TueCF_CAN_5-18-09-Zae-Kim

TueCF_CAN_5-18-09-Zae-Kim - Tuesday Case Conference May...

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Tuesday Case Conference May 2009
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Biopsy finding LM Glomeruli are normal in size to mildly enlarged Mild enlargement of the mesangial areas with occasional nodular appearance Tubulointerstitial Interstitial fibrosis and tubular atrophy, involving approximately 50% Artery Severe intimal fibrosis of arcuate artery Sever cirucumferential hyalinosis of arterioles IF Negative for C4D, BKV, and CMV EM Podocyte effacement invovling ~40% of the surface area Diagnosis: Early Diabetic Nephropathy IFTA related to CNI
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Objectives What are different causes of allograft failure? What is Interstitial Fibrosis and Tubular Atrophy - Chronic Allograft Nephropathy? A new biomarker for IFTA?
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Transplantation The preferred prescription for ESRD patients
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Mortality on Dialysis Annual Death Rate N All dialysis patients 16 per 100 patient years ~300,000 Patients on list 6 per 100 patient years ~50,000 Cadaver transplant patients 3 per 100 patient years ~25,000
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Graft survival increases with less time on dialysis Goldfarb-Rumyantzev A, et al. Nephrol Dial Transplant 2005;20:167–175
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Risk of Death with Transplantation OJO, A. O. et al. J Am Soc Nephrol 2001;12:589-597
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Transplant is preferred prescription of choice for ESRD patients Sooner the better Dramatic improvement, since 1980s, 1- year allograft survival rates: 90-95% Long-term outcomes have changed little
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TueCF_CAN_5-18-09-Zae-Kim - Tuesday Case Conference May...

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