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Quality of life of patients after kidney transplantation
Nováková, Monika ; Jirkovský, Daniel (advisor) ; Haluzíková, Jana (referee)
Bachelor thesis "Quality of life in patients after kidney transplant" deals with issue of patient´s quality of livfe before and after transplantation. The objective of this thesis was to map quality of life before and after kidney transplantation in several dimensions - physical functioning, physical limitation, general health, vitality, social functioning, emotional issues and mental health. In theoretial section is presented overview of kidney diseasees, proces of transplantation and quality of life. In empirical section are presented methods of data collection, realisation of survey and results of this investigation. Chosen Method was standardized questionaire SF-36 supplemented with soci-demographic and health related information questionaire devised by autor. It was distributed among patients of nefrological ambulantory practice in IKEM which underwent kidney transplantation. Results: Quality of life of patients after udergoing tranplantation of kidney was better then before transplantationin these areas: perception of one`s own health, walking up the stirs one and more floors, walking hundred meters, managing worload, lesser difficulities in activities of daily living. Pain was lesser obstacle in managing work. Positive shift occured in feeling of pep, nervousness, depression, calm and peace,...
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Analysis of serological cross-reactivity between antibodies against BK polyomavirus variants
Caisová, Helena ; Horníková, Lenka (advisor) ; Roubalová, Kateřina (referee)
BK polyomavirus (BKPyV), which asymptomatically infects about 80 % of the human population, can reactivate in immunosuppressed patients after kidney transplantation and cause nephropathy. In the European population, there are predominantly two BKPyV sub- types, BKPyV-I and BKPyV-IV, which behave as different serotypes. Recipients who receive a kidney from a donor positive for a different subtype are at a greater risk of graft rejection. So far, it is impossible to distinguish between these two subtypes using a serological ELISA test as serum antibodies against these two subtypes cross-react. This work aimed to iden- tify epitopes on the major antigenic protein VP1, which are responsible for the binding of cross-reacting and/or subtype-specific antibodies. The identification of such epitopes could further lead to improvement in pre-transplant diagnostics and better management of pati- ents after transplantation. Therefore, two types of antigens composed of the VP1 protein of the BKPyV-IV subtype with introduced mutations characteristic of BKPyV-I in the DE and EF loops of VP1 were prepared and tested using an antigen competition assay with a panel of human sera. The results showed that the DE loop region is an immunogenic epitope that binds specific antibodies for BKPyV subtype I. Conversely, a mutation in...
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Risk of skin cancer and lymphoproliferative diseases in patients after kidney transplantation
Sidorová, Kristína ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Risk of skin cancer and lymphoproliferative diseases in patients after kidney transplantation Author: Kristína Sidorová Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: Mgr. Barbora Vaňková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Organ transplantations (Tx) are associated with the lifelong use of immunosuppressive therapy (IS), which carries with it, among other risks, an increased incidence of malignancies. The most common malignancies after Tx are skin tumors, post-transplant lymphoproliferative diseases (PTLD) are also more common in transplant patients. The aim of the study was to determine the incidence of skin tumors and PTLD in patients with kidney Tx within one transplant center and to analyze the risk factors associated with these diseases. Methods: Retrospective longitudinal study was conduted in the Teaching Hospital Hradec Králové. The study included patients from the age of 18 who had overcome kidney Tx until 24 April 2019, were registered in a transplant clinic in Hradec Králové and had a medical record in the hospital information system. Data collection from medical records took place from 15 April 2019 to 31 December 2019. Collected data included demographic characteristics, family history,...
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The role of T regulatory cells in kidney transplantation
Urbanová, Anna ; Stříž, Ilja (advisor) ; Zajícová, Alena (referee)
T regulatory lymphocytes (Treg) belong to the CD4+ cell group. They are an essential part of the immunity system. Treg cells prevent from excessive activation of effector T cells and they keep the tolerance to the tissues of the body. They have high expression of CD25 and the transcription factor Foxp3. We distinguish two basic populations of Treg cells: natural Treg cells (nTreg) created in the thym and representing 5-10 % of all CD4+ cells, and induced Treg cells (iTreg), created from naive CD4+ cells in the periphery.Their regulatory effect is well-known, therefore using of Treg cells could bring about a huge treatment potential for patients with a transplantated kidney. Healthy people and patients tolerant to the transplantated kidney show higher occurance of circulating Treg cells and the Treg cells present in the graft unlike patients with chronical rejection. The tolerance is cancelled with the damage of CD4+ CD25+ cells.For a graft acceptance it is necessary to treat the patient after the transplantation with immunosuppressive medicaments resulting in suppression of immunity reaction against the graft. Their disadvantages are side effects often resulting in the patient's death. Moreover they often have a negative impact on survival and expansion of Treg cells. The analysis of flow cytometry has...
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Adherence to treatment in patients after kidney transplantation
Vaňková, Barbora ; Malý, Josef (advisor) ; Zimčíková, Eva (referee)
Adherence to Treatment in Patients after Kidney Transplantation Author: Barbora Vaňková Tutor: PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Kateřina Ládová, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Kidney transplantation (KT) is the best treatment option for patients with end- stage renal disease. However, despite its numerous benefits it requires a lifelong medical regimen of immunosuppressive treatment (IS) with a special emphasis on a strict medication adherence (MA). The objective of our study was to analyse MA in KT outpatients. We also intended to analyse non- adherence as one of the drug-related problems. Furthemore, we focused on analysis of the main self- management tasks. Methods: The prospective cross-sectional study was undertaken in one year period from March 2016 to March 2017 at the Haemodialysis Centre in the Teaching Hospital Hradec Králové. Patients ≥ 18 years old and at least 3 weeks after KT were addressed within their regularly scheduled visit to the nephrologist. Structured interview was performed by pharmacist to determine patients' self-reported MA to IS using validated Czech version of Medication Adherence Report Scale (MARS-CZ). In addition, patients were interviewed about other...
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Photoprotection in patients after kidney transplantation
Hajšelová, Zuzana ; Malý, Josef (advisor) ; Kolmanová, Eliška (referee)
Photoprotection in Patients after Kidney Transplantation Author: Zuzana Hajšelová Tutor: doc. PharmDr. Josef Malý, PhD. Consultant: Mgr. Barbora Vaňková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradci Králové, Charles University Introduction and aims: Patients after kidney transplantation (KT) are in a higher risk of developing skin cancer as a result of lifelong immunosuppressive (IS) therapy. Thorough photoprotection is therefore recommended. The aim of this study was to determine patients' awareness and level of photoprotection and to analyse selected risk factors for skin cancer development in patients after KT. Methods: The cross-sectional study was undertaken from 15th April to 31st December 2019 at the Haemodialysis Centre in the Teaching Hospital Hradec Králové. Patients included in this study were above 18 years old, who visited Haemodialysis Centre in the defined period. The data was collected from the patients' medical documentation (e.g. occurrence of skin cancer and skin cancer type, current IS) and from the written version of questionnaires (e.g. phototype, sun exposure, photoprotection). The data was analysed using descriptive statistics. Results: There were 410 KT patients in regular care of the Haemodialysis Centre, 361 fulfilled the questionnaire (88.0...
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Quality of life of hemodialysis patients
Kycltová, Pavlína ; Tomová, Šárka (advisor) ; Hlaváčová, Marie (referee)
Throughout the introduction to this bachelor thesis I would like to narrate the issue of a chronic kidney failure. The causes, symptoms, diagnosis, cure as well as the quality of life of patients diagnosed with this condition, will be mentioned. We will learn what principle hemodialysis is based on, what its complications might be and what requirements have to be met, in order for the patient to undergo a hemodialysis treatment. My aim will be to depict the problems caused by this illness in a family, work place and one's social life. The assessment of this issue will be based on information gathered from a survey conducted by myself at the hemodialysis center. My thesis will be concluded, with the use of a graphic and verbal description, by an analysis of the survey questionnaire and a disclosure of the data and final results about the quality of life of hemodialysis patients which participated in the research.
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Risk of skin cancer and lymphoproliferative diseases in patients after kidney transplantation
Sidorová, Kristína ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Risk of skin cancer and lymphoproliferative diseases in patients after kidney transplantation Author: Kristína Sidorová Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: Mgr. Barbora Vaňková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Organ transplantations (Tx) are associated with the lifelong use of immunosuppressive therapy (IS), which carries with it, among other risks, an increased incidence of malignancies. The most common malignancies after Tx are skin tumors, post-transplant lymphoproliferative diseases (PTLD) are also more common in transplant patients. The aim of the study was to determine the incidence of skin tumors and PTLD in patients with kidney Tx within one transplant center and to analyze the risk factors associated with these diseases. Methods: Retrospective longitudinal study was conduted in the Teaching Hospital Hradec Králové. The study included patients from the age of 18 who had overcome kidney Tx until 24 April 2019, were registered in a transplant clinic in Hradec Králové and had a medical record in the hospital information system. Data collection from medical records took place from 15 April 2019 to 31 December 2019. Collected data included demographic characteristics, family history,...
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