impact of hepatitis b infection on outcome of kidney transplantation: a long-term study

With the success of kidney transplantation, liver disease has emerged as an important cause of morbidity and mortality in kidney recipients. To determine the impact of hepatitis B virus [HBV] infection on patients and graft survival in both short- and long-terms. 99 renal transplant patients infected with HBV on follow-up in two major transplant centers were included in a retrospective study. These patients were grafted between 1986 and 2005 and divided into two groups: [1] those only positive for hepatitis B surface antigen [HBsAg] and [2] those who were also positive for hepatitis C virus antibodies [HCV Ab]. There were 88 patients with HBsAg[+] and 11 with both HBsAg[+] and HCV Ab[+]. The mean +/- SD age of patients was 38.8 +/- 13.2 years, and the median follow-up after transplantation was 19 months. Although not significant, the allograft survival rate in the first group [HBV[+] was better compared to that in the second group [HBV[+] and HCV[+]; 1, 5 and 10 years graft survival rates were 91, 77 and 62 in the first group and 70, 56 and 28 in the second group, respectively [P=0.07]. The overall mortality was 5% [4 of 88] in the first and 27% [3 of 11] in the second group [P=0.02]. Renal allograft recipients with HBV and HCV infections has a poor survival rate compared to pa- tients with only HBV infection. However, there is no significant difference in terms of renal graft survival between the two groups

[Importance of high C-reactive protein in patients with chronic renal disease]

An elevated serum C reactive protein [CRP] has been shown to be strongly predictive of morbidity and mortality in dialysis patients. However, little information is available regarding CRP levels in predialysis renal failure. The aim of our study was, determine the significance of high CRP levels in pre dialysis patients. In a cross- sectional study 100 pre dialysis patients were studied. The CRP levels, nutritional data [body mass index [BMI], serum albumin, cholestrol, triglycerides], hematocrit [HCT], hemoglobin [Hb], serum creatinine, creatinine clearance, urinary protein levels and blood pressure were measured and compared between patients with high [>6mg/l] or low [<6mg/l] CRP levels. In 100 chronic pre dialysis patients mean age was 48/8 +/- 12/8 years. CRP was greater than 6mg/l in 35%. We found some satistical relationship between high serum CRP levels and BMI, creatinine clearance, serum Albumin, serum cholestrol and high blood pressure. The prevalence of inflammation is high in predialysis patients. As occurs in dialysis patients, predialysis inflammation predicts morbidity in pre dialysis stage but further investigation should be done in this regard