ASN conference day 2

 Some rights reserved by Michael in San Diego, California 

The conference has been extremely crowded so far with some talks having to close doors due to inability to accommodate any more people after all sitting and standing room has been exhausted. So I have turned to the poster sessions in attempt to connect with some of the breaking research which is yet to be published. When they are eventually published the data presented in posters may be the source of the next oversubscribed big session at ASN next year.

Dr. Mita M shah et. al. sought to answer the question as to whether the immune system in older patients becomes less responsive. If this is true then older patients who receive transplants will need less medication. This would be an important finding because immunosuppressive medications have side effects which worsen lipid profile and may place a group already at risk for cardiovascular disease at further risk of increased events.

In the study that is yet to be published 158 stable patients were followed for roughly 6.5 years post transplant. The end result was that there was no basis for discontinuing or decreasing immunosuppressives  in older patients. In fact doing so may decrease graft survival.

Dr. Abdelaziz En-Nia presented a poster on polymorphism within the HLA-DR gene promoter and the predictive effect on post transplant kidney rejection and cardiovascular events. This is novel research that suggests that the HLA-DR locus that is routinely tested for prior to transplantation may be involved in the cardiovascular outcome post transplant. Cardiovascular disease mortality being one of the major causes of death after transplantation. Being able to isolate a subset of patients on a genetic basis who are more prone to cardiovascular disease will allow more aggressive therapy for the patients that need it most post transplantation which may translate into survival.

Dr. G Dreyer et. al presented a poster on the variation of Vitamin D levels in a multi ethnic renal transplantation population. The basis of the study was the fact that vitamin D deficiency is highly prevalent in patients after renal transplantation. This being important because of the risk of increased infections in patients with vitamin D deficiency and immunosuppression.

The unpublished results suggest that vitamin D levels vary considerably by ethnic group post transplant when other factors are controlled or accounted for. South Asians and Black patients having the lowest levels of vitamin D.

Research of Gudrun E Norby and others from Oslo in Norway have shown that SLE transplanted patients have equal survival of the transplanted kidney as other patients. However patients with SLE are at higher risk of death after tranplantation most likely from cardiovascular disease. This increased risk of cardiovascular disease in patients with SLE has been described before in the SLE patients with and without cardiovascular disease.