Evidence map›Paper›PMID 32556543›Full record

ArticlePediatric nephrology (Berlin, Germany)2020

Characterizing the frequency of modifiable histological changes observed on surveillance biopsies in pediatric kidney allograft recipients.

James D Odum, Alexander Kats, Judith Sebestyen VanSickle, Vimal Chadha, Brenda Brewer, Vincent S Staggs, Bradley A Warady

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Article in Pediatric nephrology (Berlin, Germany), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 9 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

James D OdumDivision of Graduate Medical Education, Children's Mercy Kansas City, Kansas City, MO, USA.
Alexander KatsDepartment of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, MO, USA.
Judith Sebestyen VanSickleDivision of Pediatric Nephrology, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Vimal ChadhaDivision of Pediatric Nephrology, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Brenda BrewerDivision of Pediatric Nephrology, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Vincent S StaggsBiostatistics & Epidemiology Core, Children's Mercy Kansas City, Kansas City, MO, USA.
Bradley A WaradyDivision of Pediatric Nephrology, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA. bwarady@cmh.edu.ORCID 0000-0003-1812-6587
Children's Mercy Hospital · USMercy Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRejection is responsible for just under 50% of graft loss in the pediatric kidney transplant population. Early identification and treatment of allograft injury, specifically modifiable pathologies such as subclinical rejection (SCR), calcineurin inhibitor toxicity, and BK virus nephropathy, may improve allograft survival. Protocol surveillance biopsy (SB) currently offers the earliest opportunity for targeted interventions.

methodsThis is a single-center retrospective review of 215 kidney SBs obtained from 2008 to 2016 in 97 pediatric kidney transplant recipients. SBs were obtained at 6, 12, and 24 months post-transplantation. Frequency of abnormal histologic findings, estimated glomerular filtration rate at time of SB, and SB-related complications were recorded. Data were analyzed to investigate possible time trends and the presence of demographic or clinical associations with abnormal histologic findings.

resultsPotentially modifiable histologic findings were seen in 38.1% of all SBs. SCR was found with increasing frequency across all time points with an estimated 49% increase in the odds of a SCR finding per additional 6 months post-transplantation (aOR 1.49, 95% CI 1.06-2.09, p = 0.022). Among follow-up biopsies in patients who underwent treatment for SCR, 50% had no SCR and 18.8% showed histologic improvement. The complication rate associated with SB was 1.9% (4/215 SBs) and consisted of only minor complications.

conclusionsSBs are safe and offer the opportunity to identify and treat modifiable histologic changes in the pediatric kidney transplant population. The performance of SBs for up to 2 years after transplantation can have meaningful clinical impact.

Indexed as

AdolescentBiopsyChildChild, PreschoolFemaleGraft RejectionHumansImmunosuppression TherapyInfantKidney TransplantationMaleRetrospective StudiesTransplant RecipientsCalcineurin inhibitor toxicityInterstitial fibrosisKidneyPediatricsSubclinical rejectionSurveillance biopsiesTransplant

Identifiers

PMID32556543
OpenAlexW3036074964

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.