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Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study / Fabián Alberto Jaimes Barragán
Título : Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2016 Títulos uniformes : Transplantation Reports Idioma : Inglés (eng) Palabras clave : CKD Chronic kidney disease CKF Chronic kidney failure ESRD end stage renal disease HD hemodialysis KTR kidney transplant recipients MDR Multidrug resistant MMF mycophenolate mofetil mTOR mammalian target of rapamycin PD peritoneal dialysis RRT renal replacement therapy UTI Urinary tract infection TMP/SMX Trimethoprim-sulfamethoxazole XDR Extensively drug-resistant Resumen : Introduction: Urinary tract infection (UTI) is the most common infectious problem in kidney transplant recipients (KTR). It has been associated with risk factors inherent to the transplant and it could negatively affect clinical outcomes. The aim of this study was to describe demographic, clinical and microbiological characteristics of patients with UTI. Methods: We underwent a retrospective study reviewing the database of kidney transplants patients in a national reference center in Colombia. We included patients admitted for inpatient treatment related to urinary tract infection in the first year after transplantation. Results: We describe clinical information from 65 patients, the mean age was 46 years, the most common comorbidity was hypertension (n=48/62, 77.4%) followed by diabetes mellitus (n=11/62, 17.7%); 77% (n=50/65) of the infections were diagnosed in the first 6 months after transplant and 70% (n=45/65) had pyelonephritis. Acute dysfunction of the graft was the most common complication in 59% (n=33/56) of cases. The most common etiological agent described was E. coli in 67% (n=37/55) of patients followed by Klebsiella pneumoniae (n=13/55). Bacteremia was present in 25% of cases. Infection with extended-spectrum betalactamases producing bacteria was present in 42% (n=18/42) of our isolations and multidrug resistance was documented in 39% (n=21/54) of isolates. Conclusion: Most UTI leading to hospitalization in KTR occur in the first six months. Pyelonephritis explains the majority of clinical diagnosis. The rate of blood stream infections and multidrug resistance bacteria is high, justifying an empiric broad-spectrum antibiotic treatment. Mención de responsabilidad : Santiago Giraldo-Ramírez, Oscar Emilio Díaz-Portilla, Andrés Felipe Miranda-Arboleda, Jorge Henao-Sierra, Lina María Echeverri-Toro, Fabian Jaimes DOI (Digital Object Identifier) : 10.1016/j.tpr.2016.09.001 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2451959616300154 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4616 Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2016.
Obra : Transplantation Reports
Idioma : Inglés (eng)
Palabras clave : CKD Chronic kidney disease CKF Chronic kidney failure ESRD end stage renal disease HD hemodialysis KTR kidney transplant recipients MDR Multidrug resistant MMF mycophenolate mofetil mTOR mammalian target of rapamycin PD peritoneal dialysis RRT renal replacement therapy UTI Urinary tract infection TMP/SMX Trimethoprim-sulfamethoxazole XDR Extensively drug-resistant Resumen : Introduction: Urinary tract infection (UTI) is the most common infectious problem in kidney transplant recipients (KTR). It has been associated with risk factors inherent to the transplant and it could negatively affect clinical outcomes. The aim of this study was to describe demographic, clinical and microbiological characteristics of patients with UTI. Methods: We underwent a retrospective study reviewing the database of kidney transplants patients in a national reference center in Colombia. We included patients admitted for inpatient treatment related to urinary tract infection in the first year after transplantation. Results: We describe clinical information from 65 patients, the mean age was 46 years, the most common comorbidity was hypertension (n=48/62, 77.4%) followed by diabetes mellitus (n=11/62, 17.7%); 77% (n=50/65) of the infections were diagnosed in the first 6 months after transplant and 70% (n=45/65) had pyelonephritis. Acute dysfunction of the graft was the most common complication in 59% (n=33/56) of cases. The most common etiological agent described was E. coli in 67% (n=37/55) of patients followed by Klebsiella pneumoniae (n=13/55). Bacteremia was present in 25% of cases. Infection with extended-spectrum betalactamases producing bacteria was present in 42% (n=18/42) of our isolations and multidrug resistance was documented in 39% (n=21/54) of isolates. Conclusion: Most UTI leading to hospitalization in KTR occur in the first six months. Pyelonephritis explains the majority of clinical diagnosis. The rate of blood stream infections and multidrug resistance bacteria is high, justifying an empiric broad-spectrum antibiotic treatment. Mención de responsabilidad : Santiago Giraldo-Ramírez, Oscar Emilio Díaz-Portilla, Andrés Felipe Miranda-Arboleda, Jorge Henao-Sierra, Lina María Echeverri-Toro, Fabian Jaimes DOI (Digital Object Identifier) : 10.1016/j.tpr.2016.09.001 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2451959616300154 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4616 Reserva
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2016-095.pdfAdobe Acrobat PDF Immunosupressive therapy in children with steroid-resistant nephrotic syndrome: single center experience / Catalina Vélez Echeverri ; Gustavo Adolfo Zuluaga Valencia ; Lina Maria Serna Higuita ; John Jairo Zuleta Tobón ; Juan José Vanegas Ruiz
Título : Immunosupressive therapy in children with steroid-resistant nephrotic syndrome: single center experience Tipo de documento : documento electrónico Autores : Catalina Vélez Echeverri, ; Gustavo Adolfo Zuluaga Valencia, ; Lina Maria Serna Higuita, ; John Jairo Zuleta Tobón, ; Juan José Vanegas Ruiz, Fecha de publicación : 2013 Títulos uniformes : Brazilian Journal of Nephrology Idioma : Inglés (eng) Palabras clave : Immunosuppressive Agents Chronic Kidney Failure mycophenolic acid Nephrotic Syndrome Resumen : INTRODUCTION: Nephrotic syndrome is one of the most frequent glomerular diseases among children, and steroid therapy remains as the treatment choice. In spite of this, 10 to 15% of the patients are steroidresistant, and the best therapy for such cases has never been defined. Mycophenolate acid (MA) is one of the treatments used in such situations. OBJECTIVE: To describe the clinical behavior of children diagnosed with steroid-resistant nephrotic syndrome (SRNS) and to assess the therapeutic response to MA. METHODS: This was a retrospective and descriptive study. RESULTS: 26 clinical records of patients with SRNS; 70% male and 30% female. All patients underwent kidney biopsies, which showed a predominance of focal segmental glomerulosclerosis (FSGS). The immunosuppresive drugs used were: Mycophenolate mofetil (MMF) 100%, Cyclosporine 69.2%, Cyclophosphamide 23.1%, and Rituximab 23%. One month after treatment initiation with MMF 61.5% achieved remission. The median of relapses per year for the patients was 3 (p25: 2.75 – p75: 4). This median became 1 (p25: 1 – p75: 3.25) after using this medication (p = 0.08). Furthermore, prior to the start of the MMF treatment, the median of the steroid dose was 1 (p25: 0.5- p75: 1.62) mg/k/day. After using MMF, this median became 0.07 (p25: 0 – p75: 0.55) mg/k/day (p Mención de responsabilidad : Catalina Velez Echeverri, Gustavo Adolfo Zuluaga Valencia, Lina Maria Serna Higuita, Ana Katherina Serrano Gayubo, Carolina Lucia Ochoa, Luisa Fernanda Rojas Rosas, Laura Carolina Muñoz, Javier Sierra, Jhon Jairo Zuleta, Juan José Vanegas Ruiz Referencia : J Bras Nefrol. Jul-Sep 2013;35(3):200-5. DOI (Digital Object Identifier) : 10.5935/0101-2800.20130032 PMID : 24100739 Derechos de uso : CC BY En línea : https://bjnephrology.org/en/article/immunosupressive-therapy-in-children-with-st [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4951 Immunosupressive therapy in children with steroid-resistant nephrotic syndrome: single center experience [documento electrónico] / Catalina Vélez Echeverri, ; Gustavo Adolfo Zuluaga Valencia, ; Lina Maria Serna Higuita, ; John Jairo Zuleta Tobón, ; Juan José Vanegas Ruiz, . - 2013.
Obra : Brazilian Journal of Nephrology
Idioma : Inglés (eng)
Palabras clave : Immunosuppressive Agents Chronic Kidney Failure mycophenolic acid Nephrotic Syndrome Resumen : INTRODUCTION: Nephrotic syndrome is one of the most frequent glomerular diseases among children, and steroid therapy remains as the treatment choice. In spite of this, 10 to 15% of the patients are steroidresistant, and the best therapy for such cases has never been defined. Mycophenolate acid (MA) is one of the treatments used in such situations. OBJECTIVE: To describe the clinical behavior of children diagnosed with steroid-resistant nephrotic syndrome (SRNS) and to assess the therapeutic response to MA. METHODS: This was a retrospective and descriptive study. RESULTS: 26 clinical records of patients with SRNS; 70% male and 30% female. All patients underwent kidney biopsies, which showed a predominance of focal segmental glomerulosclerosis (FSGS). The immunosuppresive drugs used were: Mycophenolate mofetil (MMF) 100%, Cyclosporine 69.2%, Cyclophosphamide 23.1%, and Rituximab 23%. One month after treatment initiation with MMF 61.5% achieved remission. The median of relapses per year for the patients was 3 (p25: 2.75 – p75: 4). This median became 1 (p25: 1 – p75: 3.25) after using this medication (p = 0.08). Furthermore, prior to the start of the MMF treatment, the median of the steroid dose was 1 (p25: 0.5- p75: 1.62) mg/k/day. After using MMF, this median became 0.07 (p25: 0 – p75: 0.55) mg/k/day (p Mención de responsabilidad : Catalina Velez Echeverri, Gustavo Adolfo Zuluaga Valencia, Lina Maria Serna Higuita, Ana Katherina Serrano Gayubo, Carolina Lucia Ochoa, Luisa Fernanda Rojas Rosas, Laura Carolina Muñoz, Javier Sierra, Jhon Jairo Zuleta, Juan José Vanegas Ruiz Referencia : J Bras Nefrol. Jul-Sep 2013;35(3):200-5. DOI (Digital Object Identifier) : 10.5935/0101-2800.20130032 PMID : 24100739 Derechos de uso : CC BY En línea : https://bjnephrology.org/en/article/immunosupressive-therapy-in-children-with-st [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4951 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001537 AC-2013-161 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2013-161.pdfAdobe Acrobat PDF