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To verify factors associated with anxiety and depression in renal transplant recipients. Quantitative study, cross-sectional design carried out in a hospital of high complexity, with 80 renal transplant recipients, over 18 years of age. The Hospital Anxiety and Depression Measurement Scale - HADS was used. The data were analyzed by simple descriptive statistics, Student's t-test or ANOVA, Mann Whitney, Kruskal-Wallis or Dunnet, and spearman correlation efficiency. Prevalence of anxiety in 25% and depression in 15% of those surveyed; predominance of females, ages between 30 and 59 years old; having a fixed companion favored anxiety symptoms; sedentary lifestyle was associated symptoms of anxiety and depression, recipients of deceased donors presented more anxiety; the longer transplant time, more anxiety and depression. It was concluded that scientific knowledge, technical skill, and empathy are indispensable tools in these situations, because they favor multiprofessional, interdisciplinary and humanized support, sensitives to the demands of the patients renal transplant recipients. [ABSTRACT FROM AUTHOR]

Introducción. Cerca del 15 % de los pacientes con insuficiencia renal crónica terminal tienen alteraciones de las vías urinarias inferiores. Estas anomalías eran consideradas una contraindicación para el trasplante renal. Por lo anterior, el objetivo del presente trabajo es describir el comportamiento sociodemográfico y clínico de los pacientes trasplantados renales con ureterostomía cutánea como técnica de derivación definitiva de las vías urinarias. Métodos. Se realizó un estudio descriptivo, longitudinal y retrospectivo de los pacientes trasplantados renales con vejiga anormal y ureterostomía cutánea, entre enero de 1973 y octubre de 2012. Resultados. En 4.294 trasplantes renales, se practicaron 24 (0,55 %) ureterostomías, 19 (79,1 %) como técnica inicial y 5 por falla de la ureteroneocistostomía. Diez (41,7 %) ureterostomías fallaron, la mayoría (8 casos) por estenosis. Se presentó infección urinaria en 20 pacientes y la mortalidad fue del 8,3 % (2/24). El 50 % (12/24) de los pacientes con trasplante de riñón estuvieron libres de infección urinaria durante el primer año. La supervivencia del riñón trasplantado fue de 93,8 % (23/24) a los 18 meses, de 85,9 % (20/24) a los 36 meses y de 66,7 % (16/24) a los 50 meses de seguimiento. La supervivencia de los injertos con ureterostomía sin infección fue del 100 % durante el periodo de seguimiento, mientras que la supervivencia de los riñones con infección urinaria fue de 93 % (23/24) a los 18 meses, de 76 % (18/24) a los 36 meses y de 54 % (13/24) a los 50 meses (p=0,235). Conclusiones. La ureterostomía cutánea es una alternativa segura para la derivación urinaria en pacientes trasplantados renales con alteraciones de la vejiga que no permite su uso o preparación antes del trasplante.

Introducción. Se presenta un paciente con falla renal crónica secundaria a hidroureteronefrosis bilateral, con antecedente de síndrome de abdomen en ciruela pasa (prune belly), en quien se realiza trasplante renal. El objetivo de este reporte de caso es exponer una anomalía congénita, con baja incidencia mundial y en menor proporción asociado a trasplante renal, con énfasis en la dificultad para la técnica quirúrgica dada por la hipoplasia de los músculos de la pared abdominal. Métodos. Revisión de Historia clínica, Consentimiento Informado. Búsqueda de la literatura. Caso clínico. En cirugía se identifica ausencia de músculos de la pared abdominal y fibrosis de las venas Iliaca externa y común derecha. Se realiza abordaje bajo técnica de Gibson contralateral, con trasplante renal sin complicaciones. Presentó adecuada evolución en seguimiento ambulatorio. Discusión. El síndrome de abdomen en ciruela pasa (prune belly) es una anomalía congénita de baja incidencia, con pocos reportes asociados a trasplante renal. El reto quirúrgico está dado por la ausencia de músculos de la pared abdominal, que aumentan los riesgos por posibles complicaciones, como la lesión de los vasos epigástricos inferiores. Para el cierre de pared abdominal en trasplante renal, se describe en dos planos, que en este caso se realiza sobre fascia muscular y piel. Aun siendo un reto, el paciente presenta adecuada evolución postoperatoria.

Introduction: Cytomegalovirus (CMV) is the most frequent opportunistic infection after renal transplantation. There are two strategies for its prevention: Universal prophylaxis, with valganciclovir for 90 days, and anticipated therapy, using weekly viral load surveillance, and therapy only if positive. Meta-analysis directly comparing both strategies have shown them to have similar effectiveness. Objective: To determine which strategy is more cost-effective in intermediate risk patients in Colombia. Materials and methods: We designed a third-party payer perspective decision tree, considering only direct medical costs in 2014 Colombian pesos (COP) (USD$ 1=COP$ 2,000) and a time horizon of one year. The target population was intermediate CMV risk patients (positive receptor). Transition probabilities were extracted from clinical studies, validated with a Delphi expert panel method; procedural costs were obtained from the ISS 2001 manual with a 33% increment based on the Consumer Price Index for 2014, while medication costs were obtained from the official Ministry of Health information system. Results: Universal prophylaxis with valganciclovir was dominant, with lower costs and less probability of infection. The average cost of the first year in anticipated therapy would be COP$ 30,961,290, whereas in the case of universal therapy the cost would be COP$ 29,967,834 (incremental cost of COP$ 993,456). Conclusions: For Colombian renal transplant patients at intermediate risk for CMV infection, universal prophylaxis strategy is the best option.

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genodermatosis characterized by abnormalities in the anchoring fibrils which attach the basal cell layer of the epidermis to the underlying structures. A characteristic feature of this disorder is the presence of recurrent blistering or erosions, the result of even minor traction to these tissues. Patients with RDEB frequently develop chronic renal failure, and require renal replacement therapy being a major cause of morbidity and mortality. The role of renal transplantation in these patients is scarcely known.We present the case of an end-stage renal disease patient with RDEB treated by renal transplantation and his follow-up during a period of 83 months after the transplant. In this period, there were very low frequency of serious infections as well as the absence of skin tumors.Renal transplantation could be an alternative to renal replacement therapy in epidermolysis bullosa patients with end-stage renal disease, reducing the comorbidities associated with this treatment.

Se presenta una paciente de la sexta década de la vida, con historia de enfermedad renal poliquística e hipertensión arterial, que arriba a la enfermedad renal crónica estadio V, por lo que fue tratada con diálisis peritoneal continua ambulatoria durante dos años. Recibió trasplante renal de donador cadavérico que requirió ablación una semana más tarde de su implantación por una trombosis intrarrenal. Incorporada a terapia con hemodiálisis periódica a partir de entonces presentó diferentes episodios de infecciones bacterianas en distintas localizaciones que se resolvieron con antimicrobianos de acuerdo a la susceptibilidad in vitro de los microorganismos aislados. La presencia de fiebre persistente en ausencia de patógenos aislados en los medios habituales, incluidas bacterias y virus, supuso la pertinencia de cultivar el líquido peritoneal, que arrojó la presencia de Aspergillus spp. y, por consiguiente, el diagnóstico de peritonitis fúngica.

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Graft damage is a process that starts at the moment of transplantation, due to comorbidities of receptor, donor status, ischemia time, ischemia-reperfusion phenomenon, among others, those induce metabolic and immune factors that ultimately trigger clinical manifestations of graft dysfunction. But between the time of transplant and the appearance of signs and symptoms, there is a preclinical process that can take weeks to years. For this reason, it is important to carry out a rational monitoring in the post-transplant period, which includes not only clinical follow-up but also anticipates the immunological damage of the graft. In this review, we propose a post-kidney transplant immunological monitoring algorithm. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Laparoscopic nephrectomy in living donor is the best option during the process of kidney transplantation for patients with end-stage chronic renal failure. The aim of this article is to describe the experience in a kidney living donor program since 2013 to 2018 at "Colombiana de Trasplantes" in the Colombian Caribbean region. A descriptive study was performed in which a consecutive sample of 55 living donors operated in "Colombiana de Trasplantes" since January 2013 to January 2018. Statistical analysis was done on the relevant variables. The mean of the age was 41 years. 57.4% of the living donors were female. Surgical time had mean time of 1.9 hours. None of the donors died after 6 months follow-up and the mean time of postoperative stay was 2 days. Important variables and main outcomes in living donors are similar to what is shown by other groups. However, there are specific characteristics that could help to improve health strategies in the Caribbean Region. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pediatric kidney transplant patients have an increased risk of developing arterial hypertension, dyslipidemia, carbohydrate intolerance and diabetes mellitus, risk factors associated with increased cardiovascular morbidity and mortality. Objective: This study evaluates the frequency of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism in a cohort of pediatric kidney transplant patients during 2006-2016 at the Pablo Tobon Uribe Hospital, in Colombia. Material and methods: Retrospective descriptive study in which descriptive statistics were used. Additionally, a bivariate analysis was performed to compare patients according to the outcome of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism. Results: From a total of 48 pediatric kidney transplants in the period studied, complete information was obtained from 43 patients at one year of follow-up. There was a post-transplant frequency of hypertension of 86%, dyslipidemia 48%, carbohydrate intolerance 14% and diabetes of 2%. Conclusions: In the evaluated cohort a high frequency of arterial hypertension and dyslipidemia was found after kidney transplantation. The development of early diagnosis and treatment guidelines is suggested to reduce the impact of these diseases associated with cardiovascular risk in adult life. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 76-year-old female with history of end-stage renal disease due to IgA nephropathy, submitted to a kidney transplant 28 years before, secondary hyperparathyroidism under vitamin D analogue, chronic anaemia, diabetes mellitus, arterial hypertension, atrial fibrillation (anticoagulated with warfarin) and peripheral venous insufficiency presented with a 1-month history of a skin ulcer on the left lower limb. The patient was started on amoxicillin-clavulanic acid, but the ulcer worsened: it became bigger and more painful. Laboratory tests showed worsened anemia, leucocytosis, high C-reactive protein, high parathyroid hormone and hyperphosphatemia. Multi-resistant Staphylococcus epidermidis was isolated in blood cultures; vancomycin was started and the central venous catheter switched. Infective endocarditis was excluded. Nevertheless, the ulcer grew bigger and evolved to necrosis. Leg radiography showed calcified vessels surrounding non-calcium-containing radiolucent tissues. Skin biopsy revealed extensive necrosis of epidermis, dermis and subcutaneous tissue; areas of recent thrombosis of hypodermic vessels and calciphilia of small vessels of the subcutaneous tissue. Unfortunately, the patient died of septic shock before the result of the skin biopsy. Calciphylaxis or calcific uremic arteriolopathy is a rare, life-threatening condition, that rarely occur in renal transplant recipients. Delayed diagnosis can lead to sepsis-related morbidity and mortality, as in this case we report.

Introduction: renal transplantation is the therapy of choice for the majority of patients with chronic renal failure. Immunosuppressive treatment shows associations with neoplastic diseases. Objective: to characterize neoplastic diseases in patients with functional renal transplantation. Method: an observational, descriptive, transverse study was carried out at "Arnaldo Milián Castro" Hospital. An intentional sample of 16 patients with neoplastic diseases was selected. Information was obtained from the renal transplant Consultation, from the clinical file and database of the Department of Pathological Anatomy. Results: male sex predominated (81%), mean age higher than female sex, and white skin color (93.7%). The most commonly used renal replacement therapy was hemodialysis (nine, 56%). Squamous cell carcinoma (six) and basal cell (three) prevailed. The frequency of viral diseases such as hepatitis C and cytomegalovirus was evidenced. Immunosuppressive treatment with prednisone, immuran, and cyclosporin was more than half of the patients (62%), and seven died after three years of neoplastic disease treatment for each patient. Conclusions: squamous cell carcinoma and basal cellular carcinoma were the most prevalent neoplastic diseases and after the treatment received, the survival was the expected.

El autotrasplante renal es un procedimiento quirúrgico poco frecuente, especialmente, cuando el paciente tiene un solo riñón funcional y su indicación es alguna anormalidad vascular compleja. En el presente artículo, se presenta un paciente a quien se practicó una nefrectomía más reconstrucción vascular ex vivo y autotrasplante renal. Además, se reporta su evolución hasta el octavo año después de la cirugía.

El trasplante renal es una medida de tratamiento sustitutivo en patologías que implican un desgaste del riñón. Propósito. Explorar la adaptación en personas con trasplante renal de acuerdo con los modos adaptativos del modelo de adaptación de Sor Callista Roy. Material y Métodos. Estudio cualitativo con método fenomenológico, la muestra estuvo conformada por cinco participantes por saturación teórica, seleccionados a través de un muestreo por bola de nieve. Se utilizó una guía de entrevista semiestructurada y la observación directa, para la recolecta de datos. El análisis de los discursos se realizó a través de la técnica de Minayo. Para la validación se consideró la triangulación de datos entre el cuidador principal y los pacientes con trasplante renal. Resultados y discusión. Se describen tres categorías predefinidas y una emergente de acuerdo con los modos adaptativos de la teoría, donde destaca el autoconcepto del grupo y la adaptación emocional, y se ve reflejado con gran importancia el apoyo espiritual y el retomo de las actividades. Conclusiones. Los aspectos emocionales, espirituales y del autoconcepto influyen de manera significativa en el proceso de adaptación tras un trasplante renal. Palabras clave: trasplante, trasplante de riñón, riñón, adaptación.

INTRODUCCIÓN El tratamiento con inmunoadsorción no selectiva fue introducido en nuestra unidad de hemodiálisis hospitalaria con el objetivo de permitir la desensibilización previa a un trasplante renal con incompatibilidad de grupo sanguíneo y el tratamiento del rechazo mediado por anticuerpos. OBJETIVO Analizar los resultados de la técnica de inmunoadsorción no selectiva, en una unidad de hemodiálisis hospitalaria. MATERIAL Y MÉTODOS Estudio retrospectivo, descriptivo, de los primeros 18 pacientes tratados en nuestro centro con inmunoadsorción no selectiva (años 2012-2017) en las indicaciones de acondicionamiento del trasplante ABOi y tratamiento del rechazo humoral. RESULTADOS Durante un periodo de 5 años se analizaron un total de 128 sesiones de inmunoadsorción no selectiva. El 38,9% (n=7) de los casos para desensibilización previa al trasplante renal con incompatibilidad de grupo sanguíneo y el 61,1% (n=11) restante para el tratamiento del rechazo mediado por anticuerpos. En el primer caso, realizaron una media de 8±0,6 sesiones de inmunoadsorción previas al trasplante renal y el 57,1% se complementaron 2 sesiones posteriores. El tratamiento concomitante fue el protocolizado con Rituximab e inmunoglobulinas, requiriendo el 57,1% la realización de recambios plasmáticos. En el segundo caso, realizaron una media de 5,9±2 sesiones de inmunoadsorción. El tratamiento concomitante fue el mismo y el 27,3% realizaron recambios plasmáticos. CONCLUSIONES El trasplante renal de donante vivo ABOi tras la desensibilización fue posible en el 100% de los pacientes. El 72,7% de los pacientes tratados para el rechazo mediado por anticuerpos mantienen actualmente la funcionalidad del injerto.

Introducción: La calidad de vida es un indicador de bienestar percibido por personas diagnosticadas con Enfermedad Renal Crónica Avanzada (ERCA), al respecto la literatura reporta diferentes instrumentos para su medición y de algunos de ellos describe las características psicométricas y adaptación transcultural. Objetivo: Identificar los instrumentos reportados por la literatura para evaluar la calidad de vida en la persona con ERCA y describir las características psicométricas y validación transcultural de los mismos. Material y Método: Se realizó una revisión integrativa de la literatura científica publicada en el periodo 2013 a 2018, en español, inglés y portugués. La búsqueda se realizó en 2 etapas, utilizando los operadores booleanos AND y OR, y los términos DeCS y MeSH para identificar escalas que evalúan la calidad de vida de los pacientes con ERCA, posteriormente se realizó una búsqueda focalizada para identificar cuales contaban con adaptación transcultural y las características psicométricas de las mismas. Resultados: La búsqueda inicial reportó 364 títulos elegibles, se seleccionaron 20, que comprendían instrumentos genéricos y específicos, de ellos 5 escalas se han usado en pacientes con ERCA: SF-12, SF-36, KDQOL 36, WHOQOL BREF, WHOQOL OLD. Conclusión: La escala KDQOL 36, posee dimensiones específicas para evaluar al paciente con ERCA , se encuentra adaptada transculturalmente en varios países de habla hispana y sus características psicométricas son confiables, el Alfa de Cronbach es >0.7, y su utilidad es adecuada porque es de fácil aplicación, poco compleja y a un bajo costo.

Background: Kidney transplantation is the therapy of choice for patients with chronic renal failure. In Mexico, good short-term results have been reported for graft survival, which is why it was carried out a study in a third level center in Mexico City to broaden these results. Objective: To identify long-term results of patient and graft survival. Material and methods: Retrospective study with first 1600 kidney transplants performed at the Hospital de Especialidades (Specialties Hospital) "Dr. Antonio Fraga Mouret" from La Raza National Medical Center. Patient and graft survival was analyzed at 1, 3, 5, 7 and 10 years. Kaplan-Meier survival analysis and log-rank test were performed. Results: Between October 1979 and May 2015, 1600 kidney transplants were performed (1473 [92.1%] of living donor and 127 [7.9%] of deceased donor). Graft survival censored for death with functional graft at 1, 3, 5, 7 and 10 years was 95.4, 91.7, 88.2, 86.6 and 85.5%, respectively. Patient survival was 92.7, 90.4, 89.7, 89.4, and 88.9% at 1, 3, 5, 7 and 10 years, respectively. Conclusions: Long-term patient and graft survival in our center is similar to that reported by other centers at an international level. [ABSTRACT FROM AUTHOR]

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Cerebral feohifomycosis are severe infections caused by dematiaceous fungi. Cladophialophora bantiana, is one of the most commonly isolated species, it has tropism for the central nervous system, in which it often manifests itself as a brain abscess in immunocompetent patients, in immunocompetent patients it can lead to brain abscesses and disseminated infections. Despite the availability of broadspectrum antifungal drugs, mortality is high, so that surgical management should be performed as far as possible in addition to drug therapy. The diagnostic approach must be invasive to establish opportune diagnosis and direct treatment based on culture and susceptibility tests. We report a case of brain abscess caused by C. bantiana in an immunosuppressed patient; which was treated with surgical resection and therapy with voriconazole, with adequate response to therapy and without neurological consequences.xad [ABSTRACT FROM AUTHOR]

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Introduction: generalities on the current panorama of renal transplantation and the social perception as a category to work. Objective: to explore the elements of social perception that conditions the refusal of renal transplantation. Method: a qualitative study was carried out, with a phenomenological focus. Semi-structured interviews, observation and review of documents were used. The study was conducted with a sample of 26 subjects, including 17 patients and nine medical assistants. Results: a social perception mediated by criteria contrary to renal transplantation was evidenced by a part of the healthcare personnel and by patients of the unit, due to the recent failures of renal transplants, iatrogenies in the communication, inadequate strategy of attraction of patients for the renal transplantation program and the socialization of frustrations. And at individual level, due to the presence of fear, inadequate self-evaluation of the state of health, distrust in the surgical team and lack of psychological senses with respect to the transplant. Conclusions: the social perception of renal transplantation among patients is conditioned by the confluence of exogenous and endogenous factors that hinder vision and decision making. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The Estimated Post Transplant Survival (EPTS) score is calculated based on age, the presence of diabetes mellitus, years on dialysis, and prior organ transplant. It has been validated in other countries. Objective: To apply and assess the EPTS score in our population of deceased-donor kidney transplants. Materials and methods: Retrospective study of adult deceased-donor kidney transplants from January, 2003, to December, 2016. For the statistical analysis it was used Spearman's correlation, receiver-operator curves (ROC) and Kaplan-Meier curves. A p value < 0.05 was considered statistically significant. Results: 176 adult deceased-donor kidney transplants were included. Medium age was 34.7 ± 11 years; 53.4% were men, 4% diabetics; mean dialysis time was 5.5 ± 3.9 years and 4% had a prior organ transplant. The medium of EPTS score was 16.3 ± 18.7 (1-94). Spearman's correlation was -0.394 (p = 0.0001). C value (ROC) was 0.64 ± 0.6 (95% CI, 0.52-0.75) (p = 0.011). Medium survival calculated with Kaplan-Meier in patients with an EPTS score < 20, was 10.2 ± 0.3 years (95% CI, 9.5-10.9) versus patients with EPTS score > 20: 7.03 ± 0.9 years (95% CI, 5.1-8.9) (p = 0.001). Each 20% increase of EPTS, patient survival time diminished (p = 0.0001). Conclusions: The EPTS score is a useful tool for establishing survival in adult Mexican recipients of deceased-donor kidney transplants. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction in people with chronic kidney disease is progressive and worsens with the deterioration of kidney functions. Although most people recover their sexual function after kidney transplantation, many sexual problems may persist after transplantation. Objectives: To characterize the sexual function of kidney transplant recipients and analyze their association with demographic and clinical variables. Methodology: A descriptive-correlational study was conducted with a sample of 139 kidney transplant recipients. Data were collected using a questionnaire for sociodemographic and clinical characterization, the International Index of Erectile Function, the Female Sexual Function Index, and the Beck Depression Inventory. Results: The prevalence rate of sexual dysfunction in kidney transplant recipients was high (> 90%), and sexual desire was the most affected domain. Sexual function was influenced by age, depressive states, and the presence of a menstrual cycle. Conclusion: Considering the prevalence of sexual dysfunction, nurses should integrate the research findings and promote sexual health in their daily clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Foundation: the use of medications potentially inmunodepressors has allowed an improvement in the longer and quality life in patients with renal transplant, but favor the deterioration of the immune system and the appearance of diverse opportunistic viral infections, among them herpes simplex, which is contagious and incurable and responsible of the starting of multiple lesions which affect the skin and mucose. Objective: to identify the clinical and cytopathological manifestations of oral lesions caused by the herpes simplex virus in patients with kidney transplant. Methods: a descriptive cross study, with a universe of 50 patients with renal transplant diagnosed clinically with a herpes infection, assisted in a dentistry consultation of the Polyclinic of Specialties at the Clinical Surgical University Hospital Saturnino Lora Torres, Santiago of Cuba, from November 2014 to the same the month 2016. For primary data collection a survey was designed including: age, sex, topographic location, clinical symptoms and lesion predisposing factors, so as present cellular disturbances in the oral epithelium. A cytopathological study of the lesions was performed. Results: the male sex and pain as a clinical symptom predominated, the most frequent location was the vermillon of the lower lip, the presence of giant epithelial multinucleated cells with bodies of intranuclear inclusions, and necrosis of infected cells, respectively, were the most important cytologic findings. Conclusion: in all of the patients there were oral lesions compatible with infection by the virus of herpes simplex. [ABSTRACT FROM AUTHOR]

Objective. To compare the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in Latin America and Europe, as well as to study differences in macroeconomic indicators, demographic and clinical patient characteristics, mortality rates, and causes of death between these two populations. Methods. We used data from 20 Latin American and 49 European national and subnational renal registries that had provided data to the Latin American Dialysis and Renal Transplant Registry (RLADTR) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, respectively. The incidence and prevalence of RRT in 2013 were calculated per million population (pmp), overall and by subcategories of age, sex, primary renal disease, and treatment modality. The correlation between gross domestic product and the prevalence of RRT was analyzed using linear regression. Trends in the prevalence of RRT between 2004 and 2013 were assessed using Joinpoint regression analysis. Results. In 2013, the overall incidence at day 91 after the onset of RRT was 181 pmp for Latin American countries and 130 pmp for European countries. The overall prevalence was 660 pmp for Latin America and 782 pmp for Europe. In the Latin American countries, the annual increase in the prevalence averaged 4.0% (95% confidence interval (CI): 2.5%-5.6%) from 2004 to 2013, while the European countries showed an average annual increase of 2.2% (95% CI: 2.0%-2.4%) for the same time period. The crude mortality rate was higher in Latin America than in Europe (112 versus 100 deaths per 1 000 patient-years), and cardiovascular disease was the main cause of death in both of those regions. Conclusions. There are considerable differences between Latin America and Europe in the epidemiology of RRT for ESRD. Further research is needed to explore the reasons for these differences. [ABSTRACT FROM AUTHOR]

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El trasplante de páncreas-riñón (TPR) para pacientes portadores de diabetes mellitus tipo 1 (DM1) con insuficiencia renal crónica terminal, ha demostrado ser una terapia eficaz para alcanzar el estado de normoglicemia de manera estable, con la consecuente disminución de las complicaciones crónicas de la DM y mejoría de la expectativa y calidad de vida. Actualmente, en casos seleccionados, se ha planteado el trasplante de páncreas (TP) como una alternativa para los pacientes con diabetes mellitus tipo 2 (DM2) considerando la diferencia entre los pacientes del tipo 1 y 2. Si bien es menos frecuente en la experiencia mundial, trasplantar pacientes con DM2 demuestra cifras alentadoras y comparables con el TP en enfermos portadores de DM1. En general, pacientes que desarrollan enfermedad renal terminal secundaria a diabetes 1 o 2 que requieren insulina, no obesos, deben ser considerados para el trasplante de páncreas con riñón simultáneo o secuencial. Clínica Las Condes es la de mayor experiencia en Chile, con resultados muy comparables a centros de gran importancia a nivel internacional. Objetivo: Dar a conocer la situación actual del trasplante de páncreas y sus modalidades en el mundo y mostrar la experiencia en TPR en Clínica Las Condes en la sobrevida de los pacientes, de injerto de páncreas e injerto de riñón en 10 años y sus complicaciones, además de las técnicas quirúrgicas realizadas. Método: Se recolectó la información de 16 pacientes sometidos a trasplante páncreas-riñón en Clínica Las Condes entre 1994-2014, analizando las variables con estadística descriptiva. Resultados: De los 16 enfermos, 9 de ellos fueron hombres, la edad promedio fue 38,7 años al momento del trasplante, el tiempo promedio de diabetes fue 23,5+/-7.3 años. Todos los injertos pancreáticos fueron anastomosados a los vasos ilíacos comunes derechos en forma término-terminal y el duodeno fue anastomosado en 8 casos a la vejiga y en los últimos 8 al íleon. La sobrevida de los pacientes a 10 años fue del 81%, del injerto de páncreas el 82% y del injerto renal el 65%. La complicación post operatoria más importante fue sepsis, causando la muerte en 2 pacientes. Y entre las complicaciones de tipo inmunológico, 8 pacientes presentaron rechazo agudo, siendo manejados con terapia esteroidal de rescate o timo globulina.

El objetivo del presente reporte es dar a conocer los dos primeros casos de nefropatía del injerto asociada a poliomavirus BK (NPBK) ocurridos en el Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. El diagnóstico definitivo de la NPBK se corroboró mediante biopsia renal y estudio de microscopia electrónica. Caso 1.- El deterioro funcional renal no se controló a pesar de reducir la inmunosupresión y añadir drogas antivirales (leflunamide y ciprofloxacina), evolucionando a falla renal y su posterior acceso a retrasplante renal. Caso 2.-La alternativa terapéutica se basó en infusión de inmunoglobulina endovenosa asociada a reducción de la inmunosupresión, resultando en moderada mejora histológica y estabilización de la función renal. En ambos injertos renales hubo concomitantemente NPBK y lesiones histológicas compatibles con rechazo agudo celular pendientes de interpretar. En conclusión, la presencia del poliomavirus BK representa serio problema en el riñón trasplantado. La mejor conducta terapéutica se basa en el diagnóstico precoz y subsecuente reducción de la inmunosupresión. Es imprescindible disponer de metodología apropiada que posibilite un diagnóstico preciso. Se utiliza tamizaje de células señuelo o marcadoras (decoy cells) en orina, reacción de cadena polimerasa (PCR), biopsia renal o la microscopia electrónica como método valioso de ayuda en el diagnóstico etiológico viral. Se considera el retrasplante como opción ante la pérdida del injerto por NPBK (caso Nº 1).

Objetivo: evaluar la calidad de vida de los pacientes trasplantados de riñón que son seguidos en la consulta externa. Método: Este es un estudio transversal y correlacional. La muestra consistió en 55 pacientes que se sometieron a un trasplante de riñón en la región de Lisboa, Portugal. La recolección de datos se realizó en mayo de 2017. También se utilizaron el cuestionario WHOQOL-bref y variables sociodemográficas y clínicas. Los resultados: El valor más bajo se encuentra en el dominio físico y los valores más altos en las facetas ambientales y generales de la calidad de vida. La faceta general de la calidad de vida se asocia positivamente con el dominio físico, el dominio psicológico y el dominio ambiental. Conclusiones: El dominio físico de la calidad de vida relacionada con los pacientes trasplantados de riñón fue el más perjudicado. Se examinan las consecuencias de la práctica clínica para la enfermería.

Introducción: El aumento en el número de trasplantes de órganos y la escasa adherencia a los tratamientos una vez realizado el trasplante suscita una actitud de alerta entre los profesionales de enfermería y un problema de salud pública. Objetivo: Conocer los factores asociados a la resiliencia que influyen sobre la adherencia al tratamiento, en este caso en el trasplante con injerto renal. Material y Método: Estudio descriptivo trasversal y retrospectivo en población adulta trasplantada con injerto funcionante desde enero de 2012 hasta junio de 2016 con edades comprendidas entre 18 y 70 años, de ambos sexos, autosuficientes en el manejo de tratamiento; y trasplantados en el Hospital Marqués de Valdecilla. Pertenecientes, como socios, a la Asociación Alcer Cantabria. Resultados: Los resultados obtenidos, aun no siendo significativos por el tamaño muestral, demuestran una influencia positiva (3% de la variabilidad) de la resiliencia en la adherencia al tratamiento. Se demuestran que existen diferencias significativas en alguna de las variables sociodemográficas como la actividad profesional, nivel de estudios y edad. Así mismo, se encuentran diferencias según el nivel de tolerancia a los efectos negativos y estrés. Conclusiones: Los datos revelan mayor riesgo de no adherencia en el grupo de menor edad, por lo que resulta necesario sensibilizar de la importancia de la adherencia al tratamiento. Sorprende la relación inversa entre baja adherencia en pacientes y mayor control situacional.

Introducción: los ImTOR, sirolimus y everolimus son una alternativa de inmunosupresión en personas que han recibido transplantes renales. En este artículo, se describe la experiencia de pacientes que han experimentado una conversión a ImTOR, y a los que se les ha hecho un seguimiento por más de cinco años. Materiales y métodos: se incluyeron pacientes con transplantes renales desde 1995 hasta 2013, quienes tuvieron indicación de suspensión del inhibidor de calcineurina (ICN) después del tercer mes posterior al trasplante. Todos los pacientes fueron sometidos a biopsia renal antes de la administración de ImTOR. Ningún paciente tuvo diagnóstico de nefropatía crónica, IFTA >40 % o proteinuria >350 mg/24h. Se elaboró un análisis descriptivo para todas las variables. Para estudiar la supervivencia del paciente y del injerto, y la incidencia de rechazo agudo, se usó el método de Kaplan-Meier. Resultados: de 1273 trasplantes renales, la conversión de ICN a ImTOR se realizó en 166 casos (13 %). Al 78 % (n=129) se le administró sirolimus. El 13 % de los pacientes perdió la función del injerto y 7 pacientes (4,2 %) fallecieron. En el 37 % de los casos, se retiró el ImTOR. La principal causa de retiro fue el hallazgo de proteinuria patológica. La incidencia de rechazo agudo después del cambio a ImTOR fue de 9,6 %. La supervivencia del injerto tras uno y cinco años fue de 96,6 % y 83,5 %, respectivamente; y la supervivencia del paciente a uno y cinco años fue de 98 % y 97 %, respectivamente. Conclusiones: el uso de inhibidores ImTOR parece ser seguro en este grupo de pacientes trasplantados, pues hubo una baja tasa de rechazo y buena supervivencia del injerto.

OBJECTIVE To verify if the type of donor is a risk factor for infection in kidney transplant recipients. METHODS Systematic Review of Literature with Meta-analysis with searches conducted in the databases MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO and CINAHL. RESULTS We selected 198 studies and included four observational studies describing infections among patients distinguishing the type of donor. Through meta-analysis, it was shown that in patients undergoing deceased donor transplant, the outcome infection was 2.65 higher, than those who received an organ from a living donor. CONCLUSION The study showed that deceased kidney donor recipients are at an increased risk for developing infections and so the need for establishing and enforcing protocols from proper management of ischemic time to the prevention and control of infection in this population emerges.

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.

SARS-CoV-2 infection (COVID-19) has had a significant impact on transplant activity in our country. Mortality and the risk of complications associated with COVID-19 in kidney transplant recipients (KT) were expected to be higher due to their immunosuppressed condition and the frequent associated comorbidities. Since the beginning of the pandemic in March 2020 we have rapidly improved our knowledge about the epidemiology, clinical features and management of COVID-19 post-transplant, resulting in a better prognosis for our patients. KT units have been able to adapt their programs to this new reality, normalizing both donation and transplantation activity in our country. This manuscript presents a proposal to update the general recommendations for the prevention and treatment of infection in this highly vulnerable population such as KT., (Copyright © 2022 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)