Unilateral calciphylaxis in a patient with systemic lupus erythematosus, chronic kidney disease, and hemodialysis-associated steal syndrome

2011 ◽  
Vol 17 (9) ◽  
Author(s):  
Ekama Onofiok ◽  
Raja K Sivamani ◽  
Keira L Barr
Author(s):  
Annastacia N. Mbithi ◽  
Harun M. Kimani ◽  
Alloys S. S. Orago

Background: Chronic kidney disease (CKD) is a worldwide public health issue with high prevalence (8% and 16%) among adults. The severity of CKD and associated clinical features are less characterized in Kenya. We set to determine severity and clinical features of CKD among outpatient attendees in selected hospitals in Nairobi county.Methods: In this hospital based analytical cross-sectional study design, we collected data from Kenyatta National Hospital (KNH), Aga Khan University Hospital (AKUHN) and Mater Misericordiae Hospital. We recruited 336 adult CKD outpatients aged 18 years and above attending nephrology clinics between January and July, 2020 using a simple random sampling. A self-administered questionnaire was used to collect social-demographic data while data on severity and clinical features were retrieved from patient’s files of those who had given an informed consent. Descriptive and inferential statistics were performed using statistical package of social science version 26.0.Results: Majority of CKD patients (61.9%) had severe disease. Among patients with CKD, the following clinical features were statistically significant with severe disease; diabetic nephropathy (OR 3.43, 95% CI; 1.72, 5.67), glomerulonephritis (OR 2.52, 95% CI; 2.07, 4.05), hypertensive nephrosclerosis (OR 1.95, 95% CI; 1.87, 3.11), polycystic kidney disease (OR 1.26, 95% CI; 1.12, 2.61) and systemic lupus erythematosus (OR 1.16, 95% CI; 1.06, 1.39).Conclusions: Among outpatient attendees in Nairobi county, severe CKD is likely to be found in patients with diabetic nephropathy, glomerulonephritis, hypertensive nephrosclerosis, polycystic kidney disease and systemic lupus erythematosus. Therefore, the patients with these features need proper follow up and treatment to slow down progression of CKD to severe stages. However, more studies are need to be done to ascertain that the clinical features are responsible for severe CKD.  


2019 ◽  
Vol 7 (12) ◽  
Author(s):  
Raziel Tapia‐Llanos ◽  
José F. Muñoz‐Valle ◽  
Ilce V. Román‐Fernández ◽  
Miguel Marín‐Rosales ◽  
Diana C. Salazar‐Camarena ◽  
...  

Author(s):  
Arthur Mageau ◽  
Jean-Francois Timsit ◽  
Anne Perozziello ◽  
Benedicte Giroux Leprieur ◽  
Stephane Ruckly ◽  
...  

2020 ◽  
pp. annrheumdis-2020-217728
Author(s):  
Chia-Ying Wu ◽  
Magdalene Tan ◽  
Jing-Yang Huang ◽  
Jeng-Yuan Chiou ◽  
James Cheng-Chung Wei

2015 ◽  
Vol 28 (3) ◽  
pp. 333 ◽  
Author(s):  
Lígia Peixoto ◽  
Patrício Aguiar ◽  
Raquel De Bragança ◽  
Joana Rosa Martins ◽  
Alba Janeiro Acabado ◽  
...  

<strong>Purpose:</strong> Cystatin C has a higher correlation with glomerular filtration rate and a more significant clinical prognosis than creatinine. We sought to determine whether it is a marker of renal function different from creatinine (cystatin C potentially superior to creatinine), in patients with systemic lupus erythematosus.<br /><strong>Material and Methods:</strong> 37 patients with systemic lupus erythematosus were evaluated. Serum cystatin C was determined by nephelometry and creatinine by modified Jaffe method. We compared five formulas: Chronic Kidney Disease – Epidemiology Collaboration cystiatin; Chronic Kidney Disease – Epidemiology Collaboration creatinine-cystatin; Cockcroft-Gault; Modification of Diet in Renal Disease and Chronic Kidney Disease – Epidemiology Collaboration creatinine, using the latter as a reference. We analyzed the influence of clinical and laboratory factors in cystatin C variation, using multivariate linear regression.<br /><strong>Results:</strong> Cystatin C was singly elevated in ten participants, versus none isolated creatinine elevation, and this difference was significant (p = 0.002). There was a difference between the estimated glomerular filtration rate by Chronic Kidney Disease – Epidemiology Collaboration cystatin and by Chronic Kidney Disease – Epidemiology Collaboration creatinine (-6.0541 mL/min/1.73 m2, p = 0.07), more pronounced for lower glomerular filtration rate. Consequently, Chronic Kidney Disease – Epidemiology Collaboration cystatin reclassified 4 patients as having chronic kidney disease de novo and 1 patient as not having chronic kidney disease (p = 0.375).<br />Cystatin C was only significantly influenced by age (p &lt; 0.001).<br /><strong>Discussion:</strong> Several reports showed cystatin C as a better marker to define chronic kidney disease, allowing more accurate classification and risk stratification, compared with creatinine. In this study, Cystatin C revealed as a promisor marker of renal function in patient with lupus, mainly in patients with lower glomerular filtration rates. The correlation between age and cystatin C seems to be a confounding<br />factor, as glomerular filtration rate physiologically declines with ageing.<br /><strong>Conclusion:</strong> Cystatin C was potentially superior to creatinine and in this study and cystatin C seems to detect changes in glomerular filtration rate earlier than creatinine and may be a better screening method for chronic kidney disease in systemic lupus erythematosus.


Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Yasmin Mahfouz ◽  
Anastasia-Vasiliki Madenidou ◽  
Coziana Ciurtin

Abstract Background Systemic lupus erythematosus (SLE) is a systemic autoimmune/inflammatory disorder that can affect any organ system. An estimated 10- 20% of all patients with SLE develop clinical disease before the age of 16 years and are therefore classified as juvenile-onset SLE (JSLE). JSLE is characterised by more severe clinical manifestations, such as lupus nephritis, more complications and less favourable outcomes compared to adult-onset SLE. Chronic kidney disease (CKD) refers to a state of irreversible kidney damage and/or reduction of kidney function that is associated with progressive loss of function over time. Lupus nephritis does not always lead to CKD. However, when it does it is associated with increased morbidity and mortality. It is important to identify clinical and laboratory predictors of CKD development in JSLE patients, as a more aggressive treatment approach could be advocated for these patients. In this study we compared the baseline characteristics of JSLE patients with and without chronic kidney disease to ascertain if there are any significant differences between the two groups. Methods This is a single-centre retrospective study, who included patients reviewed in our young adult and adolescent clinics. All data were analysed descriptively. Mann-Whitney U or Chi-Square tests were performed to compare the characteristics between the patients with and without CKD. We used the Pearson’s (r) or Kendall’s τ (tau) correlation to examine if there is any association between the CKD and the baseline characteristics. Results We identified 44 JSLE patients, out of which 17 (39%) fulfilled the diagnostic criteria for CKD at their last clinical review. The stages of CKD varied from 2 to 5. All patients with CKD also had lupus nephritis, while 5/44 patients (11%) had lupus nephritis without CKD. There were statistical significant differences in the treatments used for patients with and without CKD. As expected, the highest dsDNAlevels were higher in patients with CKD (p = 0.03). There was also a positive moderate correlation (ρ = 0.32) between raised levels of dsDNAand the development of CKD (p = 0.008). We also found a negative moderate correlation (τ= -0.439) between the presence of RF and CKD (p = 0.04). Conclusion We found a negative moderate correlation between the presence of RF and CKD, which has also been reported in the literature before. Further research using a large JSLE cohort is suggested to explore further if RF exerts a protective effect against renal disease in SLE. dsDNA is a serological marker of lupus nephritis and it is reasonable that the highest dsDNA correlates with CKD. Conflicts of Interest The authors declare no conflicts of interest.


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