https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)60601-1.pdf

Autosomal dominant polycystic kidney disease

Background: The incidence of acute left-sided colonic diverticulitis (ACD) is increasing in the Western world. To improve the quality of patient care, a guideline

/pdf/guidelines-of-diagnostics-and-treatment-of-acute-left-sided-1po8mr4e3z.pdf

Guidelines of Diagnostics and Treatment of Acute Left-Sided Colonic Diverticulitis

Since 1980 the incidence and prevalence of end-stage renal disease have grown each year in Canada and throughout the world. From 1981 to 1999, the number of new patients with the disease increased at a compound annual rate of 7.3%,[1][1] and similar trends have been documented worldwide. By the end

/pdf/canadian-society-of-transplantation-consensus-guidelines-on-yayhulbghq.pdf

Canadian Society of Transplantation: consensus guidelines on eligibility for kidney transplantation.

At a time when the judicious use of a broad range of immunosuppressive drugs has ensured excellent patient and organ survival rates after kidney transplantation, attention is focusing on strategies to minimize their side effects. Almost all immunosuppressive medications are associated with some form

Gastrointestinal complications of transplant immunosuppression.

This clinical practice guideline addresses access to kidney transplantation together with the evaluation, selection and preparation of the potential kidney transplant recipient. Guidance on the medical management of the kidney transplant recipient is provided in another module of the Renal Association guidelines available at www.renal.org. Readers should refer to the joint British Society for Histocompatibility and Immunogenetics/ British Transplantation Society document for guidelines on the detection and characterisation of HLA antibodies in renal transplantation and to the NHS Blood and Transplant/British Transplantation Society guidelines for consent for solid organ transplantation (www.bts.org. uk/standards-and-guidelines.htm) [1]. In this guideline Chronic Kidney Disease stage 5 (CKD 5) includes pre-dialysis and transplant patients with eGFR <15ml/min/1.73m as well as patients on dialysis i.e. CKD 5, CKD 5Tand CKD 5D. This guideline is an updated version of the Renal Association guidance developed by the same lead co-authors published in 2007 and is based on a review of the literature between 2007 and 2010. Where evidence was available from RCTs and systematic reviews recommendations were based on these publications. Where there was a lack of evidence from high-quality studies, recommendations were based on the best available evidence taking in account the previous clinical practice guidelines on evaluation of the potential kidney transplant recipient from North America [2] and the European Renal Best Practice (ERBP) guidelines for renal transplantation [3].

/pdf/renal-association-clinical-practice-guideline-on-the-4wtq5uoi9r.pdf

Renal Association Clinical Practice Guideline on the Assessment of the Potential Kidney Transplant Recipient

Colonic complications after renal transplantation are uncommon but have a high mortality rate. Some have recommended colonic screening in patients over 50 years of age prior to transplantation to lessen the impact of colonic diverticular disease. We report our 9-year experience of colonic screening for diverticular disease in potential recipients over the age of 50 and compare these results to the overall colonic complication rate in the same time period. From 1981-1990, 1186 renal transplants in 1019 patients were performed, during which time all potential recipients over the age of 50 yr were required to undergo colon evaluation prior to transplantation. Twenty cases of diverticular disease were found with more than a quarter of the cases in patients with adult polycystic disease. All underwent renal transplantation without a pre-transplant colectomy, and none had post transplant symptomatic colon disease. During that same time period a total of 14 colonic complications requiring surgical intervention were encountered with a mortality rate of 40%. Acute diverticulitis occurred in 5 patients, all of whom were over 50 yr of age, on low-dose immunosuppression, and in most cases it occurred remotely after transplantation. Colonic dysplasia/neoplasia also occurred remotely after transplantation in 2 patients over the age of 50. Cytomegalovirus (CMV) colitis was the next most common complication, accounting for 3 cases. This complication, which occurred in younger patients, was associated with high-dose steroid immunosuppression and had a high mortality rate, in spite of surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Colonic screening prior to renal transplantation and its impact on post-transplant colonic complications.

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Colonic screening prior to renal transplantation and its impact on post-transplant colonic complications.