<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transpla...<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.展开更多
Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed(HD) and post-renal transplant(Tx) patients are proatherogenic,but elevated concentrations of plasma high-density lipoprotein(...Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed(HD) and post-renal transplant(Tx) patients are proatherogenic,but elevated concentrations of plasma high-density lipoprotein(HDL) reduce the risk of cardiovascular disease.We investigated the concentrations of lipid,lipoprotein,HDL particle,oxidized low-density lipoprotein(ox-LDL) and anti-ox-LDL,and paraoxonase-1(PON-1) activity in HD(n=33) and Tx(n=71) patients who were non-smokers without active inflammatory disease,liver disease,diabetes,or malignancy.HD patients had moderate hypertriglyceridemia,normocholesterolemia,low HDL-C,apolipoprotein A-I(apoA-I) and HDL particle concentrations as well as PON-1 activity,and increased ox-LDL and anti-ox-LDL levels.Tx patients had hypertriglyceridemia,hypercholesterolemia,moderately decreased HDL-C and HDL particle concentrations and PON-1 activity,and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference,but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients.However,in both patient groups,lipid and lipoprotein ratios(total cholesterol(TC)/HDL-C,LDL-C/HDL-C,triglyceride(TG)/HDL-C,HDL-C/non-HDL-C,apoA-I/apoB,HDL-C/apoA-I,TG/HDL) were atherogenic.The Spearman's rank coefficient test showed that the con-centration of ox-LDL correlated positively with HDL particle level(R=0.363,P=0.004),and negatively with TC(R=?0.306,P=0.012),LDL-C(R=?0.283,P=0.020),and non-HDL-C(R=?0.263,P=0.030) levels in Tx patients.Mul-tiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration,as an independent variable,was associated significantly positively with HDL particle level.The results indicated that ox-LDL and de-creased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs,which are less stable,easily un-dergo metabolic remodeling,generate a greater number of smaller pre-β-HDL particles,and thus accelerate reverse cholesterol transport,which may be beneficial for Tx patients.Further studies are necessary to confirm this.展开更多
目的:随着对补体失调研究的深入,以C3沉积为主的肾小球肾炎日益受到关注,其病理类型多样,且病理类型间症状及预后差异具有异质性。为避免误诊及漏诊,本研究分析不同病理类型C3沉积为主的肾小球肾炎的临床、病理及预后特点。方法:回顾性...目的:随着对补体失调研究的深入,以C3沉积为主的肾小球肾炎日益受到关注,其病理类型多样,且病理类型间症状及预后差异具有异质性。为避免误诊及漏诊,本研究分析不同病理类型C3沉积为主的肾小球肾炎的临床、病理及预后特点。方法:回顾性分析52例2013年6月至2022年10月行肾活检诊断为以C3沉积为主肾小球肾炎患者的临床、病理及随访资料。根据临床表现以及病理检查结果分为感染后肾小球肾炎(post-infectious glomerulonephritis,PIGN)组(n=15)和非感染后肾小球肾炎(non-post-infectious glomerulonephritis,N-PIGN)组(n=37)。进一步行N-PIGN亚组分析,分为C3独立沉积组(n=16)与C3复合沉积组(n=21),或C3肾病(C3 glomerulopathy,C3G)组(n=27)与非C3肾病(N-C3G)组(n=10)。结果:PIGN组相较于N-PIGN组,活检时血清肌酐值更低(84.60μmol/L vs 179.62μmol/L,P=0.001),补体C3值更低(0.36 g/L vs 0.74 g/L,P<0.001),病理慢性化病变程度更轻。在N-PIGN亚组分析中,C3复合沉积组较C3独立沉积组血清肌酐值更高(235.30μmol/L vs 106.70μmol/L,P=0.004),24 h尿蛋白值更高(4025.62 mg vs 1981.11 mg,P=0.037)。PIGN组的预后好于N-PIGN组(P=0.049),C3独立沉积组的预后好于C3复合沉积组(P=0.017),C3G组的预后好于N-C3G(P=0.018)。结论:C3沉积为主的肾小球肾炎涵盖多种病理类型,诊断C3G前需先排除PIGN,但对于非典型PIGN患者仍需要警惕C3G叠加或者相互转化;此外,荧光显微镜下经典补体C1q的沉积可能提示肾预后不良,应加强相关诊治与随访。展开更多
Background: Kidney transplantation is the most efficient treatment for renal failure but may be ruined by complications. Objective: To report the surgical complications of renal transplantation and the therapeutic mea...Background: Kidney transplantation is the most efficient treatment for renal failure but may be ruined by complications. Objective: To report the surgical complications of renal transplantation and the therapeutic means applied. Method: It was a retrospective study including 42 files of kidney transplantation in Côte d’Ivoire. We report 11 cases of surgical complications of the recipient’s intervention during the first five years. Results: The mean age was 42.64 years (±15.04). In 90.9% of the cases, there was a comorbidity factor. Lymphocele and stenosis of the uretero vesical anastomosis were the most frequent complications. One death was observed. Conclusion: Kidney transplantation is an effective way of managing chronic renal failure. Postoperative complications are polymorphic and unpredictable.展开更多
文摘<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.
基金Project(Nos.PW 55/09 and DS 41/10) supported by the Department of Laboratory Diagnostics,Medical University of Lublin,Poland
文摘Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed(HD) and post-renal transplant(Tx) patients are proatherogenic,but elevated concentrations of plasma high-density lipoprotein(HDL) reduce the risk of cardiovascular disease.We investigated the concentrations of lipid,lipoprotein,HDL particle,oxidized low-density lipoprotein(ox-LDL) and anti-ox-LDL,and paraoxonase-1(PON-1) activity in HD(n=33) and Tx(n=71) patients who were non-smokers without active inflammatory disease,liver disease,diabetes,or malignancy.HD patients had moderate hypertriglyceridemia,normocholesterolemia,low HDL-C,apolipoprotein A-I(apoA-I) and HDL particle concentrations as well as PON-1 activity,and increased ox-LDL and anti-ox-LDL levels.Tx patients had hypertriglyceridemia,hypercholesterolemia,moderately decreased HDL-C and HDL particle concentrations and PON-1 activity,and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference,but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients.However,in both patient groups,lipid and lipoprotein ratios(total cholesterol(TC)/HDL-C,LDL-C/HDL-C,triglyceride(TG)/HDL-C,HDL-C/non-HDL-C,apoA-I/apoB,HDL-C/apoA-I,TG/HDL) were atherogenic.The Spearman's rank coefficient test showed that the con-centration of ox-LDL correlated positively with HDL particle level(R=0.363,P=0.004),and negatively with TC(R=?0.306,P=0.012),LDL-C(R=?0.283,P=0.020),and non-HDL-C(R=?0.263,P=0.030) levels in Tx patients.Mul-tiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration,as an independent variable,was associated significantly positively with HDL particle level.The results indicated that ox-LDL and de-creased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs,which are less stable,easily un-dergo metabolic remodeling,generate a greater number of smaller pre-β-HDL particles,and thus accelerate reverse cholesterol transport,which may be beneficial for Tx patients.Further studies are necessary to confirm this.
文摘目的:随着对补体失调研究的深入,以C3沉积为主的肾小球肾炎日益受到关注,其病理类型多样,且病理类型间症状及预后差异具有异质性。为避免误诊及漏诊,本研究分析不同病理类型C3沉积为主的肾小球肾炎的临床、病理及预后特点。方法:回顾性分析52例2013年6月至2022年10月行肾活检诊断为以C3沉积为主肾小球肾炎患者的临床、病理及随访资料。根据临床表现以及病理检查结果分为感染后肾小球肾炎(post-infectious glomerulonephritis,PIGN)组(n=15)和非感染后肾小球肾炎(non-post-infectious glomerulonephritis,N-PIGN)组(n=37)。进一步行N-PIGN亚组分析,分为C3独立沉积组(n=16)与C3复合沉积组(n=21),或C3肾病(C3 glomerulopathy,C3G)组(n=27)与非C3肾病(N-C3G)组(n=10)。结果:PIGN组相较于N-PIGN组,活检时血清肌酐值更低(84.60μmol/L vs 179.62μmol/L,P=0.001),补体C3值更低(0.36 g/L vs 0.74 g/L,P<0.001),病理慢性化病变程度更轻。在N-PIGN亚组分析中,C3复合沉积组较C3独立沉积组血清肌酐值更高(235.30μmol/L vs 106.70μmol/L,P=0.004),24 h尿蛋白值更高(4025.62 mg vs 1981.11 mg,P=0.037)。PIGN组的预后好于N-PIGN组(P=0.049),C3独立沉积组的预后好于C3复合沉积组(P=0.017),C3G组的预后好于N-C3G(P=0.018)。结论:C3沉积为主的肾小球肾炎涵盖多种病理类型,诊断C3G前需先排除PIGN,但对于非典型PIGN患者仍需要警惕C3G叠加或者相互转化;此外,荧光显微镜下经典补体C1q的沉积可能提示肾预后不良,应加强相关诊治与随访。
文摘Background: Kidney transplantation is the most efficient treatment for renal failure but may be ruined by complications. Objective: To report the surgical complications of renal transplantation and the therapeutic means applied. Method: It was a retrospective study including 42 files of kidney transplantation in Côte d’Ivoire. We report 11 cases of surgical complications of the recipient’s intervention during the first five years. Results: The mean age was 42.64 years (±15.04). In 90.9% of the cases, there was a comorbidity factor. Lymphocele and stenosis of the uretero vesical anastomosis were the most frequent complications. One death was observed. Conclusion: Kidney transplantation is an effective way of managing chronic renal failure. Postoperative complications are polymorphic and unpredictable.
