The BK polyomavirus is a small, non-enveloped DNA virus, which is an ongoing concern for the transplant population as it primarily causes clinical disease in immunocompromised hosts, leading to BK-associated nephropathy (BKN) and graft loss. Primary infection of…
Tacrolimus extended-release capsules were approved in the US by the Food and Drug Administration (FDA) in July 2013. The development of this new formulation garnered interest due to a possible improvement in immunosuppressive medication compliance. This formulation has…
Being a parent is probably one of the most desirable and difficult tasks in life. While ESRD is associated with a high rate of infertility related to hormonal changes and anovulation, most patients undergoing renal transplantation resume menstrual…
At ASN Kidney Week there was some interest in abatacept as a targeted therapy for glomerular diseases. T-cell activation requires 2 signals; (i) binding of the T-cell receptor to the antigen-MHC complex on the antigen-presenting cell and (ii)…
Most kidney transplant centers in the United States utilize induction agents as part of their immunosupression protocols. The reasoning behind is that induction therapy has been shown to reduce the rate of acute rejection, however no trial has…
Acute humoral or antibody-mediated rejection (AMR) is attributed to the presence of alloantibodies against the graft, which could be either antibodies against human leukocyte antigens (HLAs) Class I and/or II , non-HLA antigens or endothelial antigens. Diagnosis of…
We recently discussed this issue in conference and I thought it might be worth sharing a few interesting points: Azathioprine is normally converted to the active metabolite 6-mercaptopurine. However, in pregnancy the placenta can metabolize azathioprine to thiouric…
This is a question we face quite often in the Nephrology clinic when we are commencing patients on high dose steroids for glomerular and other systemic inflammatory diseases. I came across a couple of interesting retrospective studies while…
I’ve had the privilege of being a part of the care team for several patients who have participated in Stanford’s Immune Tolerance program here in Palo Alto. The idea behind the program is pretty cool: create chimerism (the…
