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The development of an arteriovenous fistula (AVF) after renal graft biopsy is a rare complication, it is associated in most cases with spontaneous resolution. However, interventional therapies are required in some cases, to prevent graft loss. Selective embolization has been described as an alternative treatment. In the present study, we describes our experience on AVF after biopsy in kidney transplant patients, which was managed with selective embolization. From 2005 to 2015, a total of 452 kidney transplant biopsies were performed, 12 had an AVF requiring embolization. In 92% of cases, this was successful. Beforehand, mean serum creatinine levels were 2.45 mg/dL, after the procedure, that increased to 3.05, however, 3 months later, mean creatinine levels dropped to 1.85 mg/dL. Graft survival after 2 follow-up years was 72%. Our experience demonstrates that selective embolization of the AVF after kidney transplant biopsy is a safe procedure, and that transplant function can be maintained in patients with this complication.

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Peritonitis has been the most common complication of continues ambulatory peritoneal dialysis (CAPD) since it was first implemented, and it remains the leading cause of treatment failure and transfer to other renal replacement therapies. This study presents a Colombian series with a total of 2,469 episodes of peritonitis in 914 patients from a cohort of 1,497 patients on PD, who were followed for almost three decades at a single center. This is the largest Latin American series of patients with PD-related peritonitis. Objective: To describe the CAPD-related peritonitis in a cohort of patients followed for 27 years at a single center, and compare the results with those observed elsewhere in the world. Study Design: Prospective study of incident patients on CAPD from March 1981 to December 2008. Results: In our center, the rate of peritonitis has been steady between 0.8 and 0.9 since 1981 and no significant changes have been noticed in the 27 years of follow up. The rate remains similar to that described nowadays by other large dialysis centers in the world, which have reported significant improvements in recent decades. No significant differences were found in the isolates of gram-positive and gram-negative microorganisms or fungi with respect to those reported by other large series, or in the frequency of culture-negative peritonitis. Conclusion: This study presents the largest Latin American series of patients with CAPD-related peritonitis with a total of 2,469 patients. In this study, the rate of CAPD-related peritonitis remained almost the same during the three decades of observation despite having used three different CAPD systems. Our hypothesis is that the socio-economic conditions of the patients admitted for peritoneal dialysis influences the rate of peritonitis (AU)

Desde que se implementó por primera vez, la peritonitis ha sido la complicación más común de la diálisis peritoneal ambulatoria continua (DPAC) y sigue siendo la causa principal del fracaso del tratamiento y del cambio a otros tratamientos renales sustitutivos. En este estudio se presenta una serie colombiana de un total de 2469 episodios de peritonitis en 914 pacientes de una cohorte de 1497 pacientes en diálisis peritoneal (DP), que fueron sometidos a seguimiento durante casi tres décadas en un único centro. Se trata de la mayor serie de Latinoamérica de pacientes con peritonitis asociada con DP. Objetivo: Describir la peritonitis asociada con la DPAC en una cohorte de pacientes sometidos a seguimiento durante 27 años en un único centro y comparar los resultados con los observados en otras partes del mundo. Diseño del estudio: Estudio prospectivo de pacientes incidentes de DPAC desde marzo de 1981 hasta diciembre de 2008. Resultados: En nuestro centro, la tasa de peritonitis ha permanecido estable entre 0,8 y 0,9 desde 1981 y no se han observado cambios significativos en los 27 años de seguimiento. La tasa es similar a la descrita actualmente por otros grandes centros de diálisis del mundo, que han registrado importantes mejoras en las últimas décadas. No se detectaron diferencias significativas en las muestras aisladas de microorganismos gram positivos o gram negativos u hongos en lo que respecta a los registrados en otras grandes series ni en la frecuencia de peritonitis con cultivo negativo. Conclusión: En este estudio se presenta la mayor serie de Latinoamérica de pacientes con peritonitis asociada con DPAC con un total de 2469 pacientes. La tasa de peritonitis asociada con DPAC permaneció prácticamente inalterable durante las tres décadas de observación, a pesar de haber utilizado tres sistemas diferentes de DPAC. Nuestra hipótesis es que las condiciones socioeconómicas de los pacientes ingresados para diálisis peritoneal influyen en la tasa de peritonitis

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La mucormicosis rino-órbito-cerebral es una infección micótica potencialmente mortal en los pacientes inmunosuprimidos. Los principales factores de riesgo para adquirirla son la diabetes mellitus mal controlada, la sobrecarga de hierro, la inmunosupresión potente y el uso crónico de esteroides. En esta revisión presentamos el caso de un paciente trasplantado de riñón que, luego del tratamiento de un rechazo agudo con dosis altas de esteroides e inmunosupresión potente con tacrolimus más micofenolato, presentó mucormicosis rino-órbito-cerebral de rápida progresión con necesidad de tratamiento quirúrgico agresivo, suspensión de la inmunosupresión y tratamiento antifúngico potente (AU)

Rhino-orbital-cerebral mucormycosis is a potentially fatal mycotic infection in immunosuppressed patients. The main risk factors for acquiring this infection are poorly controlled diabetes mellitus, iron overload, potent immunosuppression and chronic steroid use. In this review, we present the case of a kidney transplant patient who, after treatment of an acute rejection episode with high doses of steroids and potent immunosuppression with tacrolimus and mycophenolate, presented with rapidly progressing rhino-orbital-cerebral mucormycosis that required aggressive surgical treatment, immunosuppression discontinuation and potent antifungal treatment (AU)

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Rhino-orbital-cerebral mucormycosis is a potentially fatal mycotic infection in immunosuppressed patients. The main risk factors for acquiring this infection are poorly controlled diabetes mellitus, iron overload, potent immunosuppression and chronic steroid use. In this review, we present the case of a kidney transplant patient who, after treatment of an acute rejection episode with high doses of steroids and potent immunosuppression with tacrolimus and mycophenolate, presented with rapidly progressing rhino-orbital-cerebral mucormycosis that required aggressive surgical treatment, immunosuppression discontinuation and potent antifungal treatment.

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UNLABELLED: Peritonitis has been the most common complication of continues ambulatory peritoneal dialysis (CAPD) since it was first implemented, and it remains the leading cause of treatment failure and transfer to other renal replacement therapies. This study presents a Colombian series with a total of 2,469 episodes of peritonitis in 914 patients from a cohort of 1,497 patients on PD, who were followed for almost three decades at a single center. This is the largest Latin American series of patients with PD-related peritonitis. OBJECTIVE: To describe the CAPD-related peritonitis in a cohort of patients followed for 27 years at a single center, and compare the results with those observed elsewhere in the world. STUDY DESIGN: Prospective study of incident patients on CAPD from March 1981 to December 2008. RESULTS: In our center, the rate of peritonitis has been steady between 0.8 and 0.9 since 1981 and no significant changes have been noticed in the 27 years of follow up. The rate remains similar to that described nowadays by other large dialysis centers in the world, which have reported significant improvements in recent decades. No significant differences were found in the isolates of gram-positive and gram-negative microorganisms or fungi with respect to those reported by other large series, or in the frequency of culture-negative peritonitis. CONCLUSION: This study presents the largest Latin American series of patients with CAPD-related peritonitis with a total of 2,469 patients. In this study, the rate of CAPD-related peritonitis remained almost the same during the three decades of observation despite having used three different CAPD systems. Our hypothesis is that the socio-economic conditions of the patients admitted for peritoneal dialysis influences the rate of peritonitis.

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