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After successful kidney transplantation, the recovery of exocrine and endocrine kidney function occurs. Serum calcium, parathyroid hormone (PTH) phosphate, fibroblast growth factor 23 (FGF-23) and vitamin D values normalize. Therefore, positive changes in bone metabolism improve bone quality, reducing the frequency of fractures and vascular calcifications. In some patients, despite successful transplantation, disorders in bone metabolism remain. The incidence of hyperparathyroidism (HPT) after the first year of kidney transplantation ranges from 10-50%. The duration of dialysis and the degree of hyperplasia of the parathyroid glands are risk factors for the development of posttransplant HPT. The treatment of posttransplant HPT includes vitamin D therapy, vitamin D analogs, calcimimetics and parathyroidectomy (PTX). [ABSTRACT FROM AUTHOR]

Cilj: Važnost i uloga antitijela usmjerenih protiv humanih leukocitnih antigena (HLA) u reakcijama odbacivanja posredovanih antitijelima nakon transplantacije solidnih organa danas je jasno dokazana. Smatra se da su i antitijela usmjerena na antigene koji nisu dio sustava HLA, tzv. antitijela non-HLA, također povezana s humoralnim odbacivanjem te da mogu utjecati na preživljenje presatka. Prisutnost antitijela non-HLA dodatno ukazuje na bolesnike s povećanim imunološkim rizikom prije i nakon transplantacije organa. Cilj rada bio je odrediti prisutnost antitijela non-HLA u skupinama bolesnika prije i nakon transplantacije bubrega, odrediti njihovu učestalost pojavljivanja validiranim testovima probira te verificirati analizu rezultata. Ispitanici i metode: Analiza prisutnosti antitijela non-HLA provedena je u 17 visoko HLA-senzibiliziranih bolesnika na listi čekanja za transplantaciju bubrega (skupina pre-tx) i u 10 bolesnika s transplantiranim bubregom (skupina post-tx) čiji nalazi biopsija ukazuju na humoralno odbacivanje, a bez dokazanih prisutnih donor-specifičnih antitijela HLA (DSA). Za određivanje antitijela non-HLA korišten je test temeljen na tehnologiji Luminex koji omogućuje izravnu simultanu detekciju antitijela IgG protiv 60 različitih antigena non-HLA. Rezultati: Prisutnost antitijela non-HLA najmanje jedne specifičnosti dokazana je u 16/17 (94,1%) primatelja pre-tx skupine te u 7/10 (77,0%) primatelja post-tx skupine. Vrijednosti intenziteta fluorescencije pozitivnih reakcija bile su statistički značajno više u pre-tx skupini u usporedbi s post-tx skupinom. Broj specifičnosti antitijela non-HLA određenih po pojedinom primatelju bio je veći u pre-tx skupini. Zaključak: Test omogućuje vrlo osjetljivo dokazivanje prisutnosti i specifičnosti antitijela non-HLA. Prisutnost antitijela non-HLA visoka je u obje ispitivane skupine, a broj specifičnosti i intenzitet pozitivnih reakcija značajno je veći u visoko HLA-senzibiliziranih primatelja. Biopsijom dokazano humoralno odbacivanje bez prisutnih HLA DSA može biti povezano s antitijelima non-HLA u post-tx skupini.

Multisystem inflammatory syndrome after COVID-19 (MIS-A) is a consequence of an abnormal inflammatory response after COVID-19 resolution. Current criteria for diagnosis consist of the involvement of several organ systems. We present two cases, one in an immunosuppressed kidney transplant recipient and one in a patient on hemodialysis currently not on immunosuppression. The different clinical presentations and disease development may indicate that the current criteria for MIS-A diagnosis may be inadequate for immunosuppressed patients, as chronic immunosuppression may alter disease presentation. Both patients were treated with corticosteroids and intravenous immunoglobulins, and in both cases the treatment resulted in a prompt resolution of symptoms and stabilization of inflammatory parameters. [ABSTRACT FROM AUTHOR]

Introduction/Aim. Patients who undergo kidney transplantation can encounter significant changes in body composition because of weight gain caused by fat mass accumulation and muscle mass loss, resulting in poor graft outcomes. The study aimed to investigate the impact of different obesity parameters on graft function in kidney transplant recipients. Methods. A cross-sectional study was conducted on 80 kidney transplant patients aged 25 - 75 years (40% females). All were on triple immunosuppressive therapy. Weight, height, waist, and hip circumferences measurements were taken to calculate body mass index (BMI) and waist-to-hip ratio (WHR). Body fat percentage (BF%) was measured using a 4-site skinfold method calculated through the Jackson-Pollock equation utilizing a Cescorf caliper. The patients were divided into two groups depending on their glomerular filtration rate (GFR). Results. BMI showed that 16.28% of males and 10% of females were obese. However, according to BF%, as many as 44.68% of males and 72.72% of females were obese. Statistically significant differences in BMI, WHR, and BF% were observed among patients with normal and lower GFR. After adjustment for covariables, lower GFR was related to higher levels of all obesity parameters. The combination of central obesity (WHR>0.85 for women and > 0.9 for men) and higher BF% was associated with lower GFR compared with that in lean subjects (p < 0.001 for both groups). Conclusion. High BF% and WHR may be important risk factors for reducing GFR in kidney transplant recipients. [ABSTRACT FROM AUTHOR]