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Article ; Online: Strategiewechsel zur minimal-invasiven Ösophagektomie – Ergebnisse an einem zertifizierten Zentrum.

Merboth, Felix / Hasanovic, Jasmin / Stange, Daniel / Distler, Marius / Kaden, Sandra / Weitz, Jürgen / Welsch, Thilo

Chirurgie (Heidelberg, Germany)

2021 Volume 93, Issue 7, Page(s) 694–701

Abstract: Background: There are indications that robot-assisted minimally invasive esophagectomy (RAMIE) can reduce the morbidity compared with the conventional operative technique.: Objective: A comparative analysis of a single-center change in strategy of ... ...

Title translation	Change of strategy to minimally invasive esophagectomy-Results at a certified center.
Abstract	Background: There are indications that robot-assisted minimally invasive esophagectomy (RAMIE) can reduce the morbidity compared with the conventional operative technique. Objective: A comparative analysis of a single-center change in strategy of the standard from open esophagectomy to RAMIE with perioperative, enteral, selective bowel decontamination (SBD) was carried out. Material and methods: Patient and morbidity data after elective RAMIE treated according to the novel standard management between July 2018 and September 2020 were compared retrospectively with an historical control cohort after open esophagectomy between January 2014 and June 2018. A 1:1 propensity score matching (PSM) analysis was performed. Results: A total of 75 patients could be analyzed in both groups after PSM. Approximately two thirds of the operations were carried out due to an adenocarcinoma and one third due to a squamous cell carcinoma. The median number of resected lymph nodes was 22 and 21, respectively. In the RAMIE group the intrathoracic esophagogastrostomy was performed using a circular stapler with a diameter of ≥28 mm in 97%, whereas a 25 mm stapler was used in 90% in the control group. The operative time was longer (median 490min vs. 339 min, p < 0.001) but in contrast blood loss (median 300ml vs. 500 ml, p < 0.001), anastomotic leaks (8.0% vs. 25.3%, p = 0.004), surgical site infections (4.0% vs. 17.3%, p = 0.008) and pulmonary complication rates (29.3% vs. 44.0%, p = 0.045) as well as the median hospital stay (14 days vs. 20 days, p < 0.001) and 90-day mortality were significantly reduced compared with the open control group (4.0% vs. 13.3%, p = 0.039). Conclusion: A consistent change of the perioperative management including RAMIE and SBD can lead to a stable reduction of morbidity without compromising oncological radicalness.
MeSH term(s)	Esophageal Neoplasms/surgery ; Esophagectomy/methods ; Humans ; Lymph Node Excision/methods ; Retrospective Studies ; Robotic Surgical Procedures/adverse effects
Language	German
Publishing date	2021-12-21
Publishing country	Germany
Document type	Journal Article
ISSN	2731-698X
ISSN (online)	2731-698X
DOI	10.1007/s00104-021-01550-2
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Article: Eleven years intraoperative ATG bolus. A list of successes.

Kaden, Jürgen

Annals of transplantation

2002 Volume 7, Issue 3, Page(s) 4–10

Abstract: Induction therapy for organ transplantation using monoclonal antibodies has been in recent years reevaluated. Results from various centers indicate the value of such therapy, especially in sensitized patients undergoing kidney transplantation as well as ... ...

Abstract	Induction therapy for organ transplantation using monoclonal antibodies has been in recent years reevaluated. Results from various centers indicate the value of such therapy, especially in sensitized patients undergoing kidney transplantation as well as in simultaneous kidney--pancreas transplant patients. Author presents the experience of eleven years of intraoperative ATG bolus administration in the Berlin--Friedrichshain Kidney Transplantation Center.
MeSH term(s)	Animals ; Antibodies, Monoclonal/therapeutic use ; Antibody Formation ; Antibody Specificity ; Antilymphocyte Serum/administration & dosage ; Antilymphocyte Serum/therapeutic use ; Humans ; Immunity, Cellular ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/therapeutic use ; Intraoperative Care ; Kidney Transplantation/immunology
Chemical Substances	Antibodies, Monoclonal ; Antilymphocyte Serum ; Immunosuppressive Agents
Language	English
Publishing date	2002
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1484710-3
ISSN	1425-9524
ISSN	1425-9524
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Article ; Online: Selective decontamination of the digestive tract in colorectal surgery reduces anastomotic leakage and costs: a propensity score analysis.

Bogner, Andreas / Stracke, Maximilian / Bork, Ulrich / Wolk, Steffen / Pecqueux, Mathieu / Kaden, Sandra / Distler, Marius / Kahlert, Christoph / Weitz, Jürgen / Welsch, Thilo / Fritzmann, Johannes

Langenbeck's archives of surgery

2022 Volume 407, Issue 6, Page(s) 2441–2452

Abstract: Purpose: Anastomotic leakage (AL) and surgical site infection (SSI) account for most postoperative complications in colorectal surgery. The aim of this retrospective trial was to investigate whether perioperative selective decontamination of the ... ...

Abstract	Purpose: Anastomotic leakage (AL) and surgical site infection (SSI) account for most postoperative complications in colorectal surgery. The aim of this retrospective trial was to investigate whether perioperative selective decontamination of the digestive tract (SDD) reduces these complications and to provide a cost-effectiveness model for elective colorectal surgery. Methods: All patients operated between November 2016 and March 2020 were included in our analysis. Patients in the primary cohort (PC) received SDD and those in the historical control cohort (CC) did not receive SDD. In the case of rectal/sigmoid resection, SDD was also applied via a transanally placed Foley catheter (TAFC) for 48 h postoperatively. A propensity score-matched analysis was performed to identify risk factors for AL and SSI. Costs were calculated based on German diagnosis-related group (DRG) fees per case. Results: A total of 308 patients (154 per cohort) with a median age of 62.6 years (IQR 52.5-70.8) were analyzed. AL was observed in ten patients (6.5%) in the PC and 23 patients (14.9%) in the CC (OR 0.380, 95% CI 0.174-0.833; P = 0.016). SSI occurred in 14 patients (9.1%) in the PC and 30 patients in the CC (19.5%), representing a significant reduction in our SSI rate (P = 0.009). The cost-effectiveness analysis showed that SDD is highly effective in saving costs with a number needed to treat of 12 for AL and 10 for SSI. Conclusion: SDD significantly reduces the incidence of AL and SSI and saves costs for the general healthcare system.
MeSH term(s)	Aged ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Anti-Bacterial Agents/therapeutic use ; Colorectal Surgery ; Decontamination ; Elective Surgical Procedures/adverse effects ; Gastrointestinal Tract ; Humans ; Middle Aged ; Propensity Score ; Retrospective Studies ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-05-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02540-6
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Article ; Online: Dynamics and Diagnostic Relevance of Kynurenine Serum Level after Kidney Transplantation.

Kaden, Jürgen / Abendroth, Dietmar / Völp, Andreas / Marzinzig, Michael

Annals of transplantation

2015 Volume 20, Page(s) 327–337

Abstract: Background: Inflammatory events after kidney transplantation (Tx) may lead to activation of the tryptophane-catabolizing enzyme indoleamine 2,3-dioxygenase followed by the formation of kynurenine (KYN). Post-transplant KYN serum levels in kidney ... ...

Abstract	Background: Inflammatory events after kidney transplantation (Tx) may lead to activation of the tryptophane-catabolizing enzyme indoleamine 2,3-dioxygenase followed by the formation of kynurenine (KYN). Post-transplant KYN serum levels in kidney allograft recipients were analyzed for their diagnostic value. Material and methods: This was a retrospective analysis of KYN levels (normal value: 2.7±0.6 nmol/ml) measured in 4083 blood samples collected from 355 kidney graft recipients in connection with uncomplicated courses, acute rejections (ARs), infections, and type of immunosuppression. We performed descriptive data analysis and analysis of variance. Results: In 212 recipients with immediately functioning grafts, the KYN levels dropped from pre-Tx 13.3±5.9 nmol/ml to nearly normal values at day 5 (5.8±3.0 nmol/ml). In patients with delayed graft function, the KYN reduction started only after the last hemodialysis treatment. With respect to ARs in recipients with creatinine values <300 µmol/l pre-AR, the increase of KYN levels depended on the severity of ARs (steroid-sensitive ARs: from 4.5±1.4 to 6.0±6.1 nmol/ml; steroid-resistant ARs: from 6.1±3.1 to 12.9±7.1 nmol/ml; vascular rejections: from 5.8±3.0 to 16.9±9.1 nmol/ml). In patients with creatinine values ≥300 µmol/l pre-AR, a further increase of the KYN level (from 10.1 to 13.2 nmol/ml) was only observed in severe, steroid-resistant ARs. With respect to infections evaluated, the KYN levels before diagnosis/start of treatment were 5.7±3.4 nmol/ml in asymptomatic CMV infections, 7.5±4.4 nmol/ml in CMV diseases, 8.3±3.3 nmol/ml in pneumonia, and 10.4±6.5 nmol/ml in bacterial sepsis. Conclusions: Serum KYN seems to be a reliable diagnostic tool for the assessment of post-transplant inflammatory complications, already in an early stage, and for monitoring the efficacy of therapeutic interventions. Prospective studies are recommended.
MeSH term(s)	Adult ; Female ; Graft Rejection/blood ; Graft Rejection/diagnosis ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney Transplantation/methods ; Kynurenine/blood ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Immunosuppressive Agents ; Kynurenine (343-65-7)
Language	English
Publishing date	2015-06-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1484710-3
ISSN	2329-0358 ; 1425-9524
ISSN (online)	2329-0358
ISSN	1425-9524
DOI	10.12659/AOT.893721
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Article ; Online: Determination of the pH Gradient in Hair Follicles of Human Volunteers Using pH-Sensitive Melamine Formaldehyde-Pyranine Nile Blue Microparticles.

Kaden, Dennis / Dähne, Lars / Knorr, Fanny / Richter, Heike / Lademann, Jürgen / Meinke, Martina C / Patzelt, Alexa / Darvin, Maxim E / Jung, Sora

Sensors (Basel, Switzerland)

2020 Volume 20, Issue 18

Abstract: Nanoparticles can be applied to the hair follicles, which can serve as reservoirs for triggered drug release. A valid measurement method for the determination of the pH within the hair follicle in vivo has not been shown yet. Here, melamine formaldehyde ... ...

Abstract	Nanoparticles can be applied to the hair follicles, which can serve as reservoirs for triggered drug release. A valid measurement method for the determination of the pH within the hair follicle in vivo has not been shown yet. Here, melamine formaldehyde particles up to 9 µm in size were applied on 40 freshly plucked scalp hairs of eight individuals to determine the pH along the hair shaft down to the root area of the hair. For fluorescent pH indicators, pyranine and Nile blue were incorporated into the particles. Measurements were conducted using confocal laser scanning microscopy. A pH decay gradient could be found from the hair sheath towards the external hair shaft (
MeSH term(s)	Arylsulfonates ; Hair Follicle/chemistry ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Microscopy, Confocal ; Oxazines ; Proton-Motive Force ; Triazines
Chemical Substances	Arylsulfonates ; Oxazines ; Triazines ; melamine formaldehyde ; Nile Blue (2381-85-3) ; pyranine (I2W85YOX9L)
Language	English
Publishing date	2020-09-14
Publishing country	Switzerland
Document type	Letter
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s20185243
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Article ; Online: Massilia norwichensis sp. nov., isolated from an air sample.

Orthová, Ivana / Kämpfer, Peter / Glaeser, Stefanie P / Kaden, René / Busse, Hans-Jürgen

International journal of systematic and evolutionary microbiology

2014 Volume 65, Issue Pt 1, Page(s) 56–64

Abstract: A Gram-negative, rod-shaped and motile bacterial isolate, designated strain NS9(T), isolated from air of the Sainsbury Centre for Visual Arts in Norwich, UK, was subjected to a polyphasic taxonomic study including phylogenetic analyses based on partial ... ...

Abstract	A Gram-negative, rod-shaped and motile bacterial isolate, designated strain NS9(T), isolated from air of the Sainsbury Centre for Visual Arts in Norwich, UK, was subjected to a polyphasic taxonomic study including phylogenetic analyses based on partial 16S rRNA, gyrB and lepA gene sequences and phenotypic characterization. The 16S rRNA gene sequence of NS9(T) identified Massilia haematophila CCUG 38318(T), M. niastensis 5516S-1(T) (both 97.7% similarity), M. aerilata 5516S-11(T) (97.4%) and M. tieshanensis TS3(T) (97.4%) as the next closest relatives. In partial gyrB and lepA sequences, NS9(T) shared the highest similarities with M. haematophila CCUG 38318(T) (94.5%) and M. aerilata 5516-11(T) (94.3%), respectively. These sequence data demonstrate the affiliation of NS9(T) to the genus Massilia. The detection of the predominant ubiquinone Q-8, a polar lipid profile consisting of the major compounds diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol and a polyamine pattern containing 2-hydroxyputrescine and putrescine were in agreement with the assignment of strain NS9(T) to the genus Massilia. Major fatty acids were summed feature 3 (C16:1ω7c and/or iso-C15 : 0 2-OH), C16:0, C18: 1ω7c and C10:0 3-OH. Dissimilarities in partial lepA and gyrB gene sequences as well as results from DNA-DNA hybridizations demonstrate that strain NS9(T) is a representative of an as-yet undescribed species of the genus Massilia that is also distinguished from its close relatives based on physiological and biochemical traits. Hence, we describe a novel species, for which we propose the name Massilia norwichensis sp. nov., with the type strain NS9(T) ( = CCUG 65457(T) =LMG 28164(T)).
MeSH term(s)	Air Microbiology ; Bacterial Typing Techniques ; Base Composition ; DNA, Bacterial/genetics ; Fatty Acids/chemistry ; Genes, Bacterial ; Molecular Sequence Data ; Nucleic Acid Hybridization ; Oxalobacteraceae/classification ; Oxalobacteraceae/genetics ; Oxalobacteraceae/isolation & purification ; Phylogeny ; Putrescine/analogs & derivatives ; Putrescine/chemistry ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Ubiquinone/chemistry ; United Kingdom
Chemical Substances	DNA, Bacterial ; Fatty Acids ; RNA, Ribosomal, 16S ; Ubiquinone (1339-63-5) ; 2-hydroxyputrescine (539-59-3) ; ubiquinone 8 (CQA993F7P8) ; Putrescine (V10TVZ52E4)
Language	English
Publishing date	2014-10-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2002336-4
ISSN	1466-5034 ; 1466-5026
ISSN (online)	1466-5034
ISSN	1466-5026
DOI	10.1099/ijs.0.068296-0
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Article ; Online: High graft protection and low incidences of infections, malignancies and other adverse effects with intra-operative high dose ATG-induction: a single centre cohort study of 760 cases.

Kaden, Jürgen / Völp, Andreas / Wesslau, Claus

Annals of transplantation

2013 Volume 18, Page(s) 9–22

Abstract: Background: In 1990 we introduced the intra-operative single high-dose induction (HDI) with ATG-Fresenius as a novel renal sparing concept. The aim of this analysis was to compare both the long-term patient and graft survival and the incidences of ... ...

Abstract	Background: In 1990 we introduced the intra-operative single high-dose induction (HDI) with ATG-Fresenius as a novel renal sparing concept. The aim of this analysis was to compare both the long-term patient and graft survival and the incidences of adverse effects in recipients treated with standard triple-drug therapy (TDT) alone or with an additional HDI with ATG-F. Material and methods: A total of 760 renal transplant recipients receiving either TDT, consisting of steroids, azathioprine and cyclosporine (n=238) or TDT + 9mg/kg ATG-F intra-operatively (n=522) were included in this retrospective analysis. Results: Compared to the TDT cohort the graft and patient survival over the entire ten year period was significantly prolonged in the TDT+HDI cohort. In contrast, main adverse effects (TDT+HDI vs. TDT) such as malignancies (4.4 vs. 2.1%), PTLD (0.4 vs. 0.4%), CMV diseases (18.6 vs. 15.5%), Herpes zoster infections (2.9 vs. 1.3%), bacterial pneumonias (3.1 vs. 1.3%) and post-operative thrombocytopenia <50×10³/µl (0.5 vs. 1.3%) did not significantly differ between the two immunosuppressive regimens. Only CMV-IgM seroconversions occurred significantly more in the HDI cohort (39.3 vs. 23.5%). The absolute numbers of CD3, CD4 and CD8 cell counts were significantly reduced in TDT+ATG-F HDI cohort only over a time period of about five days. Conclusions: This world-wide largest single-centre cohort analysis clearly shows the superiority of the HDI with ATG-F compared to TDT alone in improving long-term graft survival without increasing the risk for infections, malignancies or other adverse effects.
MeSH term(s)	Adult ; Antilymphocyte Serum/administration & dosage ; Azathioprine/administration & dosage ; Cohort Studies ; Cyclosporine/administration & dosage ; Cytomegalovirus Infections/prevention & control ; Female ; Graft Survival ; Humans ; Immunosuppressive Agents/administration & dosage ; Intraoperative Period ; Kaplan-Meier Estimate ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Lymphoproliferative Disorders/prevention & control ; Male ; Middle Aged ; Neoplasms/prevention & control ; Retrospective Studies ; Steroids/administration & dosage ; T-Lymphocytes/immunology ; Young Adult
Chemical Substances	Antilymphocyte Serum ; Immunosuppressive Agents ; Steroids ; Cyclosporine (83HN0GTJ6D) ; Azathioprine (MRK240IY2L)
Language	English
Publishing date	2013-01-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1484710-3
ISSN	2329-0358 ; 1425-9524
ISSN (online)	2329-0358
ISSN	1425-9524
DOI	10.12659/AOT.883792
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Article: Massilia norwichensis sp. nov., isolated from an air sample

Orthová, Ivana / Kämpfer, Peter / Glaeser, Stefanie P / Kaden, René / Busse, Hans-Jürgen

International journal of systematic and evolutionary microbiology. 2015 Jan., v. 65, no. Pt 1

2015

Abstract: A Gram-negative, rod-shaped and motile bacterial isolate, designated strain NS9 ᵀ, isolated from air of the Sainsbury Centre for Visual Arts in Norwich, UK, was subjected to a polyphasic taxonomic study including phylogenetic analyses based on partial ... ...

Abstract	A Gram-negative, rod-shaped and motile bacterial isolate, designated strain NS9 ᵀ, isolated from air of the Sainsbury Centre for Visual Arts in Norwich, UK, was subjected to a polyphasic taxonomic study including phylogenetic analyses based on partial 16S rRNA, gyrB and lepA gene sequences and phenotypic characterization. The 16S rRNA gene sequence of NS9 ᵀ identified Massilia haematophila CCUG 38318 ᵀ, M. niastensis 5516S-1 ᵀ (both 97.7 % similarity), M. aerilata 5516S-11 ᵀ (97.4 %) and M. tieshanensis TS3 ᵀ (97.4 %) as the next closest relatives. In partial gyrB and lepA sequences, NS9 ᵀ shared the highest similarities with M. haematophila CCUG 38318 ᵀ (94.5 %) and M. aerilata 5516-11 ᵀ (94.3 %), respectively. These sequence data demonstrate the affiliation of NS9 ᵀ to the genus Massilia . The detection of the predominant ubiquinone Q-8, a polar lipid profile consisting of the major compounds diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol and a polyamine pattern containing 2-hydroxyputrescine and putrescine were in agreement with the assignment of strain NS9 ᵀ to the genus Massilia . Major fatty acids were summed feature 3 (C ₁₆ : ₁ω7 c and/or iso-C ₁₅ : ₀ 2-OH), C ₁₆ : ₀, C ₁₈ : ₁ω7 c and C ₁₀ : ₀ 3-OH. Dissimilarities in partial lepA and gyrB gene sequences as well as results from DNA–DNA hybridizations demonstrate that strain NS9 ᵀ is a representative of an as-yet undescribed species of the genus Massilia that is also distinguished from its close relatives based on physiological and biochemical traits. Hence, we describe a novel species, for which we propose the name Massilia norwichensis sp. nov., with the type strain NS9 ᵀ (= CCUG 65457 ᵀ = LMG 28164 ᵀ).
Keywords	Massilia ; air ; fatty acids ; microbiology ; nucleic acid hybridization ; nucleotide sequences ; phosphatidylethanolamines ; phylogeny ; polyamines ; putrescine ; ribosomal RNA ; ubiquinones ; United Kingdom
Language	English
Dates of publication	2015-01
Size	p. 56-64.
Publishing place	International Union of Microbiological Societies
Document type	Article
ZDB-ID	2002336-4
ISSN	1466-5034 ; 1466-5026
ISSN (online)	1466-5034
ISSN	1466-5026
DOI	10.1099/ijs.0.068296-0
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Article ; Online: Causes and prognostic value of pre-transplant elevated kynurenine level in kidney allograft recipients.

Kaden, Jürgen / Abendroth, Dietmar / Völp, Andreas / Marzinzig, Michael / Wesslau, Claus

Annals of transplantation

2014 Volume 19, Page(s) 51–59

Abstract: Background: The activation of the tryptophane catabolizing enzyme Indoleamine 2,3-dioxygenase leads to the formation of kynurenine and other metabolites that counter-regulate immune activation resulting in restoration of immune homeostasis. But in ... ...

Abstract	Background: The activation of the tryptophane catabolizing enzyme Indoleamine 2,3-dioxygenase leads to the formation of kynurenine and other metabolites that counter-regulate immune activation resulting in restoration of immune homeostasis. But in chronic immune activation, as in hemodialysed patients, the immunosuppressive feedback mechanisms continue as indicated by elevated kynurenine concentrations. However, its relevance is still a matter of debate. Material/methods: This retrospective analysis presents the pre-transplant kynurenine levels (quantified photometrically) of 307 kidney graft recipients in connection with some pre- and post-transplant variables and the type of immunosuppression (cyclosporine-based triple drug therapy without/with ATG-Fresenius-induction). Statistical analyses performed were analysis of variance, Scheffé's test for pairwise comparisons, Cox regression, Spearman's rank correlation, and extended segmentation analysis. Results: The pre-transplant kynurenine level was significantly elevated as compared to healthy adults (14.1±5.9 vs. 2.7±0.6 nmol/ml, p<0.0001), significantly higher in PRA positive than in PRA negative patients (16.1 vs. 12.9 nmol/ml, p<0.001) and, supporting this observation, also higher (p<0.0001) in a cohort with predominant (89.7%) pre-sensitized patients (16.4±6.4 nmol/ml) having the longest time on the waiting list (median 39 months) as compared to cohorts with fewer (16.8-22%) pre-sensitized patients (12.7±4.4 resp. 13.4±5.8 nmol/ml) having shorter times on the waiting list (16-24 months). Patients with immediately functioning grafts showed a lower pre-transplant kynurenine level than patients with non-immediately functioning grafts (13.5±6.0 vs. 14.9±5.7 nmol/ml, p=0.053). No associations were found with basic diseases, rejections, or graft survival. Conclusions: The pre-transplant elevated serum kynurenine levels were highly associated with the patient's pre-sensitization status and their longer time on hemodialysis treatments, but did not allow prognostic assessments.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Graft Rejection/drug therapy ; Graft Rejection/immunology ; Graft Rejection/metabolism ; Graft Survival/immunology ; Humans ; Immunity, Innate/immunology ; Immunosuppressive Agents/therapeutic use ; Kidney/immunology ; Kidney/metabolism ; Kidney Transplantation ; Kynurenine/metabolism ; Male ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Prognosis ; Retrospective Studies ; Transplantation, Homologous ; Young Adult
Chemical Substances	Immunosuppressive Agents ; Kynurenine (343-65-7)
Language	English
Publishing date	2014-01-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1484710-3
ISSN	2329-0358 ; 1425-9524
ISSN (online)	2329-0358
ISSN	1425-9524
DOI	10.12659/AOT.889764
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Article ; Online: Serum uromodulin-a marker of kidney function and renal parenchymal integrity.

Scherberich, Jürgen E / Gruber, Rudolf / Nockher, Wolfgang Andreas / Christensen, Erik Ilsø / Schmitt, Hans / Herbst, Victor / Block, Matthias / Kaden, Jürgen / Schlumberger, Wolfgang

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2017 Volume 33, Issue 2, Page(s) 284–295

Abstract: Background: An ELISA to analyse uromodulin in human serum (sUmod) was developed, validated and tested for clinical applications.: Methods: We assessed sUmod, a very stable antigen, in controls, patients with chronic kidney disease (CKD) stages 1-5, ... ...

Abstract	Background: An ELISA to analyse uromodulin in human serum (sUmod) was developed, validated and tested for clinical applications. Methods: We assessed sUmod, a very stable antigen, in controls, patients with chronic kidney disease (CKD) stages 1-5, persons with autoimmune kidney diseases and recipients of a renal allograft by ELISA. Results: Median sUmod in 190 blood donors was 207 ng/mL (women: men, median 230 versus 188 ng/mL, P = 0.006). sUmod levels in 443 children were 193 ng/mL (median). sUmod was correlated with cystatin C (rs = -0.862), creatinine (rs = -0.802), blood urea nitrogen (BUN) (rs = -0.645) and estimated glomerular filtration rate (eGFR)-cystatin C (rs = 0.862). sUmod was lower in systemic lupus erythematosus-nephritis (median 101 ng/mL), phospholipase-A2 receptor- positive glomerulonephritis (median 83 ng/mL) and anti-glomerular basement membrane positive pulmorenal syndromes (median 37 ng/mL). Declining sUmod concentrations paralleled the loss of kidney function in 165 patients with CKD stages 1-5 with prominent changes in sUmod within the 'creatinine blind range' (71-106 µmol/L). Receiver-operating characteristic analysis between non-CKD and CKD-1 was superior for sUmod (AUC 0.90) compared with eGFR (AUC 0.39), cystatin C (AUC 0.39) and creatinine (AUC 0.27). sUmod rapidly recovered from 0 to 62 ng/mL (median) after renal transplantation in cases with immediate graft function and remained low in delayed graft function (21 ng/mL, median; day 5-9: relative risk 1.5-2.9, odds ratio 1.5-6.4). Immunogold labelling disclosed that Umod is transferred within cytoplasmic vesicles to both the apical and basolateral plasma membrane. Umod revealed a disturbed intracellular location in kidney injury. Conclusions: We conclude that sUmod is a novel sensitive kidney-specific biomarker linked to the structural integrity of the distal nephron and to renal function.
MeSH term(s)	Adolescent ; Adult ; Biomarkers/blood ; Case-Control Studies ; Child ; Child, Preschool ; Cohort Studies ; Creatinine/blood ; Cystatin C/blood ; Female ; Glomerular Filtration Rate ; Glomerulonephritis/blood ; Glomerulonephritis/pathology ; Hemorrhage/blood ; Hemorrhage/pathology ; Humans ; Infant ; Lung Diseases/blood ; Lung Diseases/pathology ; Lupus Erythematosus, Systemic/blood ; Lupus Erythematosus, Systemic/pathology ; Lupus Nephritis/blood ; Lupus Nephritis/pathology ; Male ; Middle Aged ; ROC Curve ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/pathology ; Uromodulin/blood ; Young Adult
Chemical Substances	Biomarkers ; Cystatin C ; UMOD protein, human ; Uromodulin ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2017-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfw422
Database	MEDical Literature Analysis and Retrieval System OnLINE

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