Practice of cardiorenal syndrome treatment among renal transplant patients, single-centre experience

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dc.contributor.advisorSzabó, Réka
dc.contributor.advisordeptÁltalános Orvostudományi Kar::Belgyógyászati Intézet::Nephrológiai Tanszék
dc.contributor.authorGandhi, Natasha
dc.contributor.departmentDE--Általános Orvostudományi Kar
dc.date.accessioned2024-08-16T11:32:44Z
dc.date.available2024-08-16T11:32:44Z
dc.date.created2024-03-31
dc.description.abstractThe term Cardiorenal syndrome has been used to describe the physiological interactions between diseased heart and healthy kidney and vice versa. The leading cause of death after kidney transplantation is due to cardiovascular factors. Based on the new guidelines, sodium-glucose contransporters improve cardiovascular and renal outcomes in both diabetic and non-diabetic patients. Kidney transplant recipients(KTR) have been excluded from landmark trials using SGLT2 inhibitors and the literature on safety and efficacy is scarce. In the course of our work, we aim to present our clinical practice regarding the application of this class of drugs. A regular follow up of 178 kidney transplant recipients was done at our centre. We demonstrate our experience with SGLT2 inhibitors initiated in the case of acute decompensation, requiring acute admission between November 2022 and February 2023 at our department. The average age of patients was 68.5 years, with an average of 7.57 years since transplantation. Mean eGFR was 52 ml/min/m2 (25-68 ml/min2), maintenance immunosuppression was tarolimus+mycofenolic acid in two cases and everolimus + mycofenolic acid in two cases. NTproBNP levels were averaged 20731 ngL (38020-6080 ng/L) on hospital admission, with an ejection fraction of 41.8% (25-54%). The basic therapy of heart failure was titrated to the patients, consisting of a beta blocker, ACE inhibitor, MRA, SGLT2 inhibitor, supplemented by immunosuppression appropriate to the immunological risk, depending on DSA and previous biopsy result. The dry weight of the patients (by an average of 4.3 kg) and thus their volume load decreased, their NtProBNP value decreased 804 ng/L (1700-406 ng/L) after adjusting the therapy. No infectious complications were observed during the study period. As a summary KTRs could benefit from SGLT2 inhibitors, especially because they ahve a high cardiovascular burden, an increased risk of diabetes and suffer from chronic kidney allograft function deterioration.
dc.description.courseáltalános orvos
dc.description.courselangangol
dc.description.degreeegységes, osztatlan
dc.format.extent28
dc.identifier.urihttps://hdl.handle.net/2437/379035
dc.language.isoen
dc.rights.accessHozzáférhető a 2022 decemberi felsőoktatási törvénymódosítás értelmében.
dc.subjectSglt2 inhibitors
dc.subjectCardiorenal syndrome
dc.subject.dspaceMedicine
dc.titlePractice of cardiorenal syndrome treatment among renal transplant patients, single-centre experience
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