학술논문

Renal transplantation in Bardet-Biedl Syndrome.
Document Type
Article
Source
Pediatric Nephrology. Nov2016, Vol. 31 Issue 11, p2153-2161. 9p. 3 Charts, 1 Graph.
Subject
*TREATMENT of chronic kidney failure
*KIDNEY abnormalities
*CHRONIC kidney failure
*FISHER exact test
*GLOMERULAR filtration rate
*GRAFT versus host reaction
*KIDNEY transplantation
*LAURENCE-Moon-Biedl syndrome
*METABOLIC disorders
*OBESITY
*PROBABILITY theory
*BODY mass index
*TREATMENT effectiveness
*DATA analysis software
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*LOG-rank test
*MANN Whitney U Test
*DISEASE complications
Language
ISSN
0931-041X
Abstract
Background: Renal anomalies are common in patients with Bardet-Biedl syndrome (BBS), a renal cystic ciliopathy with multi-systemic features. Renal transplantation is indicated in cases of end-stage renal disease (ESRD), but transplant centers may be hesitant to perform the necessary transplant in light of the multitude of metabolic comorbidities these patients often face with the potential to complicate outcomes. Methods: Data from the Clinical Registry Investigating BBS (CRIBBS) were used to investigate renal transplant outcomes in the largest BBS cohort described to date. Results: Of the 206 patients enrolled in the CRIBBS, 21 children (10.2 %; 16 girls, 5 boys; median age 8.4 years) had been diagnosed with ESRD. Renal transplantation was performed in 18 of these individuals between 1982 and 2015, including repeat transplantation in some cases, for a total of 22 kidneys. Overall graft survival was 81.6 % at 1 year post-transplantation, 75.7 % at 5 years, 59 % at 10 years, and 49.2 % at 25 years. Patient survival was 94.4 % at 1 year post-transplantation, 87.2 % at 8 years, and 79.3 % at 25 years. Conclusions: At a median follow-up time of 97 months, relatively few complications of renal transplantation were reported in the patients of this study. However, body mass index was significantly elevated in transplanted individuals compared to non-transplanted individuals participating in CRIBBS at the most recent follow-up. Although the frequency of obesity and other manifestations of the metabolic syndrome warrant meticulous management in this high-risk population, favorable long-term outcomes suggest that renal transplantation is a viable option for patients with BBS and ESRD. [ABSTRACT FROM AUTHOR]