A series of pharmacokinetic studies of ceftaroline fosamil in select populations: Normal subjects, healthy elderly subjects, and subjects with renal impairment or end-stage renal disease requiring hemodialysis

2014 ◽  
Vol 54 (7) ◽  
pp. 742-752 ◽  
Author(s):  
Todd Riccobene ◽  
Abhijeet Jakate ◽  
Doug Rank
Keyword(s):  
Renal Impairment ◽  
End Stage Renal Disease ◽  
Normal Subjects ◽  
Elderly Subjects ◽  
Pharmacokinetic Studies ◽  
Ceftaroline Fosamil ◽  
Healthy Elderly ◽  
Stage Renal Disease ◽  
End Stage ◽  
Healthy Elderly Subjects

The patient with vasculitis

2015 ◽  
Author(s):  
Lorraine Harper ◽  
David Jayne
Keyword(s):  
Renal Impairment ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Drug Toxicity ◽  
Response To Therapy ◽  
Renal Outcome ◽  
Remission Induction ◽  
Renal Vasculitis ◽  
Stage Renal Disease ◽  
End Stage

The goals of treatment in renal vasculitis are to stop vasculitic activity and recover renal function. Subsequent strategies are required to prevent vasculitis returning and to address longer-term co-morbidities caused by tissue damage, drug toxicity, and increased cardiovascular and malignancy risk.Cyclophosphamide and high-dose glucocorticoids remain the standard induction therapy with alternative immunosuppressives, such as azathioprine, to prevent relapse. Plasma exchange improves renal recovery in severe presentations. Refractory disease resulting from a failure of induction or remission maintenance therapy requires alternative agents and rituximab has been particularly effective. Replacement of cyclophosphamide by rituximab for remission induction is supported by recent evidence. Methotrexate is effective in non-renal vasculitis but difficult to use in patients with renal impairment. Mycophenolate mofetil seems to be effective but there is less long-term evidence.Drug toxicity contributes to co-morbidity and mortality and has led to newer regimens with reduced cyclophosphamide exposure. Glucocorticoid toxicity remains a major problem with controversy over the rapidity with which glucocorticoids can be reduced or withdrawn.Disease relapse occurs in about 50% of patients. Early detection is less likely to lead to an adverse affect on outcomes. Rates of cardiovascular disease and malignancy are higher than in control populations but strategies to reduce their risk, apart from cyclophosphamide-sparing regimens, have not been developed. Thromboembolic events occur in 10% and may be linked to the recently identified autoantibodies to plasminogen and tissue plasminogen activator.Renal impairment at diagnosis is a strong predictor of patient survival and renal outcome. Other predictors include patient age, antineutrophil cytoplasmic antibody subtype, disease extent and response to therapy. Chronic kidney disease can stabilize for many years but the risks of end-stage renal disease are increased by acute kidney injury at presentation or renal relapse. Renal transplantation is successful with similar outcomes to other causes of end-stage renal disease.

scholarly journals C3-Glomerulonephritis in New Zealand – A Case Series

2020 ◽  
Author(s):  
Luke J Sutherland ◽  
Hari Talreja
Keyword(s):  
New Zealand ◽  
Renal Impairment ◽  
Renal Disease ◽  
Clinical Outcomes ◽  
End Stage Renal Disease ◽  
Disease Incidence ◽  
Pacific Islanders ◽  
C3 Glomerulonephritis ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: C3-glomerulonephritis can lead to progressive renal impairment from complement-mediated glomerular injury. Incidence and outcomes of C3-glomerulonephritis are not known in the New Zealand population. Methods: We reviewed all cases of C3-glomerulonephritis from the past 10 years at a tertiary referral centre in New Zealand. Descriptive information on baseline characteristics and clinical outcomes was collected. Results: 26 patients were included (16 men; mean±SD age 44±25 years) with a median follow-up of 30 months. Disease incidence was 1.3 cases per million individuals, of which 42% were Pacific Islanders. Most patients presented with renal impairment, with a median (IQR) creatinine at diagnosis of 210 (146-300) µmol/L, and nephrotic-range proteinuria with a protein/creatinine ratio of 551.5 (293-983) mg/mmol. 8 (31%) patients progressed to end stage renal disease and 2 (8%) had died. End stage renal disease occurred in 25% of patients treated with immunosuppression and in 50% of those not treated. Complete remission was seen in 25% of patients treated with some form of immunosuppression and in 17% of those not treated. Conclusions: Our results are consistent with previous descriptions of C3-glomerulonephritis. There was a suggestion of better clinical outcomes in patients treated with immunosuppression. There was a higher disease incidence in Pacific Islanders, which may indicate an underlying susceptibility to complement dysfunction in this population.

1101 THE EFFECT OF RENAL IMPAIRMENT AND END STAGE RENAL DISEASE ON THE SINGLE-DOSE PHARMACOKINETICS OF PSI-7977

2012 ◽  
Vol 56 ◽  
pp. S433 ◽  
Author(s):  
M.T. Cornpropst ◽  
J.M. Denning ◽  
D. Clemons ◽  
T.C. Marbury ◽  
H. Alcorn ◽  
...  
Keyword(s):  
Single Dose ◽  
Renal Impairment ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage
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