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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant III: Nursing Management01:16

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Outcomes for Frail Dialysis Patients Not Referred for Transplantation: A Cohort Study.

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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Reduced Functional Status among Kidney Transplant Recipients over Time and Associated Risks Post-Transplant.

Sage L Dixon1, Karthik K Tennankore1,2, George L Worthen1,2

  • 1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Clinical Transplantation
|October 22, 2025
PubMed
Summary

Reduced functional status (RFS) before kidney transplant increases risks for delayed graft function (DGF), early graft loss (EGL), and all-cause graft loss (ACGL). These risks vary based on recipient characteristics and donor type.

Keywords:
delayed graft functionfunctional statusgraft survivalkidney transplant

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Area of Science:

  • Nephrology
  • Transplant Surgery
  • Public Health

Background:

  • Reduced functional status (RFS) is linked to poorer outcomes post-kidney transplant.
  • The association between RFS and short-term outcomes like delayed graft function (DGF) and early graft loss (EGL) remains unclear.

Purpose of the Study:

  • To investigate the association between RFS and DGF, EGL, and all-cause graft loss (ACGL) in kidney transplant recipients (KTRs).
  • To explore how recipient age, sex, race, donor status, and transplant era modify these risks.

Main Methods:

  • Analysis of adult living and deceased donor KTR data from the SRTR (2000-2017).
  • Utilized multivariable logistic regression and Cox proportional hazards models.
  • Examined RFS (Karnofsky Performance Status ≤50%) against functional independence (KPS 80%-100%).

Main Results:

  • RFS was associated with increased risk of DGF, EGL, and ACGL in both deceased and living donor KTRs.
  • Specific risks were higher in deceased donor recipients.
  • Recipient age, sex, and race modified DGF risk in deceased donors; sex modified EGL risk.
  • Age modified DGF risk and sex modified ACGL risk in living donors.

Conclusions:

  • RFS at kidney transplant has increased and is linked to higher risks of DGF, EGL, and ACGL.
  • Recipient characteristics significantly modify these risks, highlighting the need for personalized risk assessment.