Úvod: Transplantácia obličky je dnes rutinnou metódou, ktorá sa používa v liečbe terminálneho zlyhania obličiek. Asi 10 % pacientov po transplantácii obličky predstavujú pacienti s autozomálne dominantnou polycystickou chorobou obličiek (ADPKD). Po úspešnej transplantácii obličky sa aj u pôvodne asymptomatických pacientov vyskytujú recidivujúce uroinfekcie. Materiál a metódy: Do súboru bolo zaradených 320 pacientov po transplantácii obličky. Porovnali sme pacientov s ADPKD versus pacientov bez ADPKD z hľadiska prítomnosti recidivujúcich uroinfekcií. Výsledky: Výskyt recidivujúcich uroinfekcií (rIMC) po transplantácii bol u pacientov bez ADPKD 18 % a u pacientov po transplantácii s ADPKD to bolo 48 %. Nefrektómia po transplantácii obličky z dôvodu recidivujúcich uroinfekcií viedla k eliminácii tejto infekčnej komplikácie (u 86 % pacientov). Záver: Pacienti po transplantácii obličky s ADPKD majú signifikantne vyšší výskyt recidivujúcich uroinfekcií. Vhodným riešením pri pretrvávaní infekcie je odstránenie polycystických obličiek.
Introduction: Kidney transplantation is now a routine method used to treat end-stage renal disease. About 10 % of kidney transplant patients are patients with autosomal dominant polycystic kidney disease (ADPKD). After successful kidney transplantation, recurrent urinary tract infections also occur in initially asymptomatic patients. Material and methods: The group included 320 patients after kidney transplantation. We compared patients with ADPKD versus patients without ADPKD in terms of the presence of recurrent urinary tract infections. The results: The incidence of recurrent urinary tract infections (rIMCs) was 18% in patients without ADPKD and 48% in patients without ADPKD. Nephrectomy after kidney transplantation due to recurrent urinary tract infections eliminated this infectious complication (in 86% of patients). Conclusion: Kidney transplant patients with ADPKD have a significantly higher incidence of recurrent urinary tract infections. Removal of polycystic kidneys is a suitable solution if the infection persists.
- MeSH
- časové faktory MeSH
- diabetické nefropatie epidemiologie MeSH
- dialýza ledvin * statistika a číselné údaje MeSH
- dospělí MeSH
- imunosupresivní léčba metody statistika a číselné údaje MeSH
- lidé MeSH
- přežívání štěpu MeSH
- seznamy čekatelů MeSH
- transplantace ledvin * statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- multicentrická studie MeSH
BACKGROUND AND AIMS: The CONCERTO study results showing the beneficial effects of conversion from cyclosporine to tacrolimus prolonged-release (tacrolimus PR) in stabilised patients after kidney transplantation, were first published in 2011. This communication describes our first experience of conversion from cyclosporine to tacrolimus PR in stabilised kidney transplant patients. The aim was to determine whether it could be used in routine clinical practice in the Czech and Slovak Republics. METHODS: Evaluation was carried out at five transplantation centres in the Czech Republic and Slovakia. In all participating Centres, the drug conversion was conducted according to the ICH/GCP guidelines. A total of 104 patients stabilised after kidney transplantation were converted from maintenance therapy with cyclosporine to treatment with tacrolimus PR. The data were collected 26 weeks after the switch. The primary endpoint was change in kidney graft function measured from the estimated glomerular filtration rate (GFR). The effect of conversion on blood pressure, metabolic parameters and cosmetic changes was also recorded. Special attention was paid to the safety and tolerability of treatment with tacrolimus PR. RESULTS: GFR increased after six months by 10 % (P = 0.040). In addition a significant decrease in serum creatinine and triglycerides level was found together with major reduction in the incidence and severity of gingival hyperplasia and hirsutism. 3% of patients developed new onset of diabetes mellitus. Otherwise, the switch was very well-tolerated, without serious adverse events or acute rejections. CONCLUSION: Conversion from cyclosporine to tacrolimus PR was shown to be a safe therapeutic alternative with patient benefits.
- MeSH
- cyklosporin aplikace a dávkování MeSH
- diabetické nefropatie patofyziologie MeSH
- dyslipidemie etiologie MeSH
- hirzutismus etiologie MeSH
- hodnoty glomerulární filtrace účinky léků MeSH
- hyperplazie dásní etiologie MeSH
- imunosupresiva aplikace a dávkování MeSH
- léky s prodlouženým účinkem MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada léků MeSH
- nemoci ledvin chirurgie MeSH
- renální hypertenze etiologie MeSH
- takrolimus aplikace a dávkování MeSH
- transplantace ledvin * MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
