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Rodríguez-Espinosa D, Morantes L, García J, Broseta JJ, Cuadrado-Payán E, Colmenero J, Torregrosa JV, Diekmann F, Esforzado N. Long-Term Outcomes of Incidental Liver Malignancies in Simultaneous Liver-Kidney Transplant Recipients. Transplant Proc 2024; 56:330-334. [PMID: 38350821 DOI: 10.1016/j.transproceed.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The pretransplant diagnosis of liver malignancies in nodular cirrhotic livers remains a diagnostic challenge despite current advances. Although the prognostic impact of incidental hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (iCC) in liver transplant recipients is well documented, there are no data on the impact in simultaneous liver kidney transplant (LKT) recipients. METHODS This is a single-center observational, retrospective study of all LKT performed from May 1993 to April 2022. Among these patients, demographic data, immunosuppressive therapy, rejection episodes, and prevalence of incidental HCC or iCC were evaluated. RESULTS One hundred eight LKTs were performed and 6 were excluded. There were 13 patients with incidental carcinomas in the explanted liver: one of them with both an HCC and iCC, one with an iCC, and the remaining with an HCC. One case of iCC died. No other recurrences occurred. There were no cases of incidental HCC nor iCC in patients with a hereditary or metabolic LKT indication. We found no differences in the 5-year patient survival, and death-censored kidney and liver graft survival rates for those LKT with an incidental HCC and those without it (76.9% vs 84.2%, P = .5; 100% vs 91.6%, P = .28; and 100% vs 94.7%, P = 0.39, respectively). Finally, there were no significant associations between explant carcinoma and rejections of the liver (7.7% vs 17.9%, P = .34) or kidney graft (0% vs 16.8%, P = 0.11). CONCLUSION Despite a high prevalence of incidental HCC or iCC, patient, kidney, and liver graft 5-year survival were unaffected by incidental HCC.
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Affiliation(s)
- Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain.
| | - Laura Morantes
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Jenmy García
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | - Josep Vicens Torregrosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Nuria Esforzado
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
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Maduell F, Cholbi E, Morantes L, Escudero-Saiz VJ, Ollé J, Martínez-Chillarón M, Rodas LM, Rodríguez-Espinosa D, Arias-Guillen M, Vera M, Fontseré N, Broseta JJ. Results of Salt Intake Restriction Monitored with the New Sodium Control Biosensor. Am J Nephrol 2023; 54:291-298. [PMID: 37311444 DOI: 10.1159/000531521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Adherence to a low-sodium (Na) diet is crucial in patients under hemodialysis, as it improves cardiovascular outcomes and reduces thirst and interdialytic weight gain. Recommended salt intake is lower than 5 g/day. The new 6008 CAREsystem monitors incorporate a Na module that offers the advantage of estimating patients' salt intake. The objective of this study was to evaluate the effect of dietary Na restriction for 1 week, monitored with the Na biosensor. METHODS A prospective study was conducted in 48 patients who maintained their usual dialysis parameters and were dialyzed with a 6008 CAREsystem monitor with activation of the Na module. Total Na balance, pre-/post-dialysis weight, serum Na (sNa), changes in pre- to post-dialysis sNa (ΔsNa), diffusive balance, and systolic and diastolic blood pressure were compared twice, once after 1 week of patients' usual Na diet and again after another week with more restricted Na intake. RESULTS Restricted Na intake increased the percentage of patients on a low-Na diet (<85 Na mmol/day) from 8% to 44%. Average daily Na intake decreased from 149 ± 54 to 95 ± 49 mmol, and interdialytic weight gain was reduced by 460 ± 484 g per session. More restricted Na intake also decreased pre-dialysis sNa and increased both intradialytic diffusive balance and ΔsNa. In hypertensive patients, reducing daily Na by more than 3 g Na/day lowered their systolic blood pressure. CONCLUSIONS The new Na module allowed objective monitoring of Na intake, which in turn could permit more precise personalized dietary recommendations in patients under hemodialysis.
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Affiliation(s)
- Francisco Maduell
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Ester Cholbi
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Laura Morantes
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Júlia Ollé
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Lida Maria Rodas
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | | | | | - Manel Vera
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Néstor Fontseré
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
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Casals J, Acosta Y, Caballero G, Morantes L, Zamora C, Xipell M, Viladot M, Guillen E, Piñeiro G, Blasco M, Marco J, Padrosa J, Pereira A, Jhaveri KD, Quintana L, García-Herrera A. Differentiating Acute Interstitial Nephritis From Immune Checkpoint Inhibitors From Other Causes. Kidney Int Rep 2023; 8:672-675. [PMID: 36938095 PMCID: PMC10014382 DOI: 10.1016/j.ekir.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- J. Casals
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - Y. Acosta
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - G. Caballero
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - L. Morantes
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - C. Zamora
- Department of Medical Oncology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - M. Xipell
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - Margarita Viladot
- Department of Medical Oncology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - E. Guillen
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - G. Piñeiro
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - M. Blasco
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
| | - J. Marco
- Department of Medical Oncology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J. Padrosa
- Department of Medical Oncology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - A. Pereira
- Department of Hematology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Kenar D. Jhaveri
- Division of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - L.F. Quintana
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Department of Medicine, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
- Correspondence: Luis F. Quintana, Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain.
| | - A. García-Herrera
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España, Barcelona, Spain
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