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      Influence of Age on the Prognosis of Renal Transplant Recipients

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          Abstract

          With aging, morphologic organ changes due to arteriosclerosis, hypertension, or diabetes increase, and renal transplantation tends to become less successful. We analyzed the outcome of transplantation in 123 recipients who underwent renal transplantation between January 1988 and December 1989. We assessed patient and graft survival after 1, 5, and 6 years as well as mortality and transplant failure and the incidence of rejections. We compared the results of patients aged under 60 years (group 1, n = 60) with the findings of patients aged over 60 years (group 2, n = 63). Immunosuppression was with ciclosporin A and prednisolone without exception. In patients under the age of 60, the overall patient survival at 1, 5, and 6 years was 97, 95, and 90% and was significantly compromised in recipients over the age of 60 (92, 80, and 75%). The 1-, 5- and 6-year graft survival rates were 92, 90, and 90% in recipients aged over 60 years and 88, 82, and 79% in recipients under the age of 60 years. The incidence of rejection was significantly higher in recipients under the age of 60. Patient mortality was mainly due to cardiovascular complications and transplant failure mainly related to transplant thrombosis. In older patients, renal transplantation is thought to be an option of survival rate improvement in comparison with hemodialysis. The incidence of transplant rejection is significantly lower, and this indicates a promising result regarding the long-term prognosis. As cardiovascular complications present as the main mortality factors of both transplant and patient, the prognosis is considered to be highly dependent on screening and treatment of these risk factors.

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          Influence of hyperglycemia and hyperuricemia on long-term transplant survival in kidney transplant recipients.

          Long-term prognosis in kidney transplant recipients depends on multiple factors. The purpose of this study was to quantify the influence of hyperuricemia and hyperglycemia (elements of the so-called 'syndrome X', i.e., a combination of metabolic disorders like hyperuricemia, diabetes mellitus, hyperlipidemia, and hypertension) on organ function in 350 kidney transplant recipients who had received 375 kidney transplants up to 1990 and in whom sex, age of recipient and donor, nephrologic disease, duration of dialysis, human leukocyte antigen (HLA) classification, and duration of transplant ischemia had been well matched. We found the influence of hyperuricemia on graft survival to be statistically significant (p 100 mg,dL) kidney transplant recipients (p > 0.05). Transplant survival in hyperuricemic patients (male, > 8 mg dL; female, > 6.2 mg/dL) 2, 4, and 5 yr post-transplantation was significantly reduced (92.2, 70.6, and 68.8% vs. 98.1, 85.6, and 83.3%), as compared to normouricemic recipients. A combined presence of both hyperuricemia and hyperglycemia probably influencing the prognosis post-kidney-transplantation failed to reach the level of statistical significance. We found a significant correlation between age of recipients and plasma glucose (p < or = 0.01) and between serum uric acid concentrations and diuretic therapy (p < or = 0.05) and gender (p < or = 0.(5). In conclusion, hyperuricemia after kidney transplantation seems to reduce graft survival, whereas an influence of the carbohydrate metabolism has to be denied.
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            RENAL TRANSPLANTATION IN RECIPIENTS OVER THE AGE OF 60

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              Author and article information

              Journal
              AJN
              Am J Nephrol
              10.1159/issn.0250-8095
              American Journal of Nephrology
              S. Karger AG
              0250-8095
              1421-9670
              2001
              August 2001
              13 August 2001
              : 21
              : 4
              : 259-263
              Affiliations
              Medizinische Poliklinik, Universität Münster, Deutschland
              Article
              46259 Am J Nephrol 2001;21:259–263
              10.1159/000046259
              11509796
              © 2001 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 7, Tables: 2, References: 18, Pages: 5
              Product
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/46259
              Categories
              Clinical Study

              Cardiovascular Medicine, Nephrology

              Transplant survival, Risk factors, Age, Kidney transplantation

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