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Bente Jespersen

Publications and source records attributed to Bente Jespersen.

10 recordsLinked to original sources
PubMed2006

Steroid-free immunosuppression after renal transplantation-long-term experience from a single centre.

BACKGROUND: A steroid-free immunosuppressive protocol may improve the general well-being of patients, but long-term renal graft survival has been a concern. METHODS: In a retrospective clinical study, 329 consecutive transplantations with renal grafts at our centre during the period 1995-2004, were followed for up to 9.3 years. Patients mainly received steroid-free immunosuppression with an initial induction with antithymocyte globulin or basiliximab and maintenance therapy with ciclosporin and mycophenolate mofetil (MMF). Steroids were given after rejection, or if the physician judged it necessary, for instance because of primary kidney disease or when calcineurin inhibitor toxicity was suspected. RESULTS: About 71% of the patients did not take steroids at all. Nevertheless, graft survival rates at 1, 5 and 7 years were 95, 77 and 72% for all grafts, including 27% living donor transplants and 27% second or subsequent grafts. Ten patients (3.2%) died with functioning grafts. Within the first year of transplantation there were 69 acute rejections in 63 patients (19%). Four cases (1.3%) of post-transplant lymphoproliferative disorder (PTLD) occurred with one graft loss and no deaths. Owing to a high PTLD rate in a previous patient cohort, total immunosuppression was lessened after 1998. CONCLUSIONS: Steroid avoidance is possible with good results with respect to acute rejection and long-term graft survival. After introducing MMF, largely avoiding muromonab-CD3 mouse raised monoclonal antibody against CD (OKT3), and reducing doses of calcineurin inhibitor, the rates of PTLD did not differ from what is usually found. For the present, induction and use of MMF, together with a calcineurin inhibitor, is probably to be preferred.

Adolescent↗
PubMed2006

[Intrafamily kidney transplantation. Investigation of its influence on the donor's life and his or her relationship with the recipient].

INTRODUCTION: Quality of life is a vital aspect to be considered in connection with intrafamily kidney transplantations. It is important that the donor be both physically and mentally well after the donation. It is also crucial that the relationship between the donor and recipient not change for the worse. MATERIALS AND METHODS: 45 of 78 donors entered into our investigation. All had donated a kidney to a family member at Odense University Hospital between 1 January 1995 and 7 January 2003. All were interviewed using a semi-structured questionnaire covering both physical, social and mental issues and the donor's relationship with the recipient. RESULTS: The vast majority were satisfied with their decision to donate. Their relationship with the recipient was either the same or had improved. The donors had not felt pressured to donate. 25% still had some discomfort/pain, which was mainly from the scar; 47% had not changed mentally; 38% had changed mentally in a positive direction; 91% had not changed socially, but 9% had changed in a negative way. Physically, 82% felt the same as before the donation; 16% were less active physically. DISCUSSION: Intrafamily kidney transplantation is a good way to help kidney patients. Within the limits of the survey, the risk of suffering a lower quality of life after donating was shown to be low. The discomfort/pain was of limited inconvenience. On the contrary, the investigation showed that most often the donor was getting better mentally and his or her relationship with the recipient had changed for the better. However, there is room for improvement in operative techniques and donor selection.

Adult↗
PubMed2004

Inhibition of cGMP-specific phosphodiesterase type 5 reduces sodium excretion and arterial blood pressure in patients with NaCl retention and ascites.

In the present study, we tested the hypothesis that inhibition of renal phosphodiesterase type 5 (PDE5) in patients with liver cirrhosis and ascites increases sodium excretion. The effect of sildenafil citrate was studied in a randomized double-blind. placebo-controlled crossover study. Diuretics were withdrawn, and a fixed sodium diet (100 mmol/day) was given to the patients for 5 days before both study days. After a 60-min basal period, eight patients received either oral sildenafil (50 mg) or placebo. Glomerular filtration rate (GFR) and renal blood flow (RBF) were determined by 99mTc-diethylenetriamine-pentaacetate and (131)I-hippuran clearances. In human nephrectomy specimens, PDE5 mRNA was expressed at similar levels in the cortex (n = 6) and inner medulla (n = 4). Histochemical staining showed PDE5 immunoreactivity in collecting ducts and vascular smooth muscle. At baseline, cirrhotic patients exhibited elevated plasma concentrations of ANP, renin, ANG II, and aldosterone that did not differ on the 2 study days. Basal sodium excretion was similar at the 2 study days (median 17 and 18 mmol, respectively), and patients were in positive sodium balance. Sildenafil increased heart rate, plasma renin activity, plasma ANG II, and aldosterone concentrations significantly after 60 min. Plasma cGMP concentration was increased after 120 and 180 min, and urinary sodium excretion and mean arterial blood pressure were decreased significantly at 120 and 180 min. Plasma ANP concentration, GFR, and RBF did not change after sildenafil. In patients with ascites and cirrhosis, inhibition of PDE5 did not promote natriuresis but led to increased plasma levels of the renin-angiotensin-aldosterone system.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2004

[Hyponatremia].

Explore the source record for details and available documents.

Humans↗
PubMed2003

[Salmonella infection complicated with acute renal failure].

Acute renal failure is a known complication to Salmonella gastroenteritis, and patients with chronic renal failure or impaired host defence are at increased risk. In the two presented cases there had been a few days of gastroenteritis before the hospitalisation, but the only symptoms at the admission were fatigue and dyspnoea. In both cases severe uraemia had developed and the patients and their physicians did not expect the episode of gastroenteritis to be the only etiology of acute renal failure. Both patients had normal renal histology and Salmonella was grown in their faeces. Subsequently, their renal function was normalised. In these patients dialysis and renal biopsies would have been unnecessary if the ability of even a moderate Salmonella infection to cause acute renal failure in a healthy subject had been realised and prompt rehydration had been initiated.

Acute Kidney Injury↗
PubMed2003

Nitric oxide synthase inhibition does not improve renal function in cirrhotic patients with ascites.

OBJECTIVES: Based mainly on animal experiments, nitric oxide (NO) has been proposed to account for the peripheral arterial vasodilation and hyperdynamic circulation in liver cirrhosis. The aim of this study was to clarify whether a reduction of NO synthesis would ameliorate the circulatory and renal dysfunction in decompensated cirrhotic patients. METHODS: The effects of N(G)-monomethyl-L-arginine-acetate (L-NMMA), an NO synthesis inhibitor, were studied. After a 60-min basal period, a total of 10 patients received increasing doses of L-NMMA, five patients (Low) received 12.5, 25, and 50 microg/kg/min, and five patients (High) received 25, 50, and 100 microg/kg/min as a constant infusion during 3 h, followed by a postinfusion period. Five patients (Placebo) received saline infusions only. Glomerular filtration rate and renal plasma flow were measured by clearance techniques with (99m)Tc-diethylenetriamine-pentaacetate and (131)I-Hippuran. RESULTS: L-NMMA infusion resulted in an increased blood pressure, decreased heart rate, and dose-dependent suppression of renin of up to 42.1 +/- 7.1% (p < 0.01) and angiotensin II of up to 39.9 +/- 9.6%, (p < 0.01) levels. Sodium and water excretion were not improved, most likely because of a reduction in renal blood flow of up to 29.1 +/- 8.1% (p < 0.01). CONCLUSION: Despite a partial correction of the hyperdynamic circulation, inhibition of NO synthesis does not improve sodium and water excretion in decompensated cirrhosis, probably because of an accompanying decrease in renal plasma flow. Intrarenal NO synthesis may be important for maintaining intrarenal hemodynamics in decompensated cirrhotic patients.

Angiotensin II↗