Although the number of children with end-stage RENAL disease (ESRD) in need for RENAL TRANSPLANTATION is small compared with adults, the problem associated with RENAL transplant in children are numerous, varied, and often peculiar. Pre-emptive TRANSPLANTATION has recently been growing in popularity as it avoids many of the associated long-term complications of ESRD and dialysis. Changes in immunosuppression to more potent agents over the years will have affected transplant outcome; there is also evidence that tacrolimus is more effective than cyclosporine. This review will discuss the short- and long-term complications such as acute and chronic rejection, hypertension, infections, and malignancies as well as factors related to long-term graft function.Chronic allograft nephropathy is the leading cause of RENAL allograft loss in pediatric RENAL transplant recipients. It is likely that it reflects a combination of both immune and nonimmune injury occurring cumulatively over time so that the ultimate solution will rely on several approaches. Transplant and patient survival have shown a steady increase over the years. The major causes of death after TRANSPLANTATION are cardiovascular disease, infection and malignancy. TRANSPLANTATION in special circumstances such as children with abnormal urinary tracts and children with diseases that have the potential to recur after TRANSPLANTATION will also be discussed in this review. Non-compliance with therapeutic regimen is a difficult problem to deal with and affects patients and families at all ages, but particularly so at adolescence. Growth may be severely impaired in children with ESRD which may result in major consequences on quality of life and self-esteem; a better height attainment at TRANSPLANTATION is recognized as one of the most important factors in final height achievement.Although pediatric kidney TRANSPLANTATION is active in some parts of many developing countries, it is still inactive in many others and mostly relying on living donors. The lacking deceased programs in most of these countries is one of the main issues to be addressed to adequately respond to organ shortage.In conclusion, TRANSPLANTATION is currently the best option for children with ESRD. Although improvement in immunosuppression demonstrated excellent results and has led to greater 1-year graft survival rates, chronic graft loss remains relatively unchanged and opportunistic infectious complications remain a problem.

Background: Hyperuricemic patients have been predisposed to cardiovascular disease, hypertension, and RENAL disease. Hyperuricemia is implicated in endothelial dysfunction and in increased production of inflammatory mediators including C-reactive protein.Objective: To evaluate the prevalence of hyperuricemia and its risk factors among RENAL transplant recipients.Methods: A retrospective observational study was conducted among 4217 RENAL transplant recipients between April 2008 and January 2011. All patients referred from different kidney transplant centers, Tehran, Iran to a single laboratory. The mean±SD age of TRANSPLANTATION was 5±4 (median: 4.2) year. During this period, uric acid was measured in 17, 686 blood samples of 4217 RENAL transplant recipients (64% male and 36% female). Hyperuricemia was defined as a serum uric acid (SUA) level ³7.0 mg/dL in males and ³6.0 mg/dL in females that persisted for at least two consecutive tests performed. Moderate to severe hyperuricemia was also defined as a SUA level ³8.0 mg/dL. Multivariate regression analysis was used for identifying risk factors for hyperuricemia.Results: The median age of recipients was 38 years. The majority of cases were male (63%). The median age of the donor was 28 years. The majority of grafts came from living donors (84.6% unrelated and 7.8% related), whereas 7.6% of patients received a deceased donor graft. We found that 1340 (31.8%) of recipients had hyperuricemia. Moderate to severe hyperuricemia was observed in 572 (13.6%) of patients. Although hyperuricemia was frequently occurred in women (34% in women vs 25% in men, p<0.001), the rate of moderate to severe hyperuricemia was higher in men compared to women (15.5% vs 10.3%, p<0.001). There was a significant relationship between SUA and serum creatinine (p<0.001) as well as cyclosporine levels (p<0.001). In multivariate logistic regression, we found that, the increased trough level of cyclosporine was a risk factor of hyperuricemia.Conclusion: Since hyperuricemia is frequently seen in RENAL transplant recipients and high level of cyclosporine is the most important risk factor for developing hyperuricemia, the effective treatment would be cyclosporine dose reduction as much as possible.

Context: The current study aimed at providing an evidence-based and up-to-date review of the literature regarding the assessment and outcomes of pregnancy in patients with RENAL transplant. Design: It was a review of the current literature. Conclusions: According to the current study findings, the function or survival of RENAL allograft was not adversely affected by getting pregnant. Therefore, ideal care for these patients needs a multidisciplinary approach including maternal-fetal medicine, nephrology, and neonatology specialists.

During the end of 2019 a group of patients with pneumonia were described in Wuhan city of china with progression to ARDS with variable outcome. Mortality rate was higher in the oldest and in those with comorbid conditions. Kidney transplant recipients as a group of immunocompromised hosts are believed to be a high risk group in case of infection by SARS-CoV-19 virus with unfavorable outcome. On the other hand, cytokine storm with its severe inflammatory response as a major risk factor of mortality may be prevented by ongoing immunosuppressive therapy. Our knowledge about the pathophysiology and treatment options of COVID-19 in kidney transplant recipients are growing on daily bases and at the time being is derived mainly from the few published case reports, reviews and some society guidelines in the published literature.