Elias David‐Neto

Universidade de São Paulo

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

William Carlos Nahas

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Fabiana Agena

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Flávio Jota de Paula

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Lígia Câmera Pierrotti

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Maria Cristina Ribeiro de Castro

Universidade de São Paulo

Luiz Estevam Ianhez

Hospital Alemão Oswaldo Cruz

Eduardo Mazzucchi

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Ioannis Antonopoulos

National and Kapodistrian University of Athens

José Otto Reusing

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

E Sabbaga

Universidade de São Paulo

Cooperative Institutions

Universidade de São Paulo

445

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

371

Microsoft (Brazil)

143

New Valve Technology (Germany)

123

University of New Orleans

122

Universidade Brasil

Hospital São Paulo

Universidade Federal de São Paulo

RELX Group (United States)

Hospital Universitário da Universidade de São Paulo

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Recurrence of FSGS after Kidney Transplantation in Adults

Clinical Journal of the American Society of Nephrology (2020)

Audrey Uffing María José Pérez‐Sáez Marilda Mazzali Roberto Ceratti Manfro Andréa Carla Bauer

Background and objectives FSGS recurrence after kidney transplantation is a major risk factor for graft loss. However, the natural history, clinical predictors, and response to treatment remain unclear because of small sample sizes and poor generalizability of single-center studies, and disease misclassification in registry-based studies. We therefore aimed to determine the incidence, predictors, and treatment response of recurrent FSGS in a large cohort of kidney transplant recipients. Design, setting, participants, & measurements The Post-Transplant Glomerular Disease (TANGO) project is an observational, multicenter, international cohort study that aims to investigate glomerular disease recurrence post-transplantation. Transplant recipients were screened for the diagnosis of idiopathic FSGS between 2005 and 2015 and details were recorded about the transplant, clinical outcomes, treatments, and other risk factors. Results Among 11,742 kidney transplant recipients screened for FSGS, 176 had a diagnosis of idiopathic FSGS and were included. FSGS recurred in 57 patients (32%; 95% confidence interval [95% CI], 25% to 39%) and 39% of them lost their graft over a median of 5 (interquartile range, 3.0–8.1) years. Multivariable Cox regression revealed a higher risk for recurrence with older age at native kidney disease onset (hazard ratio [HR], 1.37 per decade; 95% CI, 1.09 to 1.56). Other predictors were white race (HR, 2.14; 95% CI, 1.08 to 4.22), body mass index at transplant (HR, 0.89 per kg/m 2 ; 95% CI, 0.83 to 0.95), and native kidney nephrectomies (HR, 2.76; 95% CI, 1.16 to 6.57). Plasmapheresis and rituximab were the most frequent treatments (81%). Partial or complete remission occurred in 57% of patients and was associated with better graft survival. Conclusions Idiopathic FSGS recurs post-transplant in one third of cases and is associated with a five-fold higher risk of graft loss. Response to treatment is associated with significantly better outcomes but is achieved in only half of the cases.

Interquartile range

10.2215/cjn.08970719

Cite

Citations (137)

Análise de 10 anos de seguimento de transplantesrenais com doador vivo não aparentado

Brazilian Journal of Nephrology (2011)

Gustavo Fernandes Ferreira Igor Denizarde Bacelar Marques Clarice Hyesuk Lee Park David José de Barros Machado Francine Brambate Carvalhinho Lemos

INTRODUÇÃO: No contexto atual da elevada escassez de órgãos para o transplante renal e do reconhecimento cada vez maior da rejeição crônica mediada por anticorpos anti-HLA como uma importante causa de perda do enxerto, uma contínua demonstração da boa evolução a longo prazo de transplantes renais com doadores vivos não aparentados (DVNA) é de suma importância. OBJETIVOS: Analisar a sobrevida do enxerto e dos pacientes transplantados com DVNA, e compará-la com doadores vivos aparentados (DVA). MÉTODOS: Foram analisados 389 primeiros transplantes renais com doador vivo realizados em um único centro, entre janeiro de 1998 e dezembro de 2007, 281 com DVA e 108 com DVNA. RESULTADOS: Não houve diferença significativa na sobrevida dos pacientes (89,1% vs. 84,7%, p = 0,40) e do enxerto (81,1% vs. 68,9%, p = 0,77), em 10 anos de seguimento, entre DVA e DVNA, respectivamente. Na análise multivariada do modelo de regressão proporcional de Cox, a reatividade contra painel (PRA) > 10% e a ocorrência de rejeição aguda no 1Âº ano após o transplante foram os únicos preditores independentes de perda do enxerto (OR 2,54, IC 95% 1,35 - 4,78; p < 0,05 e OR 4,1, IC 95% 2,04 -4,78; p < 0,05, respectivamente). CONCLUSÃO: Transplantes renais com DVNA representam uma importante fonte de órgãos para suprir uma crescente demanda, com resultados semelhantes aos transplantes com DVA, independente da compatibilidade HLA.

10.1590/s0101-28002011000300011

Cite

Citations (10)

Post-transplant neutrophilic interstitial nephritis - an important cause of graft dysfunction

Transplant International (1998)

Maria Cristina Ribeiro de Castro Luiz Balthazar Saldanha William Carlos Nahas Daísa Silva Ribeiro David S Arap

Etiology

Interstitial nephritis

Nephrology

Nephritis

10.1007/s001470050447

Cite

Citations (2)

Persistent hyperparathyroidism as a risk factor for long-term graft failure: the need to discuss indication for parathyroidectomy

Surgery (2018)

Maria Júlia Correia Lima Nepomuceno Araújo Janaina Almeida Mota Ramalho Rosilene Motta Elias Vanda Jorgetti William Carlos Nahas

10.1016/j.surg.2017.12.010

Cite

Citations (53)

Reversal of Aluminum-Related Bone Disease after Renal Transplantation

American Journal of Nephrology (1993)

Elias David‐Neto Vanda Jorgetti Neide M.R. Soeiro Renata Cristina de Campos Pereira Silveira A Borelli

We evaluated the course of severe aluminum-related bone disease (ARBD) after the first year of a successful renal transplantation (RTx) in 11 adult patients. Bone pain and muscle weakness, presented in all patients previously to RTx, subsided, and all were able to walk, even the ones who were confined to wheelchairs. Bone necrosis developed in 6 patients, but none required surgical repair. Serum alkaline phosphatase activity increased 2.5 times the upper normal level, up to the 5th month and then declined to normal levels up the 12th month (p < 0.05). The inverse profile was observed in both serum calcium and phosphorus levels. In bone biopsies, there was a significant decrease in all of the following histomorphometric static parameters: osteoid volume, thickness and surface and also in aluminum surface. Also, there was a significant increase in all the dynamic parameters of mineralization: mineral apposition rate, mineralization surface, bone formation rate and adjusted apposition rate. In conclusion, ARBD remarkably improves after 1 year of successful RTx.

Apposition

Osteoid

Osteomalacia

Bone disease

10.1159/000168583

Cite

Citations (18)

Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors

Clinical and Experimental Nephrology (2021)

José Jayme G. De Lima Luís Henrique Wolff Gowdak Elias David‐Neto Luiz Aparecido Bortolotto

Nephrology

10.1007/s10157-021-02019-6

Cite

Citations (3)

Recurrent Outbreak of Carbapenem‐Resistant IMP‐1‐Producing Pseudomonas aeruginosa in Kidney Transplant Recipients: The Impact of Prolonged Patient Colonization

Transplant Infectious Disease (2024)

Maristela Pinheiro Freire Carlos Henrique Camargo Laina Bubach Amanda Yaeko Yamada Fernanda Spadão

ABSTRACT Background Infections by carbapenem‐resistant Pseudomonas aeruginosa (CRPA) have been associated with high morbidity and mortality among solid organ recipients. Objectives To delineate the epidemiological and molecular characteristics of a recurrent outbreak of imipenem (IMP)‐producing P. aeruginosa (CRPA) among kidney transplant (KT) recipient Methods We described a recurring CRPA outbreak in a KT ward, divided into two periods: before unit closure (Feb 2019–2020) and after reopening (Aug 2020–Dec 2023). Routine surveillance cultures (SCs) were performed using axillary‐perineum‐rectal swabs with immunochromatographic tests. A case‐control study identified risk factors for CRPA acquisition. Pulsed‐field gel electrophoresis and whole genome sequencing characterized the strains. Results After reopening, new cases arose from patients previously colonized, peaking 18 months later. A total of 67 KT recipients with CRPA‐IMP‐producing strains were identified. All except one sequenced strain belonged to the ST446 clone, differing by a maximum of 110 single nucleotide polymorphisms. Forty‐five (67.2%) cases were identified through SC, with 45.7% showing intermittent SC positivity. Patients remained colonized for up to 623 days. Twenty‐four (35.8%) patients had infections, with the most common site being the urinary tract. Identified risk factors included older age, deceased donor, re‐transplantation, reoperation, carbapenem or quinolone use, lymphopenia, hospital stay >10 days, and the first 60 days post‐KT. Conclusion KT recipients can harbor CRPA for extended periods, and detecting CRPA‐colonized patients is challenging. These characteristics highlight the patient as the major source and a critical point in outbreak control. image

10.1111/tid.14414

Cite

Citations (0)

Table of Contents

Kidney International (2016)

A. Richard Kitching Joshua D. Ooi Christina Wyatt J David Ken Inoki

Table (database)

10.1016/s0085-2538(16)30574-9

Cite

Citations (0)

The Dynamics of Glucose Metabolism Under Calcineurin Inhibitors in the First Year After Renal Transplantation in Nonobese Patients

Transplantation (2007)

Elias David‐Neto Francine C. Lemos Luciana M. Fadel Fabiana Agena Melissa Y. Sato

Background. The incidence of glucose metabolism disturbances after transplantation often is based on the use of hypoglycemic agents and not on the results of glucose tolerance tests (GTTs), which may camouflage the real incidence. A lack of information also exists regarding the profile of glucose metabolism during the first year after transplant. Methods. Oral GTT along with insulin measurements and drugs pharmacokinetics were prospectively performed at days 30, 60, 180, and 360 after transplant to diagnose disturbances of glucose metabolism after renal transplantation, in nonobese patients receiving either tacrolimus (n=55) or cyclosporine (n=29), along with mycophenolate mofetil and steroids. Results. The incidence of impaired glucose tolerance or diabetes mellitus reached a peak at 60 days and decreased at 1 year. It could not be adequately diagnosed using fasting plasma glucose in a decreased abnormal (>99 ng/mL) range. In both groups, insulin secretion, evaluated by the Homeostasis Model Assesment (HoMA-β), decreased (P<0.005) from the condition of normal GTT (101±56%) to impaired glucose tolerance (72±35%) and diabetes mellitus (54±25%). In the cyclosporine group, insulin secretion was normal and stable throughout the study period, but in the tacrolimus group, insulin secretion recovered over time and was inversely correlated with tacrolimus exposure. Insulin resistance (HoMA-IR) did not change. Conclusions. This study shows the need to perform an oral GTT at 60 days and at the end of the first year of renal transplantation to adequately diagnose impaired glucose metabolism.

Carbohydrate Metabolism

Glucose tolerance test

10.1097/01.tp.0000267647.03550.22

Cite

Citations (61)

Comparison of serum levels with bone content and gene expression indicate a contradictory effect of kidney transplantation on sclerostin

Kidney International (2019)

Maria Júlia Correia Lima Nepomuceno Araújo Igor Denizarde Bacelar Marques Fabiana G. Graciolli Luzia Fukuhara Luciene M. dos Reis

Sclerostin

Bone remodeling

10.1016/j.kint.2019.06.007

Cite

Citations (19)