ABSTRACT
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) as a systemic disorder represents a special subgroup among patients with end-stage renal disease (ESRD). The different organ manifestations are potential risk factors for cardiovascular events or infections in the course after renal transplantation. Therefore, a long-term evaluation of ADPKD patients and of a control group was done. PATIENTS AND METHODS: 80 ADPKD patients were compared with 88 non-diabetic patients in a retrospective follow-up after renal transplantation. Patient and graft survival (1, 5 and 10 years after transplantation) as well as complications such as infections and cardiovascular events were evaluated. RESULTS: A comparable overall transplant (1 year, 5 years, 10 years: 83%, 73%, 67% ADPKD vs. 84%, 70%, 51% controls) and patient survival rate (1 year, 5 years, 10 years: 96%, 84%, 73% ADPKD vs. 91%, 79%, 58% controls) was found in both groups. Infectious complications with the exception of urinary tract infections (UTIs: ADPKD 42.5% vs. 26%) were diagnosed in similar frequency in the graft recipients. ADPKD patients were significantly more affected by UTIs than their control group (p < 0.05) and tended to suffer more often from lethal infections (ADPKD 7 vs. controls 3), but without statistical significance. Cardiovascular events were not observed to be significantly different between both groups (ADPKD 3 vs. controls 4). An obvious difference was found in patient (p < 0.01) and transplant survival rates (p < 0.05) of male and female ADPKD patients. The female group showed a significantly better outcome. CONCLUSIONS: The overall patient and graft survival rates did not differ between the ADPKD and control groups. The better outcome of female ADPKD graft recipients compared to the male group may be related to a gender-dependent disease severity, possibly due to hormonal effects. As UTIs and lethal septicemia were the leading complications in ADPKD patients, a careful monitoring for infections is important in the post-transplant follow-up.
Subject(s)
Kidney Failure, Chronic/etiology , Kidney Transplantation/mortality , Myocardial Ischemia/epidemiology , Polycystic Kidney, Autosomal Dominant/surgery , Adult , Comorbidity , Female , Graft Survival , Humans , Hypertension/complications , Hypertension/epidemiology , Kidney Failure, Chronic/surgery , Male , Middle Aged , Myocardial Ischemia/etiology , Myocardial Ischemia/mortality , Neoplasms/epidemiology , Neoplasms/etiology , Polycystic Kidney, Autosomal Dominant/complications , Polycystic Kidney, Autosomal Dominant/epidemiology , Postoperative Complications/epidemiology , Retrospective Studies , Survival RateSubject(s)
Mutation , Polycystic Kidney, Autosomal Dominant/genetics , Polymorphism, Genetic , Proteins/genetics , DNA Mutational Analysis , Europe , Female , Genetic Heterogeneity , Genetic Linkage/genetics , Genotype , Humans , Male , Microsatellite Repeats , Peptidyl-Dipeptidase A/genetics , TRPP Cation ChannelsSubject(s)
Cornea/growth & development , Corneal Transplantation , Adult , Humans , Infant , Microscopy, Electron , Tissue DonorsABSTRACT
The distribution of fluorescein introduced into the vitreous or respectively the anterior chamber with and without induced ocular hypertension was investigated. In frozen sections it can be seen clearly that with induced hypertension fluid is forced out of the vitreous into the anterior chamber. An important point is that there was no direct discharge of fluorescein into the choroid.
