Trasplante cardíaco

CJC Open. 2025 Mar 24;7(6):813-820. doi: 10.1016/j.cjco.2025.03.015. eCollection 2025 Jun.

ABSTRACT

Clinical characteristics of progressive heart failure warranting advanced heart failure (AHF) therapies are not well defined in patients with atypical cause-specific cardiomyopathies, as in conventional ischemic and dilated cardiomyopathies. Some of these specific cardiomyopathies are associated with systemic diseases, and the impact and the severity of extracardiac involvement is crucial in defining the appropriate choice of AHF therapies. This review focuses on special considerations in cause-specific cardiomyopathies, such as hypertrophic cardiomyopathy, cardiac sarcoidosis, cardiac amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. The review evaluates AHF therapies, including heart transplantation and durable mechanical circulatory support devices, along with nuances in the management of these patients after they receive AHF therapies.

PMID:40586021 | PMC:PMC12198592 | DOI:10.1016/j.cjco.2025.03.015

Transpl Int. 2025 Jun 2;38:14153. doi: 10.3389/ti.2025.14153. eCollection 2025.

ABSTRACT

To address the shortage of organs for kidney transplantation, the Eurotransplant Senior Program (ESP) was established to enhance kidney allocation from elderly donors. This study aimed to evaluate post-transplant outcomes of deceased donor grafts and identify prognostic factors within the ESP population. We therefore analyzed patient data from 64 ESP recipients and their donors transplanted at our center between 2017 and 2022. Time-zero biopsies were analyzed using AI image analysis software for glomerular density and glomerulosclerosis. One-year patient and allograft survival rates were 96.9% and 85.9%. 5-year survival rate was 74.6%, as opposed to about 41.0% historically reported for patients on dialysis. Delayed Graft Function occurred in 29.7% of cases, with recipient coronary heart disease, BMI-disparities, and prolonged cold ischemia time as major predictors (P < 0.05). Histopathological analysis revealed that the degree of glomerulosclerosis and interstitial fibrosis and tubular atrophy (IFTA) were associated with graft failure in multivariable analyses (P < 0.05). Arteriolosclerosis (arteriolar hyalinosis) correlated with a higher risk for primary non-function (P < 0.05). The number of HLA mismatches was not significantly associated with graft outcome. Including prognostic baseline characteristics as well as histopathological AI analysis into individual allocation decisions during organ-acceptance process might improve allograft survival within the ESP and should prospectively be studied.

PMID:40585890 | PMC:PMC12203019 | DOI:10.3389/ti.2025.14153

Transpl Int. 2025 Jun 2;38:13971. doi: 10.3389/ti.2025.13971. eCollection 2025.

ABSTRACT

Normothermic ex-vivo organ perfusion (EVP) systems not only provide a physiological environment that preserves donor organ function outside the body but may also serve as platforms for ex-vivo organ modification via gene therapy. In this study, we demonstrated that a rationally designed muscle-tropic recombinant AAV, AAV-SLB101, delivered to the donor heart during brief normothermic EVP achieves durable cardiac transgene expression out to 90 and 120 days post-transplant in a porcine preclinical model. Moreover, transgene expression was detectable as early as 48 h post-transplant. Histological and MRI analyses of the donor myocardium showed no functional or structural impact on the allograft and no off-target gene expression in the recipient. This work will serve as a critical foundation to inform translational studies with therapeutic transgenes to improve allo-, xeno-, and auto-heart transplant outcomes.

PMID:40585889 | PMC:PMC12203020 | DOI:10.3389/ti.2025.13971

J Vasc Surg Cases Innov Tech. 2025 May 16;11(4):101844. doi: 10.1016/j.jvscit.2025.101844. eCollection 2025 Aug.

ABSTRACT

A 61-year-old female with previous liver transplantation was volume overloaded, requiring intubation and veno-venous extracorporeal membrane oxygenation. Workup was significant for mitral valve stenosis, for which she underwent repair. This was complicated by injury to the inferior vena cava with avulsion from the liver, which was reconstructed with bovine pericardium. Postoperatively, hemodynamic monitoring suggested poor venous return. She was taken for a venogram, demonstrating stenosis of the suprahepatic inferior vena cava, which was treated with placement of a bare metal self-expanding stent. This case report demonstrates an endovascular salvage technique for suprahepatic inferior vena cava stenosis after reconstruction during cardiac surgery.

PMID:40585579 | PMC:PMC12206025 | DOI:10.1016/j.jvscit.2025.101844

JHLT Open. 2025 May 27;9:100297. doi: 10.1016/j.jhlto.2025.100297. eCollection 2025 Aug.

ABSTRACT

Immunosuppression advances have enabled organ transplant recipients to consider parenthood, but pregnancy poses risks to maternal and fetal health. This systematic review examines pregnancy outcomes and immunosuppression management in cardiothoracic transplant recipients. We conducted a literature search of PubMed/Medline, Embase, and Maternity and Infant Care Database in December 2022. We identified 54 relevant studies and data from the Transplant Pregnancy Registry International, covering 404 pregnancies from 272 heart recipients (HTR) and 148 pregnancies from 121 lung recipients (LTR). Live births occurred in 74.3% of HTR and 65.5% of LTR pregnancies (22% preterm). Graft dysfunction developed in 11.5% (during) and 12.4% (after) of HTR pregnancies and 17.6% (during) and 18% (after) of LTR pregnancies. Other complications included hypertension (HTR: 36.9%, LTR: 58.8%), preeclampsia (HTR: 19.7%, LTR: 12.2%), and diabetes (HTR: 11%, LTR: 27%). Mortality was 17.4% for HTR and 26.5% for LTR. Half of HTR and two-thirds of LTR were on Tacrolimus. Common immunosuppression changes included discontinuation of Mycophenolate Mofetil, Azathioprine, or Sirolimus with corticosteroid dose adjustment. Despite high successful pregnancy rates, heart and lung transplant recipients may face substantial risks of graft dysfunction and maternal death post-pregnancy.

PMID:40584723 | PMC:PMC12205842 | DOI:10.1016/j.jhlto.2025.100297

JHLT Open. 2025 Jun 2;9:100288. doi: 10.1016/j.jhlto.2025.100288. eCollection 2025 Aug.

ABSTRACT

Post-myocardial infarction (MI) ventricular septal defects (VSDs) are rare but life-threatening. Temporary mechanical support options range from intra-aortic balloon pumps (IABPs) to venoarterial extracorporeal membrane oxygenation (VA-ECMO). There are few anecdotes of the Impella as a bridge to repair. We present a case of post-MI VSD and cardiogenic shock requiring combined Impella 5.5 and VA-ECMO (ECPELLA) as a bridge to transplant.

PMID:40584722 | PMC:PMC12205820 | DOI:10.1016/j.jhlto.2025.100288

JHLT Open. 2025 May 22;9:100277. doi: 10.1016/j.jhlto.2025.100277. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: We aim to describe the effect of belatacept on de novo donor-specific antibodies (DSA) formation, rejection, and renal function in heart transplant recipients.

METHODS: The cohort comprises 60 adult heart or heart-kidney recipients transplanted between 2005 and 2022. Twelve recipients initialized at ∼90 days post-transplantation on a belatacept-based immunosuppression regimen with tapered tacrolimus trough levels were matched to 48 standard tacrolimus-based regimen controls. Differences in the distribution of recipients with emergent de novo DSA and rejection were assessed over the first 85 days baseline period, the average duration pre-belatacept. Survival analysis assessed regimen group differences in the probability of remaining de novo DSA and rejection free over the follow-up period spanning 86 to 540 days. Renal function and cytomegalovirus viremia were examined as secondary outcomes.

RESULTS: There were no statistically significant regimen group differences in the distribution of recipients with de novo DSA or rejection during the baseline period. Furthermore, differences in the probability of remaining de novo DSA and rejection free during the follow-up period remained insignificant (log-rank test, p = 0.12). Belatacept-treated recipients, at follow-up, had no incidence of developing de novo DSA, unlike 19% of the controls. Additionally, there were no statistically significant differences in acute cellular and antibody mediated rejection events, renal function, and CMV viremia by regimen group.

CONCLUSION: Recipients treated with belatacept-based regimen exhibited a trend of reduced de novo DSA development compared to standard tacrolimus-based regimen controls. Larger studies are needed to evaluate the benefit of belatacept use in heart transplant populations.

PMID:40584719 | PMC:PMC12205671 | DOI:10.1016/j.jhlto.2025.100277

CASE (Phila). 2025 Apr 1;9(6):187-193. doi: 10.1016/j.case.2025.02.003. eCollection 2025 Jun.

ABSTRACT

PMID:40583872 | PMC:PMC12198111 | DOI:10.1016/j.case.2025.02.003

Multimed Man Cardiothorac Surg. 2025 Jun 30;2025. doi: 10.1510/mmcts.2025.048.

ABSTRACT

Total arterial, anaortic, off-pump coronary artery bypass grafting is seen by many as a complex, specialized operation; however, when broken down into its component parts, it can be approached as multiple reproducible techniques that all trainees should master. These components include skeletonized mammary harvest, construction of composite arterial grafts and off-pump cardiac surgery. In this video tutorial, we describe step-by-step approaches to each of these elements and demonstrate how these principles come together to facilitate an excellent surgical outcome for the patient: revascularization of all diseased coronary arteries with arterial grafts while avoiding arresting the heart or aortic manipulation.

PMID:40583699 | DOI:10.1510/mmcts.2025.048

Transplant Proc. 2025 Jun 28:S0041-1345(25)00282-9. doi: 10.1016/j.transproceed.2025.05.020. Online ahead of print.

ABSTRACT

This study examines takotsubo cardiomyopathy (TTS) following liver transplantation (LT). Out of 739 LT patients from 2018 to 2024, 76 developed cardiac dysfunction, with 6 cases of TTS, all male. TTS incidence post-LT was 0.8%, with alcoholic cirrhosis as the main diagnosis. TTS occurred a median of 2 days post-LT, highlighting early complications. High catecholamine levels were noted in 1 case. The study stresses the need for differential diagnosis of TTS in post-LT cardiac dysfunction, especially in alcohol abuse patients, with aggressive treatment including IABP, volume management, and anticoagulation. Echocardiographic assessment post-LT is crucial for TTS detection and management.

PMID:40582931 | DOI:10.1016/j.transproceed.2025.05.020

Blood Rev. 2025 Jun 23:101319. doi: 10.1016/j.blre.2025.101319. Online ahead of print.

ABSTRACT

Anemia is a hallmark of myelodysplastic syndromes/neoplasms (MDS) and most patients with MDS chronically require red blood cell transfusions. Due to the body's inability to excrete excess iron, patients are at increased risk of iron overload, often defined by ferritin levels >1000 ng/mL. Iron overload can cause progressive organ damage from iron deposition in tissues and has been linked to increased mortality. In MDS patients undergoing allogeneic hematopoietic cell transplantation (HCT), iron overload has also been associated with increased non-relapse mortality, decreased overall survival, and a higher incidence of relapse. Prospective and retrospective studies have demonstrated the safety and clinical benefit of iron chelation therapy (ICT) in lower-risk MDS. Despite some common adverse effects associated with ICT, such as renal toxicity and gastro-intestinal symptoms, managing iron levels remains essential in transfusion-dependent MDS patients, and those who are undergoing HCT to optimize pre-transplant conditions, and enhance post-transplant outcomes.

PMID:40582916 | DOI:10.1016/j.blre.2025.101319

Circ J. 2025 Jun 28. doi: 10.1253/circj.CJ-25-0088. Online ahead of print.

ABSTRACT

BACKGROUND: Japan's heart transplantation system is characterized by an extremely long waiting period, which contributes to significant mortality on the waiting list. The current allocation system may maintain favorable post-transplant outcomes at the expense of high-risk patients, particularly those with severe heart failure or complications following left ventricular assist device (LVAD) implantation. To explore an optimal allocation system for Japan, we investigated risk factors for waiting list mortality.

METHODS AND RESULTS: We analyzed 300 patients registered on the heart transplant waiting list at Osaka University between 2014 and 2024. Cox hazard analysis identified age at registration (hazard ratio [HR] 1.023) and congenital heart disease (HR 4.531) as independent risk factors for mortality. In the LVAD cohort (n=244), right heart failure (HR 4.582), stroke associated with systemic infection (HR 5.175), and sudden stroke without preceding infection (HR 3.158) were significant risk factors. Although the HeartMate 3 significantly reduced sudden stroke (P<0.001), it did not improve right heart failure or infection-related stroke. Patients with these complications had significantly lower proportions of time at home with an LVAD (P<0.001).

CONCLUSIONS: Prioritized organ allocation for patients with congenital heart disease, right heart failure, or LVAD-related infections may improve waiting list survival. Reducing hospitalizations in high-risk LVAD patients could also be beneficial from a healthcare economics perspective.

PMID:40582867 | DOI:10.1253/circj.CJ-25-0088

J Heart Lung Transplant. 2025 Jun 27:S1053-2498(25)02064-9. doi: 10.1016/j.healun.2025.06.026. Online ahead of print.

ABSTRACT

Medical assistance in dying (MAiD) provides capable patients with intolerable suffering the option to retain control over the timing and circumstances of their deaths. This case reports the first successful cardiac transplantation after MAiD. A 59-year-old male with end-stage heart failure received a donor heart from a 38-year-old male with ALS who underwent MAiD. The donor heart was retrieved using the TransMedics Organ Care System and successfully transplanted with excellent postoperative function. The recipient's recovery included transient mild rejection and acute kidney injury, both of which resolved with treatment. This case demonstrates the feasibility of cardiac transplantation following MAiD and highlights its potential to expand the donor pool.

PMID:40582651 | DOI:10.1016/j.healun.2025.06.026

Kidney Int. 2025 Jun 27:S0085-2538(25)00491-0. doi: 10.1016/j.kint.2025.06.003. Online ahead of print.

ABSTRACT

INTRODUCTION: C3 glomerulopathy (C3G) and immune-complex membranous proliferative glomerulonephritis (IC-MPGN) are rare disorders that frequently result in kidney failure over the long-term. Presently, there are no disease-specific treatments approved for these disorders, although there is much interest in the therapeutic potential of complement inhibition. However, the limited duration and necessarily small size of controlled trials means there is a need to quantify how well short-term changes in estimated glomerular filtration rate (eGFR) and proteinuria predict the clinically important outcome of kidney failure.

METHODS: We address this using longitudinal data from the UK Registry of Rare Kidney Diseases (RaDaR) involving retrospective and prospective data collection with linkage to hospital laboratories via automated feeds of 371 patients. Analyses of kidney survival were conducted using Kaplan-Meier and Cox regression with eGFR slope estimated using linear mixed models.

RESULTS: In a median of 11.0 (inter quartile range 7.4-15.1) years follow-up, 148 patients (40%) reached kidney failure. There was no significant difference in progression to kidney failure between C3G and IC-MPGN groups. Baseline urine protein-creatinine ratio (UPCR), although high, was not associated with kidney failure in either group. Two-year eGFR slope had a modest association with kidney failure. In contrast, both 20%‒50% and 50 mg/mmol reductions in UPCR between 0-12 months were associated with lower kidney failure risk in both groups. Notably, those with a UPCR under 100 mg/mmol at 12 months had a substantially lower risk of kidney failure (hazard ratio 0.10 (95% confidence interval 0.03-0.30).

CONCLUSIONS: Overall, proteinuria a short time after diagnosis is strongly associated with long-term outcomes and a UPCR under 100 mg/mmol at one year is associated with a substantially lower kidney failure risk.

PMID:40582408 | DOI:10.1016/j.kint.2025.06.003

Ann Rheum Dis. 2025 Jun 27:S0003-4967(25)01039-8. doi: 10.1016/j.ard.2025.05.021. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish the long-term impact of cytokine-directed therapies on glucocorticoid use and clinical outcomes in Vacuoles, E1-enzyme, X-linked, Autoinflammatory, Somatic (VEXAS).

METHODS: Patients with VEXAS were prospectively followed for events of transfusion dependence, haematopoietic stem cell transplantation or death. Laboratory results, glucocorticoid exposure and clinical measures were retrospectively assessed in relationship to treatment initiation with interleukin-6-directed therapies (anti-IL6R) or Janus kinase inhibitors (JAKi). Patients were stratified by UBA1 variants and presence of typical clonal haematopoiesis with variant allele fraction ≥ 10% (CHVAF≥10%).

RESULTS: In 71 VEXAS patients (81.7% with anti-IL6R or JAKi exposure), event-free survival differed by genotype and presence of concomitant CHVAF≥10%: p.M41V (HR [95% confidence interval (CI)]: 5.7 [1.5-20.4]) or p.M41L/T with CHVAF≥10% (hazard ratio [HR]: 5.7 [1.6-20.8]) compared to p.M41L. No association between event rates and exposure to anti-IL6R or JAKi was observed. The p.M41V genotype had the highest risk of anaemia, elevated C-reactive protein (CRP) levels, and monocytopenia. Over a median follow-up of 4.8 (interquartile range [IQR] 3.0, 8.1) years, the patients' mean glucocorticoid dose was >15 mg/day prednisone regardless of variant or disease duration. At prospective visits, clinical remission on ≤10 mg/day prednisone was observed in only 2.7% of visits. Treatment with anti-IL6R or JAKi showed no clinically meaningful reduction (<5 mg/day difference) in steroid exposure at 1 year post-treatment. No attenuation in the progression of anaemia was observed in response to anti-IL6R and JAKi.

CONCLUSIONS: Cytokine-directed therapies alone do not alter the risk of haematologic disease progression or significantly reduce glucocorticoid exposure in VEXAS. These data provide benchmarks for future interventional studies.

PMID:40581580 | DOI:10.1016/j.ard.2025.05.021

Phys Med Rehabil Clin N Am. 2025 Aug;36(3):647-662. doi: 10.1016/j.pmr.2025.03.008. Epub 2025 May 24.

ABSTRACT

Hospitalized pediatric heart transplant (PHT) recipients face unique and multifaceted challenges that impact their functional outcomes, including motor skills, activities of daily living, feeding, and communication. Perioperative complications, lengthy hospitalizations, physical deconditioning, and comorbidities associated with complex congenital heart disease are important considerations as they can have a profound impact on their functional abilities and progress of individuals toward achieving independence. This article explores the role of rehabilitation providers in addressing these functional challenges through performance-based outcome measures and aims to support the development of tailored rehabilitation programs to achieve improved quality of life and long-term independence for PHT recipients.

PMID:40581444 | DOI:10.1016/j.pmr.2025.03.008

J Heart Lung Transplant. 2025 Jun 26:S1053-2498(25)02038-8. doi: 10.1016/j.healun.2025.06.012. Online ahead of print.

ABSTRACT

BACKGROUND: Lung transplantation offers life-saving benefits for patients with end-stage lung disease, however, long-term outcomes remain poor, with a median survival of 6.5 years. Identifying patients at risk for poor post-transplant lung function is crucial for improving outcomes. While peri-operative and demographic factors have previously been studied, the impact of donor-specific antibodies (DSA) on longitudinal post-transplant lung function remains unclear. This study examines the effects of DSA on post-transplant lung function and the risk of baseline lung allograft dysfunction (BLAD).

RESEARCH QUESTION: Is DSA development linked to worse longitudinal lung function, higher BLAD rates, and poorer survival compared to DSA-negative patients regardless of the development of clinical AMR?

METHODS: The study included lung transplant recipients from two prospective cohort studies, comparing DSA+ and DSA- patients. All participants underwent serial surveillance and clinically-indicated bronchoscopy, pulmonary function tests, and DSA testing. Statistical analysis included linear mixed models for longitudinal lung function data, multivariable logistic regression for BLAD, and survival analysis using Cox Proportional Hazard models.

RESULTS: We analyzed 213 patients with a median follow-up of 48.1 months. Among them, 50.7% developed DSA. DSA+ patients showed significantly lower rates of post-transplant spirometric improvement compared to DSA- patients (p=0.008 for %FVC; p=0.02 for %FEV1). After DSA diagnosis, there was a significant decrease in the slopes of %FVC and %FEV1 (p=0.0008 and p=0.0006, respectively). DSA+ patients had a higher risk of developing BLAD (OR 2.14, 95% CI [1.45, 3.17], p=0.0001). Additionally, DSA+ patients had a higher risk of death (HR 2.98, 95% CI [1.79, 4.99], p<0.0001). These findings were consistent even when excluding patients with clinical antibody-mediated rejection (AMR).

INTERPRETATION: Our study demonstrates that DSA development significantly impairs post-transplant lung function and increases the risk of BLAD even in the absence of clinical AMR. These findings suggest that DSA may serve as a biomarker of BLAD, and could potentially aid in risk stratification following lung transplantation.

PMID:40581272 | DOI:10.1016/j.healun.2025.06.012

J Heart Lung Transplant. 2025 Jun 26:S1053-2498(25)02055-8. doi: 10.1016/j.healun.2025.06.019. Online ahead of print.

ABSTRACT

PURPOSE: Early referral for lung transplantation in patients with pulmonary arterial hypertension (PAH) is recommended by multiple professional societies. We sought to use the Pulmonary Hypertension Association Registry (PHAR) to describe the current landscape of referrals for lung transplantation in patients with PAH.

METHODS: PHAR is a 72-center US-based registry of patients with PAH. Participants were followed longitudinally with repeat assessments of clinical parameters, including referrals for transplantation. We compared clinical parameters between those referred for transplantation at any point, with those never referred. Next, we tested whether various clinical parameters predicted time to referral, using cox-proportional hazards modeling and stepwise backward elimination.

RESULTS: Of 1671 participants analyzed with 4607 person-years of follow up, 199 (12%) were referred for transplantation. Of those referred, 30% underwent transplantation and 21% died without transplantation. Only 18-29% of participants with functional class 4 disease, REVEAL Lite 2 high-risk disease, or 2022 ESC/ERS high-risk disease were referred for transplant. Rates of referral did not increase in sensitivity analyses restricting the cohort to participants without obvious contraindications based on body mass index or age. In multivariate modeling accounting for death as a competing risk, a diagnosis of pulmonary veno-occlusive disease, higher REVEAL Lite 2 Scores, and parenteral prostacyclin use were associated with increased likelihood of referral, while older age and higher body mass index were associated with decreased likelihood of referral.

CONCLUSION: Rates of referral for lung transplantation in patients with PAH remain unacceptably low and occur too late. Increased awareness of the benefit of early referral is necessary, even at expert centers.

PMID:40581270 | DOI:10.1016/j.healun.2025.06.019

J Geriatr Oncol. 2025 Jun 27;16(7):102303. doi: 10.1016/j.jgo.2025.102303. Online ahead of print.

ABSTRACT

INTRODUCTION: The clinical uptake of validated chemotherapy toxicity predictor tools for older adults with cancer remains low. In this qualitative study, we sought to evaluate oncologist perspectives on the acceptability, appropriateness, and feasibility of the Cancer and Aging Research Group (CARG) chemotherapy toxicity predictor tool.

MATERIALS AND METHODS: We conducted semi-structured qualitative interviews with 18 medical oncologists in the M Health Fairview system to understand barriers to CARG tool use and implementation solutions. A trained researcher conducted interviews, and two coders analyzed interview transcripts to identify themes. Using an implementation science framework, we categorized oncologist perspectives into the outcomes of acceptability, appropriateness, and feasibility.

RESULTS: We identified four themes: (1) current methods for assessing chemotoxicity risk, (2) acceptability - perceptions of the CARG tool, (3) appropriateness - perceptions of the CARG tool in practice, and (4) appropriateness - integration of the CARG tool into oncologist workflow. Participants highlighted the relevance of the CARG questions but noted that certain treatment regimens required additional information (e.g., cardiac function or pre-existing neuropathy). They also noted that the topline results lack nuance and are difficult to interpret, with concern about the tool keeping up with the rapid pace of oncology advances. They pointed out that the tool was not applicable for every patient, especially newer treatments, and questioned the benefit over standard of care. However, they emphasized that a trusted colleague who could be a champion could aid buy-in, and a workflow priority was a seamless integration into the electronic health record.

DISCUSSION: Practicing academic and community-based medical oncologists noted several implementation considerations for the CARG tool. These data have implications for health systems and policymakers who wish to implement chemotoxicity predictor tools into routine practice, and for researchers and learning health systems in designing and conducting pragmatic trials.

PMID:40580678 | DOI:10.1016/j.jgo.2025.102303

Ann Indian Acad Neurol. 2025 Jun 28. doi: 10.4103/aian.aian_74_25. Online ahead of print.

ABSTRACT

Chronic kidney disease is a global public health problem. Emphasis has been placed on uremic peripheral neuropathy (PN) in nondiabetic chronic hemodialysis (HD) patients. This complication could affect the quality of life. We aimed to determine the prevalence and risk factors of PN. This was a cross-sectional study. Evaluation of PN was made by clinical examination and electroneuromyogram. The prevalence of PN was 30.3%. The most common symptoms were paresthesia and burning. Neuropathic pain was symmetrical in the majority of cases and localized to the lower limb (60%). All patients had axonal type PN. In univariate analysis, the risk factors for PN were advanced age (P = 0.012), hypertension (P = 0.007), ischemic heart disease (P = 0.036), high C-reactive protein (microinflammation) (P = 0.002), low urea reduction ratio (P = 0.013), and high ß2 microglobulin (P = 0.002). Since PN is common in nondiabetic chronic HD patients, it becomes necessary to diagnose it and correct its risk factors.

PMID:40580435 | DOI:10.4103/aian.aian_74_25