ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Graft-derived ‘passenger’ dendritic cells have been classically considered as the instigators of acute organ rejection. However, recent advances have revealed that dendritic cells are also involved in the induction/maintenance of peripheral tolerance. This paper briefly reviews the most recent knowledge of the role of donor and recipient dendritic cells during the immune response against allografts, and of the clinical potential of ‘tolerogenic’ dendritic cells.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The safety of the renal allograft biopsy and the standardization of allograft histopathology interpretation have renewed interest in the protocol biopsy. Recent studies in the areas of ‘marginal’ donors, surveillance of acute rejection, molecular biology and chronic rejection are discussed.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Mortality in patients with end-stage renal disease remains high, with cardiovascular disease accounting for half of these deaths. Novel risk factors such as inflammation, oxidative stress, hyperhomocysteinemia, and high troponin levels are associated with cardiovascular risk in the general population. While there are substantial epidemiologic data confirming that these novel risk factors are associated with cardiovascular risk in end-stage renal disease patients, a causal relationship has not been established. Inflammation is readily identified by the presence of high levels of C-reactive protein, while studies of oxidative stress are hampered by the lack of a standardized test. The cause of both is unknown. Hyperhomocysteinemia results from decreased remethylation to methionine, although vitamin supplementation only partially corrects the defect, suggesting that uremic inhibition of the enzymatic process may be important. The most promising strategies for correcting oxidative stress and hyperhomocysteinemia are vitamin E and folinic acid therapy, respectively. Troponin I appears to be a more specific marker of myocardial injury than Troponin T, but troponin T retains its ability to predict cardiovascular mortality as well as all-cause mortality. Sorting out the role of each of these risk factors may be difficult since the factors may influence each other, may increase oxidative stress, and may mediate atherosclerosis through oxidative modification of lipids.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Infections and specifically infectious complications of vascular access remain a major cause of morbidity and mortality in the hemodialysis population. Primary arteriovenous fistulas have the lowest rates of infections and are the access of choice whenever vascular anatomy allows. The dialysis outcomes quality initiative (DOQI) guidelines have thus stressed the need for increasing the utilization of arteriovenous fistulas. Unfortunately, comorbid disease processes and late referrals for vascular access have maintained our dependence on synthetic grafts and indwelling catheters. Indwelling catheters, in particular, have the highest rate of infection and are often associated with more serious metastatic complications. Appropriate antibiotics along with aggressive surgical debridement remain crucial in bacteremia occurring in arteriovenous fistulas or synthetic grafts (polytetrafluoroethylene). Catheter related bacteremia necessitates catheter removal with either guidewire exchange or replacement after a period of antibiotic therapy. Measures to increase our utilization of primary fistulas whenever possible will lower the risk of these complications in our patients.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Over the last few years there has been an increasing interest in the frequent hemodialysis regimens in the form of short daily hemodialysis and nocturnal hemodialysis. Clinical data consistently showed improved quality of life, better control of blood pressure, less need for medications including erythropoietin (EPO) and better nutrition. Although the cost of providing daily treatment is higher than the conventional hemodialysis, the overall cost of the care of the patients may be lower. Furthermore short daily and nocturnal hemodialysis will lead to resurgence of home hemodialysis.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Recent data suggest that long-term allograft survival might be affected by two factors. The first is the endowment of the allograft, which consists of two elements: the nephron mass and the ability of these nephrons to repair injuries sustained during the transplant process. The second factor is renal inflammation. Although inflammation is traditionally ascribed to alloreactivity, recent data have shown that there is also a renal inflammatory response to early injury after transplantation, to brain death in the donor, and as part of the maladaptive response to nephron loss. These two factors contribute to the detrimental effects of delayed graft function or acute rejection on the long-term survival seen in most studies, and the beneficial effects of anti-inflammatory agents on the maladaptive response to nephron loss.

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:2000

数据来源: OVID