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Medicina
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Dialysis and Kidney Transplantation
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Dialysis and Kidney Transplantation

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Urology & Nephrology".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 14536

Special Issue Editors

Dr. Maria Cappuccilli

E-Mail Website
Guest Editor
Alma Mater Studiorum Università di Bologna, Bologna, Italy
Interests: kidney transplantation; dialysis; kidney; clinical nephrology; acute kidney injury; chronic kidney failure; transplantation; hemodialysis; organ transplantation; kidney disease
Special Issues, Collections and Topics in MDPI journals
Dr. Gabriele Donati

E-Mail Website
Co-Guest Editor
Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St Orsola Hospital, University of Bologna, Bologna, Italy
Interests: acute kidney injury; chronic kidney injury; dialysis; extracorporeal blood purification; inflammation; renal injury biomarkers; vascular access
Dr. Irene Capelli

E-Mail Website
Co-Guest Editor
1. Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2. Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
Interests: chronic kidney injury; rare diseases; diabetes; renal injury biomarkers; diet in the management of CKD
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Given the growing aging population worldwide, the number of people with end-stage renal disease (ESRD) is also increasing. Consequently, in the near future, we will have to deal with a progressive rise in the number of people needing a kidney function replacement option, such as in-center (clinic) hemodialysis, peritoneal dialysis, home hemodialysis, and transplantation.

Although renal transplant is still considered the treatment of choice for patients with ESRD, it is also important to collect information on expert views on the future of dialysis, because many patients cannot be transplanted or remain a long time under dialysis treatment, for several reasons, mainly hyperimmunization and the gap between supply and demand for organs available for transplantation.

In view of this important health emergency, the journal Medicina is going to dedicate a Special Issue on “Dialysis and Kidney Transplantation”.

For this reason, we encourage you and your co-workers to submit your manuscripts, either original articles or reviews, on any aspect of kidney function replacement.

We expect to collect an interesting series of papers on the main current challenges for nephrologists in the management of patients under dialysis and of transplant recipients. Evidence from experimental models and humans are welcome, as well as articles describing the state-of-the-art or new insights on dialysis and kidney transplant.

Dr. Maria Cappuccilli
Dr. Gabriele Donati
Dr. Irene Capelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Biocompatibility
  • Dialysis complications
  • Extracorporeal blood purification
  • Graft function biomarkers
  • Hemodialysis
  • Home dialysis
  • Immunosuppressive therapy
  • Kidney transplant
  • Peritoneal dialysis
  • Post-transplant cardiovascular disease
  • Post-transplant infections
  • Vascular access

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Published Papers (4 papers)

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Research

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7 pages, 292 KiB  
Article
Serum Osteocalcin Level is Negatively Associated with Vascular Reactivity Index by Digital Thermal Monitoring in Kidney Transplant Recipients
by Lin Lin, Liang-Te Chiu, Ming-Che Lee and Bang-Gee Hsu
Medicina 2020, 56(8), 400; https://doi.org/10.3390/medicina56080400 - 9 Aug 2020
Cited by 8 | Viewed by 2522
Abstract
Background and Objectives: Osteocalcin is the most abundant noncollagenous protein in bone matrix, which is considered a marker of bone formation. Previous studies indicate that circulating osteocalcin can be expressed by osteoblasts and even by osteoblast-like cells in vessel walls, and it is [...] Read more.
Background and Objectives: Osteocalcin is the most abundant noncollagenous protein in bone matrix, which is considered a marker of bone formation. Previous studies indicate that circulating osteocalcin can be expressed by osteoblasts and even by osteoblast-like cells in vessel walls, and it is often associated with arterial stiffness. Our study aims to examine the potential association between osteocalcin levels and endothelial function among kidney transplant (KT) recipients. Materials and Methods: Fasting blood samples were obtained from 68 KT recipients. To measure the endothelial function and vascular reactivity index (VRI), a digital thermal monitoring test (VENDYS) was used. A commercial enzyme-linked immunosorbent assay kit was also utilized to measure serum total osteocalcin levels. In this study, a VRI of less than 1.0 indicated poor vascular reactivity; a VRI of 1.0–2.0 indicated intermediate vascular reactivity; and a VRI of 2.0 or higher indicated good vascular reactivity. Results: Our findings show that 8 KT recipients (11.8%) had poor vascular reactivity (VRI < 1.0), 26 (38.2%) had intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 34 (50%) had good vascular reactivity. Increased serum osteocalcin levels (p < 0.001) were found to be associated with poor vascular reactivity. Advanced age (r = −0.361, p = 0.002), serum alkaline phosphate level (r = −0.254, p = 0.037), and log-transformed osteocalcin levels (r = − 0.432, p < 0.001) were identified to be negatively correlated with VRI in KT recipients. Multivariable forward stepwise linear regression analysis revealed that the serum level of osteocalcin (β = −0.391, adjusted R2 change = 0.174; p < 0.001) and advanced age (β = −0.308, adjusted R2 change = 0.084; p = 0.005) were significantly and independently associated with VRI in KT recipients. Conclusions: Higher serum osteocalcin level was associated with lower VRI and poorer endothelial dysfunction among KT recipients. Full article
(This article belongs to the Special Issue Dialysis and Kidney Transplantation)
9 pages, 301 KiB  
Article
Longitudinal Analysis of Cardiovascular Risk Factors in Active and Sedentary Kidney Transplant Recipients
by Valentina Totti, Bo Fernhall, Rocco Di Michele, Paola Todeschini, Gaetano La Manna, Maria Cappuccilli, Maria Laura Angelini, Marco De Fabritiis, Franco Merni, Enrico Benedetti, Giulio Sergio Roi, Alessandro Nanni Costa and Giovanni Mosconi
Medicina 2020, 56(4), 183; https://doi.org/10.3390/medicina56040183 - 16 Apr 2020
Cited by 5 | Viewed by 2509
Abstract
Background: Despite the benefits of physical activity on cardiovascular risk in kidney transplant recipients (KTRs), the long-term effects of exercise have been poorly investigated. This is a three-year observational study comparing graft function and cardiovascular risk factors in active KTRs (AKTRs) vs. sedentary [...] Read more.
Background: Despite the benefits of physical activity on cardiovascular risk in kidney transplant recipients (KTRs), the long-term effects of exercise have been poorly investigated. This is a three-year observational study comparing graft function and cardiovascular risk factors in active KTRs (AKTRs) vs. sedentary KTRs (SKTRs). Methods: KTRs with stable renal function were assigned to active or sedentary group in relation to the level of daily physical activity based on World Health Organization (WHO) recommendations (<150 or >150 minutes/week, respectively). Complete blood count, renal function indices, lipid profile, blood pressure and anthropometric measures were collected yearly for an observation period of three years. The comparisons between the two groups were performed by repeated measures analyses of covariance (ANCOVAs), with age as a covariate. Results: Fifty-four subjects were included in the study. Thirty of them were identified as AKTRs (M/F 26/4, aged 45 ± 12 years) and 24 as SKTRs (M/F 18/6, aged 51 ± 14 years). Baseline characteristics were similar between the groups except body mass index (BMI) that was significantly higher in SKTRs (p = 0.043). Furthermore, over the three-year observation period, BMI decreased in AKTRs and increased in SKTRs (p = 0.006). Graft function was stable in AKTRs, while it showed a decline over time in SKTRs, as indicated by the rise in serum creatinine levels (p = 0.006) and lower eGFR (p = 0.050). Proteinuria, glucose and uric acid levels displayed a decrease in AKTRs and an increase in SKTRs during the three-year period (p = 0.015, p = 0.004 and p = 0.013, respectively). Finally, concerning lipid profiles, AKTRs had a significant reduction over time of triglycerides levels, which conversely showed a clinically relevant increase in SKTRs (p = 0.014). Conclusions: Our findings indicate that regular weekly exercise training may counteract the increased cardiovascular risks and also prevent graft function decline in KTRs. Full article
(This article belongs to the Special Issue Dialysis and Kidney Transplantation)

Review

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11 pages, 645 KiB  
Review
Kidney Transplant in Fabry Disease: A Revision of the Literature
by Irene Capelli, Valeria Aiello, Lorenzo Gasperoni, Giorgia Comai, Valeria Corradetti, Matteo Ravaioli, Elena Biagini, Claudio Graziano and Gaetano La Manna
Medicina 2020, 56(6), 284; https://doi.org/10.3390/medicina56060284 - 10 Jun 2020
Cited by 12 | Viewed by 4720
Abstract
Fabry disease is classified as a rare X-linked disease caused by a complete or partial defect of enzyme alpha-galactosidase, due to GLA gene mutations. This disorder leads to intracellular globotriaosylceramide (Gb3) deposition associated with increased Gb3 plasma levels. Most of the symptoms of [...] Read more.
Fabry disease is classified as a rare X-linked disease caused by a complete or partial defect of enzyme alpha-galactosidase, due to GLA gene mutations. This disorder leads to intracellular globotriaosylceramide (Gb3) deposition associated with increased Gb3 plasma levels. Most of the symptoms of the disease, involving kidneys, heart and nervous system, result from this progressive Gb3 deposition. The incidence is estimated in 1/50,000 to 1/117,000 in males. Fabry nephropathy begins with microalbuminuria and/or proteinuria, which, in the classic form, appear from childhood. Thus, a progressive decline of renal function can start at a young age, and evolve to kidney failure, requiring dialysis or renal transplantation. Enzyme replacement therapy (ERT), available since 2001 for Fabry disease, has been increasingly introduced into the clinical practice, with overall positive short-term and long-term effects in terms of ventricular hypertrophy and renal function. Kidney transplantation represents a relevant therapeutic option for Fabry nephropathy management, for patients reaching end-stage renal disease, but little is known about long-term outcomes, overall patient survival or the possible role of ERT after transplant. The purpose of this review is to analyze the literature on every aspect related to kidney transplantation in patients with Fabry nephropathy: from the analysis of transplant outcomes, to the likelihood of disease recurrence, up to the effects of ERT and its possible interference with immunosuppression. Full article
(This article belongs to the Special Issue Dialysis and Kidney Transplantation)
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14 pages, 1146 KiB  
Review
Immunological Effects of a Single Hemodialysis Treatment
by Andrea Angeletti, Fulvia Zappulo, Chiara Donadei, Maria Cappuccilli, Giulia Di Certo, Diletta Conte, Giorgia Comai, Gabriele Donati and Gaetano La Manna
Medicina 2020, 56(2), 71; https://doi.org/10.3390/medicina56020071 - 12 Feb 2020
Cited by 22 | Viewed by 4009
Abstract
Immune disorders, involving both innate and adaptive response, are common in patients with end-stage renal disease under chronic hemodialysis. Endogenous and exogenous factors, such as uremic toxins and the extracorporeal treatment itself, alter the immune balance, leading to chronic inflammation and higher risk [...] Read more.
Immune disorders, involving both innate and adaptive response, are common in patients with end-stage renal disease under chronic hemodialysis. Endogenous and exogenous factors, such as uremic toxins and the extracorporeal treatment itself, alter the immune balance, leading to chronic inflammation and higher risk of cardiovascular events. Several studies have previously described the immune effects of chronic hemodialysis and the possibility to modulate inflammation through more biocompatible dialyzers and innovative techniques. On the other hand, very limited data are available on the possible immunological effects of a single hemodialysis treatment. In spite of the lacking information about the immunological reactivity related to a single session, there is evidence to indicate that mediators of innate and adaptive response, above all complement cascade and T cells, are implicated in immune system modulation during hemodialysis treatment. Expanding our understanding of these modulations represents a necessary basis to develop pro-tolerogenic strategies in specific conditions, like hemodialysis in septic patients or the last session prior to kidney transplant in candidates for receiving a graft. Full article
(This article belongs to the Special Issue Dialysis and Kidney Transplantation)
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