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Challenges and considerations in diagnosing the kidney disease in deteriorating graft function.

Ekberg, Henrik LU and Johansson, Martin E (2012) In Transplant international : official journal of the European Society for Organ Transplantation 25(11). p.1119-1128
Abstract
Despite significant reductions in acute-rejection rates with the introduction of calcineurin inhibitor (CNI)-based immunosuppressive therapy, improvements in long-term graft survival in renal transplantation have been mixed. Improving long-term graft survival continues to present a major challenge in the management of kidney-transplant patients. CNIs are a key component of immunosuppressive therapy, and chronic CNI toxicity has been widely thought to be a major factor in late graft failure. However, recent studies examining the causes of late graft failure in detail have challenged this view, highlighting the importance of antibody-mediated rejection and other factors. In addition, the diagnosis of CNI nephrotoxicity represents a challenge... (More)
Despite significant reductions in acute-rejection rates with the introduction of calcineurin inhibitor (CNI)-based immunosuppressive therapy, improvements in long-term graft survival in renal transplantation have been mixed. Improving long-term graft survival continues to present a major challenge in the management of kidney-transplant patients. CNIs are a key component of immunosuppressive therapy, and chronic CNI toxicity has been widely thought to be a major factor in late graft failure. However, recent studies examining the causes of late graft failure in detail have challenged this view, highlighting the importance of antibody-mediated rejection and other factors. In addition, the diagnosis of CNI nephrotoxicity represents a challenge to clinicians, with the potential for over-diagnosis and an inappropriate reduction in immunosuppressive therapy. When graft function is deteriorating, accurately determining the cause of the kidney disease is essential for effective long-term management of the patient. Diagnosis requires a thorough clinical investigation, and in the majority of cases a specific cause can be identified. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Transplant international : official journal of the European Society for Organ Transplantation
volume
25
issue
11
pages
1119 - 1128
publisher
Springer
external identifiers
  • wos:000309748700004
  • pmid:22738034
  • scopus:84867529594
  • pmid:22738034
ISSN
1432-2277
DOI
10.1111/j.1432-2277.2012.01516.x
language
English
LU publication?
yes
id
61aa7439-8dc3-4e4e-b10f-764116a7aa1e (old id 2858916)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22738034?dopt=Abstract
date added to LUP
2016-04-04 09:33:51
date last changed
2022-04-23 21:12:05
@article{61aa7439-8dc3-4e4e-b10f-764116a7aa1e,
  abstract     = {{Despite significant reductions in acute-rejection rates with the introduction of calcineurin inhibitor (CNI)-based immunosuppressive therapy, improvements in long-term graft survival in renal transplantation have been mixed. Improving long-term graft survival continues to present a major challenge in the management of kidney-transplant patients. CNIs are a key component of immunosuppressive therapy, and chronic CNI toxicity has been widely thought to be a major factor in late graft failure. However, recent studies examining the causes of late graft failure in detail have challenged this view, highlighting the importance of antibody-mediated rejection and other factors. In addition, the diagnosis of CNI nephrotoxicity represents a challenge to clinicians, with the potential for over-diagnosis and an inappropriate reduction in immunosuppressive therapy. When graft function is deteriorating, accurately determining the cause of the kidney disease is essential for effective long-term management of the patient. Diagnosis requires a thorough clinical investigation, and in the majority of cases a specific cause can be identified.}},
  author       = {{Ekberg, Henrik and Johansson, Martin E}},
  issn         = {{1432-2277}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1119--1128}},
  publisher    = {{Springer}},
  series       = {{Transplant international : official journal of the European Society for Organ Transplantation}},
  title        = {{Challenges and considerations in diagnosing the kidney disease in deteriorating graft function.}},
  url          = {{http://dx.doi.org/10.1111/j.1432-2277.2012.01516.x}},
  doi          = {{10.1111/j.1432-2277.2012.01516.x}},
  volume       = {{25}},
  year         = {{2012}},
}