H. Hoefeld

Goethe-Universität Frankfurt am Main, Frankfurt, Hesse, Germany

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Publications (4)13.57 Total impact

  • No preview · Article · Nov 2012 · Transplantation
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    ABSTRACT: Delayed graft function (DGF) is an important complication in renal transplantation, contributing significantly to decrease in long-term allograft survival. In addition to donor- and recipient-related risk factors such as immunosuppression, altered renal excretion of xenobiotics by membrane transporters may influence DGF. Using DNA samples from recipients and donors, we assessed the impact on DGF of genetic variants in P-glycoprotein (ABCB1), multidrug resistance protein 2 (ABCC2), and the nuclear pregnane X receptor (PXR/NR1I2), which regulates the transcription of enzymes and transporters. In our local cohort of renal transplant recipients (n = 178), DGF occurred in 27.5%. The PXR 8055TT genotype of the donor only (not of the recipient) was significantly associated with an increased risk for DGF. This finding emerged from univariate as well as multivariate logistic regression analysis including 16 nongenetic factors and held true after correction for multiple testing. Our findings provide the first evidence that PXR may be associated with risk of DGF, independent of previously identified risk factors.
    No preview · Article · Mar 2012 · Clinical Pharmacology &#38 Therapeutics
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    Hanna Höfeld · Fritz Buck · Ralf Middendorff · Dieter Müller

    Preview · Article · Aug 2011 · BMC Pharmacology
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    ABSTRACT: INTRODUCTION AND AIMS: Impaired glucose metabolism manifest as new onset diabetes after transplantation (NODAT) and impaired glucose intolerance (IGT) is a common and important unwanted outcomes with potential impacts on cardiovascular risks, infections and long-term patient and graft outcomes. Autosomal dominant polycystic kidney disease (ADPKD) has been reported by several authors as an additional predisposing factor to the development of NODAT and IGT. The present study examines the cumulative incidence of impaired glucose metabolism (NODAT and IGT) in a sequential cohort of transplant recipients at a single center. METHODS: From a cohort of 613 pateints (624 grafts), we conducted a retrospective historical cohort study examining the development of NODAT and IGT (defined by WHO criteria) in sequential transplants over 8 years to the end of 2008 in 79 patients (79 transplants) with ADPKD and 502 patients (505 transplants) without ADPKD. Exclusions included pre-exisitng diabetes either as a primary disease or a pre-transplant comorbitiy and a duration of follow-up of < 60 days. Data sources included patient records, departmental database ('Nephworks') and the ANZDATA Registry. RESULTS: There was no significant difference in the cumulative incidence of NODAT (6.3% vs. 7.3%) or IGT (16.0% vs. 12.7%) in the ADPKD compared to the non-ADPKD control group. Of the five patients in the ADPKD group with NODAT, three required treatment with insulin with or without oral hypoglycemic agents. Among the 31 NODAT patients in the non-ADPKD control group, eight were receiving insulin with or without oral hypoglycaemics. Using regression methods and by univariate analysis, only rejection episodes requiring treatment with prednisolone (OR 2.0 (CI: 1.3 - 3.2), p=.002) and dose of Tacrolimus at 6 months (OR 1.3 (1.1 - 1.4), p<.001) were risk factors for impaired glucose metabolism. By multivariate analysis, only dose of Tacrolimus at 6 months (OR 1.4 (1.1 - 1.6), p=.004) was a statistically significant risk factor. CONCLUSIONS: Contrary to the findings of a number of other authros, there was no evidence from this study that ADPKD predisposed to impaired glucose metabolism (either NODAT and/or IGT) in transplant kidney recipients.
    Full-text · Article · Jun 2011 · CKJ: Clinical Kidney Journal