scholarly journals Immunoglobulin A nephropathy and its prognostic factors

2002 ◽  
Vol 55 (11-12) ◽  
pp. 517-522
Author(s):  
Lada Petrovic ◽  
Slobodan Curic ◽  
Igor Mitic ◽  
Dusan Bozic ◽  
Slavenka Vodopivec ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Biopsy ◽  
Clinical Features ◽  
Normal Renal Function ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Laboratory Findings ◽  
Heavy Proteinuria ◽  
The Moment

Introduction Immunoglobulin A nephropathy (IgAN) is a clinicopathological entity characterized by diffuse glomerular mesangial deposition of IgA as the predominant immunoglobulin. Renal biopsy reveals a spectrum of changes in glomerula, tubulointerstitium and blood vessels. 20-50% of all patients develop end-stage renal failure 20 years after onset of disease. The aim of this study was to investigate the incidence of IgAN and to analyze clinicopathological changes and prognosis of IgAN. Material and methods The study included 60 patients with biopsy-proved IgAN without some other systemic diseases or Henoch-Schonlen purpura. We analyzed clinical features of the disease, laboratory findings, findings of immunofluorescence and light microscopy and prognosis of IgAN. The study is partly retrospective and partly prospective. Results and discussion Incidence of the disease in the period 1981-1997 was 9.78%. At the moment of renal biopsy 63.16% of patients had normal renal function, 31.58% had stage I and 5.25% had stage II chronic renal failure. At the end of study 21.05% of investigated patients were included into the worse stage of renal failure in regard to the initial stage. Progression of renal damage correlated with special tubulointerstitial damage and heavy proteinuria. Conclusions In this study we found severe histopathological changes in the group with already impaired renal function and these changes correlated with laboratory findings, clinical features and prognosis. Normal renal function at the moment of renal biopsy pointed to risk for further damage. Changes in the tubulointerstitium and mesangium, heavy proteinuria and hypertension affect the disease prognosis. Evolution to the higher stage of renal failure was 1.24% per year and this requires long-term follow-up of patients with IgAN.

scholarly journals Immunoglobulin A nephropathy: Basic characteristics

2003 ◽  
Vol 56 (5-6) ◽  
pp. 281-285
Author(s):  
Lada Petrovic ◽  
Slobodan Curic ◽  
Igor Mitic ◽  
Dusan Bozic ◽  
Slavenka Vodopivec ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Renal Biopsy ◽  
Clinical Features ◽  
Serological Test ◽  
Immunoglobulin A ◽  
Vascular Lesions ◽  
Immunoglobulin A Nephropathy ◽  
Macroscopic Hematuria ◽  
Female Ratio ◽  
Pathologic Features

Introduction Immunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis in many countries. Most clinical features of IgAN point to a renal problem, such as recurrent macroscopic hematuria or asymptomatic microscopic hematuria and proteinuria. Pathologic features of IgAN present with different types and different degrees of glomerular tubulointerstitial and vascular lesions. The aim of this study was detailed analysis of clinical and laboratory findings, as well as findings of immunofluorescence and light microscopy. We also investigated associations between these factors. Material and methods We investigated 60 patients who underwent renal biopsy. The study was partly retrospective and partly prospective. Results The average age of patients was 34.19 years. Male female ratio was 2.33:1. IgAN was most frequently asymptomatic (83.33%) as microhematuria and proteinuria, while gross hematuria was found in 16.667%. Renal biopsy material was analyzed by light microscopy revealing changes in all glomerular structures. Immunofluorescence microscopy demonstrated dominant IgA deposits. This study established association of glomerulosclerosis with clinical features of disease. Discussion and conclusions IgAN frequently develops in the 4th decade of life, mostly in males and presents as asymptomatic (83.33%). Patohistological changes include all glomerular structures. There is no specific serological test for IgAN, but pathological changes affect clinical features of the disease, as proteinuria and increase of creatinine concentration.

scholarly journals Tuberculosis-associated IgA nephropathy

2018 ◽  
Vol 46 (7) ◽  
pp. 2549-2557 ◽  
Author(s):  
Yamei Wang ◽  
Yuhong Tao
Keyword(s):  
Renal Function ◽  
Mycobacterium Tuberculosis ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Immunoglobulin A ◽  
Diagnostic Value ◽  
Accurate Diagnosis ◽  
Pathological Diagnosis ◽  
Immunoglobulin A Nephropathy ◽  
Reduced Renal Function

Immunoglobulin A nephropathy (IgAN) is the most frequent pathological diagnosis of tuberculosis (TB)-associated glomerulonephritis. Diagnosing TB-associated IgAN (TB-IgAN) is difficult because of its non-specific and insidious symptoms. An inaccurate diagnosis of TB-IgAN could result in the spread of TB and reduced renal function. Haematuria and proteinuria in conjunction with TB should be assessed because of the potential for diagnosis of IgAN. Renal biopsy is important in securing an accurate diagnosis prior to initiating treatment. Detection of Mycobacterium tuberculosis DNA and assessment of early secreted antigenic target of 6 kDa in renal biopsy tissues may have great potential diagnostic value in patients with TB-IgAN. Anti-TB therapy can effectively alleviate TB and TB-IgAN.

scholarly journals Periodontal disease characterization in dogs with normal renal function or chronic renal failure

2004 ◽  
Vol 34 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Glenda Ramalho Barbudo-Selmi ◽  
Marileda Bonafim Carvalho ◽  
André Luis Selmi ◽  
Silvio Emílio Cuevas Martins
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Periodontal Disease ◽  
Normal Renal Function ◽  
White Blood Cells ◽  
Gingival Recession ◽  
Plaque Index ◽  
Urine Specific Gravity ◽  
Bacterial Plaque

The purpose of this study was to evaluate periodontal disease (PD) in dogs with chronic renal failure (CRF) and to compare it to PD in dogs with normal renal function (NRF). Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivitis, gingival recession, pocket, calculus, dental mobility, dental loss, and ulcers. These data were used to calculate plaque index (PI), gingival index (GI) and periodontal destruction index (PDI). PD was graded as mild, moderate or severe based on the results. Mild, moderate or severe PD was observed in dogs with NRF, whereas dogs with CRF presented either mild or severe PD. Dogs with NRF showed higher involvement of the maxillary teeth, whereas dogs with CRF showed a higher involvement of the mandibular teeth. Plaque index was significantly higher in dogs with NRF. It was concluded that lesion distribution and periodontal disease progression may be altered in dogs with CRF, and gingival inflammatory response differs in dogs with NRF and CRF regarding to the stage of periodontal disease.

scholarly journals Predictors of Postoperative Acute Renal Failure after Noncardiac Surgery in Patients with Previously Normal Renal Function

2007 ◽  
Vol 107 (6) ◽  
pp. 892-902 ◽  
Author(s):  
Sachin Kheterpal ◽  
Kevin K. Tremper ◽  
Michael J. Englesbe ◽  
Michael O’Reilly ◽  
Amy M. Shanks ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Creatinine Clearance ◽  
Normal Renal Function ◽  
Noncardiac Surgery ◽  
Intraoperative Management ◽  
All Cause Mortality ◽  
Calculated Creatinine Clearance ◽  
Preoperative Predictors

Background The authors investigated the incidence and risk factors for postoperative acute renal failure after major noncardiac surgery among patients with previously normal renal function. Methods Adult patients undergoing major noncardiac surgery with a preoperative calculated creatinine clearance of 80 ml/min or greater were included in a prospective, observational study at a single tertiary care university hospital. Patients were followed for the development of acute renal failure (defined as a calculated creatinine clearance of 50 ml/min or less) within the first 7 postoperative days. Patient preoperative characteristics and intraoperative anesthetic management were evaluated for associations with acute renal failure. Thirty-day, 60-day, and 1-yr all-cause mortality was also evaluated. Results A total of 65,043 cases between 2003 and 2006 were reviewed. Of these, 15,102 patients met the inclusion criteria; 121 patients developed acute renal failure (0.8%), and 14 required renal replacement therapy (0.1%). Seven independent preoperative predictors were identified (P < 0.05): age, emergent surgery, liver disease, body mass index, high-risk surgery, peripheral vascular occlusive disease, and chronic obstructive pulmonary disease necessitating chronic bronchodilator therapy. Several intraoperative management variables were independent predictors of acute renal failure: total vasopressor dose administered, use of a vasopressor infusion, and diuretic administration. Acute renal failure was associated with increased 30-day, 60-day, and 1-yr all-cause mortality. Conclusions Several preoperative predictors previously reported to be associated with acute renal failure after cardiac surgery were also found to be associated with acute renal failure after noncardiac surgery. The use of vasopressor and diuretics is also associated with acute renal failure.

scholarly journals Characteristics of neuromuscular block after administration of rocuronium bromide in patients with end-stage renal failure

2011 ◽  
Vol 139 (11-12) ◽  
pp. 765-771
Author(s):  
Nevena Kalezic ◽  
Biljana Krivic ◽  
Vladan Zivaljevic ◽  
Djordje Ugrinovic ◽  
Dijana Jovanovic ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Normal Renal Function ◽  
Neuromuscular Block ◽  
Onset Time ◽  
Cumulative Effect ◽  
Control Group ◽  
Rocuronium Bromide ◽  
Duration Time ◽  
Development Duration

Introduction. Anaesthesia affects kidney function by reducing the renal blood flow and glomerular filtration rate. As chronic renal failure (CRF) significantly influences drug metabolism and elimination, we studied the effects of rocuronium bromide (RB) in patients with CRF. Objective. The aim of the study was to examine whether, when using RB in patients with CFR, there are differences regarding the onset time of neuromuscular block (NMB) development, duration time, speed of recovery and cumulative effects of RB. Methods. Prospective study included 60 patients who underwent urologic surgery procedures. The patients were divided into 3 groups: the first group (G1) - 20 patients with CRF and residual dieresis, the second group (G2) - 20 patients with CRF and without dieresis, and third group (G3) - 20 patients with normal renal function (control group). During surgery RB was administrated for muscle paralysis in all patients. Train-of-four (TOF) Guard acceleromyography was used for NMB monitoring. Results. Onset time in three groups was 132.3 s; 139.5 s and 113.2 s (r<0.01). Duration of intubation dose was the same in G1 and G2 (28.9 minutes), while in the third group it was 27.2 minutes (r>0.05). The number of RB repeated doses was 3-8, 3-7 and 4-8 (r>0.05). The duration time until spontaneous recovery was 31.8, 31.6 and 29.8 minutes (r>0.01). The recovery index was 16.8, 16.7 and 10.6 minutes (r<0.001). The duration time from the last dose of RB to extubation was 74.5, 74.8 and 58.9 minutes (r<0.001). Conclusion. In patients with CRF the cumulative effect of the drug was registered, with a prolonged recovery time from NMB in relation to the patients with normal renal function.

scholarly journals Renal Outcomes in Brazilian Patients with Immunoglobulin A Nephropathy and Cellular Crescentic Lesions

2020 ◽  
Vol 45 (3) ◽  
pp. 431-441
Author(s):  
Precil Diego Miranda de Menezes Neves ◽  
Rafaela Bezerra Brito Pinheiro ◽  
Cristiane Bitencourt Dias ◽  
Luis Yu ◽  
Leonardo de Abreu Testagrossa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Biopsy ◽  
Biopsy Specimen ◽  
Immunoglobulin A ◽  
Composite Outcome ◽  
Immunoglobulin A Nephropathy ◽  
Oxford Classification ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Impact

Background and Aim: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulopathy. The Oxford classification was recently updated to include crescents as markers of poor prognosis. The aim of this study was to evaluate the impact of cellular crescents on the prognosis of patients with IgAN in Brazil. Methods: This was a single-centre retrospective analysis of medical records and renal biopsies in patients with IgAN. The renal biopsy findings were classified according to the revised Oxford classification: mesangial hypercellularity, endocapillary hypercellularity (E), segmental glomerulosclerosis (S), tubular atrophy or interstitial fibrosis (T), and crescent formation (C). We evaluated a composite outcome (progression to end-stage renal disease or creatinine doubling). We performed analyses between the patients with crescents in the renal biopsy specimen (C1/C2 group) and those without such crescents (C0 group). Results: We evaluated 111 patients, of whom 72 (65.0%) were women, 80 (72.0%) self-identified as White, 73 (65.6%) were hypertensive, and 95 (85.6%) had haematuria. The distribution of patients according to cellular crescentic lesions was: C0, 80 (72%); C1, 27 (24.4%); C2, 4 (3.6%). The composite outcome was observed in 33 (29.72%) of the 111 patients. In comparison with the C0 group, the C1/C2 group had higher proportions of patients with hypertension (p = 0.04), haematuria (p = 0.03), worse serum creatinine (p = 0.0007), and worse estimated glomerular filtration rate (p = 0.0007). The C1/C2 group also had higher proportions of patients in whom the biopsy specimen was classified as E1 (p = 0.009), S1 (p = 0.001), or T1/T2 (p = 0.03), In addition, the mean follow-up period was shorter in the C1/C2 group (p < 0.0001). Furthermore, the composite outcome was observed in a greater proportion of patients and in a shorter length of time in the C1/C2 group than in the C0 group (p = 0.002 and p = 0.0014, respectively). In a Cox regression analysis, the independent risk factors for the composite outcome had Oxford classifications of S1, T1/T2, and C1/C2. Conclusion: Oxford classification findings of S1, T1/T2, or C1/C2 were independent risk factors for the composite outcome, corroborating previous studies.

Increased Fibrinogen Levels and Hemostatic Abnormalities in Patients with Arteriolar Nephrosclerosis: Association with Cardiovascular Events

2000 ◽  
Vol 84 (10) ◽  
pp. 565-570 ◽  
Author(s):  
Laura Zingaro ◽  
Cristiana Catena ◽  
Sergio De Marchi ◽  
Leonardo Sechi
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Creatinine Clearance ◽  
Normal Renal Function ◽  
Cardiovascular Events ◽  
Plasma Fibrinogen ◽  
Atherosclerotic Disease ◽  
Prothrombotic State ◽  
Arteriolar Nephrosclerosis ◽  
D Dimer

SummaryIncreased plasma fibrinogen levels and hemostatic abnormalities suggestive of a prothrombotic state are present in patients with endstage renal failure and could contribute to increased cardiovascular morbidity in these patients. We investigated the relationship between abnormalities of the hemostatic system and the degree of renal failure and whether these abnormalities are associated with increased prevalence of cardiovascular events in patients with arteriolar nephrosclerosis. In 425 patients recruited at a hypertension clinic we assessed the renal function by creatinine clearance, urinary protein excretion, and microalbuminuria, the prevalence of atherosclerotic disease, and measured prothrombin time, activated partial thromboplastin time, fibrinogen, prothrombin fragment 1+2 (F1+2), D-dimer, and antithrombin. Early impairment of renal function (creatinine clearance, 30 to 89 ml/min per 1.73 m2 of body surface area) caused by arteriolar nephrosclerosis was found in 172 patients. Patients with early renal failure were significanly older and had significantly greater values of blood pressure, plasma fibrinogen, F1+2, and D-dimer than patients with normal renal function. Elevated D-dimer and fibrinogen levels were independently associated with the presence of decreased creatinine clearance. Log fibrinogen, log F1+2, and log D-dimer were inversely correlated with creatinine clearance. The prevalence of coronary artery, cerebrovascular, and peripheral vascular disease was significantly greater in patients with mild renal failure than in those with normal renal function. Elevated levels of fibrinogen and D-dimer were associated with the presence of atherosclerotic disease independent of renal function and other risk factors. In conclusion, changes in hemostatic parameters occur early in the course of renal failure in patients with arteriolar nephrosclerosis, suggesting a prothrombotic state that may contribute to the risk for atherosclerotic disease at all levels of renal function.

Acute Renal Failure Due to Interstitial Nephritis Induced by ‘Glue-Sniffing’ with Subsequent Recovery

1988 ◽  
Vol 33 (2) ◽  
pp. 246-247 ◽  
Author(s):  
D. Taverner ◽  
D.J. Harrison ◽  
G.M. Bell
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Biopsy ◽  
Interstitial Nephritis ◽  
Hepatic Damage ◽  
Subsequent Recovery ◽  
Renal Complications ◽  
Toluene Exposure

We report a case of the deliberate inhalation of a toluene-containing adhesive which caused acute renal failure and hepatic damage. Renal biopsy disclosed a severe tubulo-interstitial nephritis, renal function recovered after 14 days' haemodialysis. The literature on renal complications of toluene exposure is reviewed, this is the only case of acute renal failure due to interstitial nephritis after toluene exposure with subsequent recovery. Recovery in this case may have been related to the avoidance of further toluene exposure.

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