
man on haemodialysis with non-valvular AF. In the base case, the total health outcomes in life-years and QALY were 2.37 and 1.47 respectively for warfarin, 2.38 and 1.61 respectively for aspirin, and 2.39 and 1.61 respectively for no treatment. Thus, warfarin led to 0.14 fewer QALY or 1.7 fewer months of life lived in full health, compared with either aspirin or no therapy. The finding that warfarin generated the lowest expected QALY was robust to one-way, two-way and probabilistic sensitivity analyses.
Our results suggest that warfarin should not be the default choice for older haemodialysis patients with non-valvular Reverse transcriptase AF as it provides the fewest QALY compared with aspirin or no therapy. “
“Aim: Living kidney donation provides the best source of kidney graft. The mortality and morbidity rates are small but the long-term effects have not been studied. This is a report on our 29-year experience of living kidney donation. Methods: All living donors were arranged to have follow-ups. Defaulters were traced via a territory-wide computer system. Results: A total of 149 living kidney donor operations were performed. 136/149 records were available. 41 defaulted follow-up. One donor died of multiple myeloma. The male to female ratio was 1.00 to 1.52. Mean age at donation was 33.94 ± 9.66 years. Mean follow-up duration was 160.39 ± 87.96 months. Hypertension was diagnosed in 27 donors (19.9%). 22 donors (17.3%) had stage 3 chronic kidney disease (CKD). Glomerular filtration rate (GFR) dropped from 90.95 ± 15.62 mL/min per 1.73 m2 at time 0 to 66.29 ± 12.