scholarly journals Impact of Proteinase 3 versus Myeloperoxidase Positivity on Risk of End-Stage Renal Disease in ANCA-Associated Glomerulonephritis Stratified by Histological Classification: A Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Vilde Solbakken ◽  
Anne-Siri Fismen ◽  
Leif Bostad ◽  
Rune Bjørneklett
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Lower Percentage ◽  
Proteinase 3 ◽  
Histological Classification ◽  
Free Survival ◽  
Stage Renal Disease ◽  
End Stage

Background. End-stage renal disease (ESRD) risk in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated glomerulonephritis (ANCA-GN) according to ANCA serotype and stratified by histological classification has not been previously investigated. Methods. Patients from the Norwegian Kidney Biopsy Registry (NKBR) between 1991 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody serology were included. Cases with ESRD during follow-up were identified in the Norwegian Renal Registry. ESRD-free survival with proteinase 3 (PR3) versus myeloperoxidase- (MPO-) ANCA positivity stratified into 4 histological classes was investigated. Results. Three hundred fifty-eight patients, of whom 87 progressed to ESRD during follow-up, were included. Patients with PR3- as compared to MPO-ANCA were younger (58 versus 64 years, p=0.001), had a higher percentage of males (62 versus 41%, p<0.001), had a lower percentage with a sclerozing glomerulonephritis pattern (4 versus 16%, p<0.001), and had a significantly higher cumulative ESRD-free survival (90 versus 80%, p=0.007) at 1-year follow-up. No significant differences in cumulative ESRD-free survival with PR3- as compared to MPO-ANCA were observed by histological stratification. Conclusion. Advanced glomerular sclerosis is found more frequently in patients with MPO-ANCA, explaining the higher risk of ESRD. ANCA serotypes have no impact on prognosis of patients with similar histological findings.

scholarly journals Prognostic Factors in Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis with Severe Glomerular Sclerosis: A National Registry-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Rune Bjørneklett ◽  
Vilde Solbakken ◽  
Leif Bostad ◽  
Anne-Siri Fismen
Keyword(s):  
Prognostic Factors ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Disease Free Survival ◽  
National Registry ◽  
Lower Percentage ◽  
Glomerular Sclerosis ◽  
Stage Renal Disease ◽  
End Stage

Background. Classification of patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) into histological classes is useful for predicting a patient’s risk of progression to end-stage renal disease (ESRD). However, even in the worst prognostic group, the 5-year end-stage renal disease-free survival rate is as high as 50%. Objectives. To investigate those prognostic factors indicative of progression to ESRD in patients with ANCA-GN and sclerosing histology. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1991 and 2012 who had biopsy verified pauci-immune glomerulonephritis, positive ANCA serology, and sclerosing histology were included. Cases with ESRD during follow-up were identified via linkage with the Norwegian Renal Registry. Potential prognostic factors with relevant cut-offs were compared in patients with and without progression to ESRD during follow-up. Results. Of 23 included patients, 10 progressed to ESRD. ESRD patients had a lower initial estimated glomerular filtration rate (eGFR; 21 versus 52 ml/min/1.73 m2) and a lower percentage of normal glomeruli (4% versus 15%). Five-year risks of ESRD with eGFR >15 versus ≤15 ml/min/1.73 m2 were 77% and 15%, with percentage normal glomeruli >10% versus ≤10%, 83% and 39%. Conclusions. eGFR and percentage of normal glomeruli are strong risk factors for ESRD in ANCA-GN with sclerosing histology.

MO282EARLY RENAL RECOVERY AFTER A FIRST FLARE OF PAUCI IMMUNE GLOMERULONEPHRITIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jeremy Zaworski ◽  
Cyrille Vandenbussche ◽  
Pierre Bataille ◽  
Eric Hachulla ◽  
Francois Glowacki ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Interstitial Fibrosis ◽  
Univariate Analysis ◽  
Renal Recovery ◽  
Neurological Involvement ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Renal involvement is a severe manifestation of ANCA-associated vasculitis. Patients often progress to end-stage renal disease. The potential for renal recovery after a first flare has seldom been studied. Our objectives were to describe the evolution of the estimated glomerular filtration rate (eGFR) and identify factors associated with the change in eGFR between diagnosis and follow-up at 3 months (ΔeGFRM0–M3) in a cohort of patients with a first flare of pauci-immune glomerulonephritis. Methods This was a retrospective study over the period 2003–2018 of incident patients in the Nord-Pas-de-Calais (France). Patients were recruited if they had a first histologically-proven flare of pauci immune glomerulonephritis with at least 1 year of follow up. Kidney function was estimated with MDRD-equation and analysed at diagnosis, 3rd, 6th and 12th months. The primary outcome was ΔeGFRM0–M3. Factors evaluated were histological (Berden classification, interstitial fibrosis, percentage of crescents), clinical (extra-renal manifestations, sex, age) or biological (severity of acute kidney injury, dialysis, ANCA subtype). Results One hundred and seventy-seven patients were included. The eGFR at 3 months was significantly higher than at diagnosis (mean ± standard deviation, 40 ± 24 vs 28 ± 26 ml/min/1.73 m2, p &lt; 0.001), with a ΔeGFRM0–M3 of 12 ± 19 ml/min/1.73 m2. The eGFR at 12 months was higher than at 3 months (44 ± 13 vs 40 ± 24 ml/min/1.73m2, p = 0.003). The factors significantly associated with ΔeGFRM0–M3 in univariate analysis were: sclerotic class according to Berden classification, percentage of interstitial fibrosis, percentage of cellular crescents, acute tubular necrosis, neurological involvement. The factors associated with ΔeGFRM0–M3 in multivariate analysis were the percentage of cellular crescents and neurological involvement. The mean increase in eGFR was 2.90 ± 0.06 ml/min/1.73m2 for every 10-point gain in the percentage of cellular crescents. ΔeGFRM0–M3 was not associated with the risks of end-stage renal disease or death in long-term follow-up. Conclusions Early renal recovery after a first flare of pauci-immune glomerulonephritis occurred mainly in the first three months of treatment. The percentage of cellular crescents was the main independent predictor of early renal recovery.

scholarly journals Perfusion defects on real-time myocardial contrast echocardiography predict higher mortality in patients with end-stage renal disease – A 3-year follow-up

Renal Failure ◽  
2010 ◽  
Vol 32 (10) ◽  
pp. 1160-1166 ◽  
Author(s):  
Anna Tomaszuk-Kazberuk ◽  
Bozena Sobkowicz ◽  
Jolanta Malyszko ◽  
Jacek S. Malyszko ◽  
Marek Kalinowski ◽  
...  
Keyword(s):  
Renal Disease ◽  
Real Time ◽  
End Stage Renal Disease ◽  
Contrast Echocardiography ◽  
Myocardial Contrast Echocardiography ◽  
Perfusion Defects ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030661 ◽  
Author(s):  
Mindy Pike ◽  
Jacob Taylor ◽  
Edmond Kabagambe ◽  
Thomas G Stewart ◽  
Cassianne Robinson-Cohen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Sedentary Time ◽  
Sitting Time ◽  
Stage Renal Disease ◽  
End Stage

ObjectiveTo examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD).Study designCase-cohort study.SettingSouth-eastern USA.ParticipantsThe Southern Community Cohort Study recruited ~86 000 black and white participants from 2002 to 2009. We assembled a case cohort of 692 incident ESRD cases and a probability sample of 4113 participants.PredictorsSedentary time was calculated as hours/day from daily sitting activities. Physical activity was calculated as metabolic equivalent (MET)-hours/day from engagement in light, moderate and vigorous activities.OutcomesIncident ESRD.ResultsAt baseline, among the subcohort, mean (SD) age was 52 (8.6) years, and median (25th, 75th centile) estimated glomerular filtration rate (eGFR) was 102.8 (85.9–117.9) mL/min/1.73 m2. Medians (25th–75th centile) for sedentary time and physical activity were 8.0 (5.5–12.0) hours/day and 17.2 (8.7–31.9) MET-hours/day, respectively. Median follow-up was 9.4 years. We observed significant interactions between eGFR and both physical activity and sedentary behaviour (p<0.001). The partial effect plot of the association between physical activity and log relative hazard of ESRD suggests that ESRD risk decreases as physical activity increases when eGFR is 90 mL/min/1.73 m2. The inverse association is most pronounced at physical activity levels >27 MET-hours/day. High levels of sitting time were associated with increased ESRD risk only among those with reduced kidney function (eGFR ≤30 mL/min/1.73 m2); this association was attenuated after excluding the first 2 years of follow-up.ConclusionsIn a population with a high prevalence of chronic kidney disease risk factors such as hypertension and diabetes, physical activity appears to be associated with reduced risk of ESRD among those with preserved kidney function. A positive association between sitting time and ESRD observed among those with advanced kidney disease is likely due to reverse causation.

An Overview of Renal Diseases in Children in Pokhara

1970 ◽  
Vol 27 (2) ◽  
pp. 75-78 ◽  
Author(s):  
T Malla ◽  
KK Malla ◽  
A Thapalial ◽  
MS Sharma
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Renal Stone ◽  
Laboratory Evaluation ◽  
Renal Diseases ◽  
Adequate Treatment ◽  
Stage Renal Disease ◽  
End Stage

Objective: To determine the current pattern and prevalence of renal diseases in childhood in this region of Nepal. Material and Methods: A retrospective study of the renal diseases in children attending the Pediatric OPD and those hospitalised in Manipal Teaching Hospital, Pokhara was done over a period of 6 years (September 2000- September 2006). A detailed clinical and laboratory evaluation was performed at baseline. The children were managed according to disease diagnosed. These cases are under follow up and some have undergone surgical treatment. Results: 228 children (123 boys & 105girls) were diagnosed to have renal disease. Among them 39.5% had urinary tract infection (UTI), 30.7 % were suffering from acute glomerulonephritis (AGN), 17.5% were cases of nephrotic syndrome (NS) and 12 % had some other problems for example, 6.14% had genetic defects, 2.63% had renal Stone, 2.2% had pre-renal acute renal failure, unexplained recurrent hematuria in 1.3%. All the cases of UTI underwent through investigation and were treated accordingly. All cases of AGN are planned for follow up for 1½ yrs and among them 3 required biopsy till date. All cases of NS are under regular follow-ups and 2 have undergone biopsy. Renal stone was operated successfully. All cases of acute and chronic renal failures had required dialysis. Out of 5 (2.5%) chronic renal failures, 2 with end stage renal disease expired after repeated hemodialysis and three are still requiring dialysis. Among the obstructive uropathies, 43 % had renal stone, 36 % had posterior urethral valve and 21% VUR. Conclusion: It can be concluded that renal disease is not uncommon in children. It can be completely cured with proper and adequate treatment. Sometimes it has a bad prognosis when it reaches end stage renal disease. Early recognition, timely treatment and regular follow up are mandatory in management of children with renal diseases. Key words: Renal disease pattern, UTI, AGN, NS, Obstructive Uropathy, Renal failure   doi:10.3126/jnps.v27i2.1414 J. Nepal Paediatr. Soc. Vol.27(2) p.75-78

Depression, Perception of Illness and Mortality in Patients with End-Stage Renal Disease

1991 ◽  
Vol 21 (4) ◽  
pp. 343-354 ◽  
Author(s):  
Rolf A. Peterson ◽  
Paul L. Kimmel ◽  
Carol R. Sacks ◽  
Mary Louise Mesquita ◽  
Samuel J. Simmens ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Early Recognition ◽  
Additional Measure ◽  
Treatment Of Depression ◽  
Severity Scores ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

A role of depression in affecting outcome in patients with end stage renal disease (ESRD) has been suggested but few have assessed psychological parameters and medical factors thought to influence survival simultaneously and prospectively. To assess whether depression or perception of illness influences survival in patients treated for ESRD, we prospectively evaluated fifty-seven patients with ESRD treated with hemodialysis (HD, n = 43) or continuous ambulatory peritoneal dialysis (CAPD, n = 14). Patients were interviewed and completed the Beck Depression Inventory (BDI) and the Illness Effects Questionnaire (IEQ). An ESRD severity coefficient was used to measure chronic illness severity. A cognitive item subset of the BDI (CDI) was used as an additional measure of depression. One and two years later, records were examined to determine survival. When initial results of the assessment of survivors and non-survivors were compared, at one year follow-up, there were no differences in mean age, duration of dialysis, severity scores, BDI or IEQ scores. The initial mean CDI scores in the group of non-survivors, however, were significantly greater than the scores in the survivor group. At two year follow-up, CDI scores were significantly different between groups, and were significant in a hazards regression. Disease severity, age and duration of dialysis were also significantly related to mortality at two year follow-up. We conclude cognitive depression is an important, early, indicator of grave prognosis in patients treated for ESRD. Early recognition of and therapeutic efforts directed toward the treatment of depression might modify outcome in ESRD patients.

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