scholarly journals Posterior reversible leukoencephalopathy syndrome associated with acute postinfectious glomerulonephritis: systematic review

Author(s):  
Corinne Orlando ◽  
Gregorio P. Milani ◽  
Giacomo D. Simonetti ◽  
Barbara Goeggel Simonetti ◽  
Sebastiano A. G. Lava ◽  
...  

Abstract Background Kidney diseases are a recognized cause of posterior reversible leukoencephalopathy syndrome, usually abbreviated as PRES. The purpose of this review was to systematically address the association between acute postinfectious glomerulonephritis and PRES. Methods We performed a systematic review of the literature on acute postinfectious glomerulonephritis associated with PRES. The principles recommended by the Economic and Social Research Council guidance on the conduct of narrative synthesis and on the Preferred Reporting Items for Systematic Reviews and Meta-analyses were used. Databases searched included Excerpta Medica, US National Library of Medicine, and Web of Science. Results For the final analysis, we evaluated 47 reports describing 52 cases (32 males and 20 females). Fifty patients were ≤ 18 years of age. Blood pressure was classified as follows: normal-elevated (n = 3), stage 1 hypertension (n = 3), stage 2 hypertension (n = 5), and severe hypertension (n = 41). Acute kidney injury was classified as stage 1 in 32, stage 2 in 16, and stage 3 in four cases. Neuroimaging studies disclosed a classic posterior PRES pattern in 28 cases, a diffuse PRES pattern in 23 cases, and a brainstem-cerebellum PRES pattern in the remaining case. Antihypertensive drugs were prescribed in all cases and antiepileptic drugs in cases presenting with seizures. A resolution of clinical findings and neuroimaging lesions was documented in all cases with information about follow-up. Conclusions The main factor associated with PRES in acute postinfectious glomerulonephritis is severe hypertension. Prompt clinical suspicion, rapid evaluation, and management of hypertension are crucial. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

2012 ◽  
Vol 4 (2) ◽  
pp. 79-82 ◽  
Author(s):  
Yoshihiko Kanno ◽  
Tsuneo Takenaka ◽  
Yusuke Watanabe ◽  
Tsutomu Inoue ◽  
Hiroshi Takane ◽  
...  

Pulse wave velocity (PWV) and augmentation index (AI) are used as indexes of arterial stiffness and cardiovascular survival. Although PWV is known to increase as the stage of chronic kidney disease (CKD) advances, how this is related to AI and CKD stage has not yet been well defined. A sub-analysis was performed using the data from the Antihypertensive and Blood Pressure of Central Artery in Japan study. This was a cross-sectional study on hypertensive patients. All the patients with available serum creatinine levels were selected, and estimated glomerular filtration rate (eGFR) was calculated according to the modification of diet in renal disease equation for a Japanese population. Augmentation indexes at different stages of CKD were compared. Data from 1392 patients were pooled and analyzed. In addition to eGFR, there were differences in age (P<0.0001), pulse rate (P<0.0001), vasodilator antihypertensive drugs (P<0.005), systolic (P<0.005) and diastolic (P<0.01) blood pressure at 5 CKD stages. Multivariate regression showed that AI correlated to age (0.19%/year), pulse rate (-0.54%/bpm), systolic blood pressure (0.18%/mmHg) and vasodilator antihypertensive drugs (-2.42%/class). Therefore, AI was adjusted for these confounding factors. Adjusted AI in stage 5 (77±20%) was lower than that in stage 1 (84±19%, P<0.05). These data indicate that AI varies according to CKD stage, and suggest that a cut-off value of AI should be set for each stage of CKD to detect cardiovascular disease.


2019 ◽  
Author(s):  
Lucy Armstrong ◽  
Lorna Hogg ◽  
Pamela Charlotte Jacobsen

The first stage of this project aims to identify assessment measures which include items on voice-hearing by way of a systematic review. The second stage is the development of a brief framework of categories of positive experiences of voice hearing, using a triangulated approach, drawing on views from both professionals and people with lived experience. The third stage will involve using the framework to identify any positve aspects of voice-hearing included in the voice hearing assessments identified in stage 1.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rozemarijn Snoek ◽  
Margriet Gosselink ◽  
Liffert Vogt ◽  
Margriet De Jong ◽  
Agne Cerkauskaite ◽  
...  

Abstract Background and Aims Chronic kidney disease (CKD) affects approximately 3% of pregnant women. CKD increases the risk of pregnancy complications such as prematurity, low birthweight and pre-eclampsia. Also, kidney function can deteriorate more quickly due to pregnancy. There is limited knowledge on pregnancy outcomes in specific kidney diseases. The aim of the ALPART network is to study pregnancy outcomes differentiated by CKD aetiology. We have started with COLA3-5 related disease (Alport syndrome), which is one of the most prevalent monogenic kidney diseases. Comparing outcomes in COLA3-5 related disease to pregnancies with other CKD aetiologies allows us to investigate whether this specific diagnosis impacts outcome in CKD pregnancies. Method The ALPART network is an international 15-center network, which aims to include ∼200 COLA3-5 related disease pregnancies. In this intermediary analysis, we present data on 109 pregnancies from 68 women with COLA3-5 related disease. We compared outcomes to a cohort of 457 CKD stage 1-2 patients (a similar CKD stage as our cohort) of diverse aetiology from a 2015 Italian study and 159,924 women from the general Dutch population. Results The main pregnancy and kidney outcomes are presented in Figure 1. Foetal outcomes were better in COLA3-5 pregnancies than in pregnancies of women with CKD stage 1-2 of diverse aetiology. We saw less prematurity (17% vs 36% respectively) and a higher mean birthweight of 3216 ± 663 gram compared to 2768 ± 680 in the Italian cohort. Maternal kidney outcomes should be interpreted with caution (&gt;30% missing data): proteinuria (73%) and hypertension (30%) were more frequent in COLA3-5 pregnancies than the Italian cohort. In the ALPART cohort, 10% developed severe hypertension. Median eGFR was not impacted by pregnancy and decline of eGFR before and after pregnancy were not significantly different between groups. Conclusion Fetal outcomes in pregnancies with COLA3-5 related disease seem to be more favorable than in a cohort with mixed cause of CKD. In this intermediary analysis, proteinuria levels and frequency of new-onset hypertension in pregnancy are higher. There is no significant eGFR loss during pregnancy or increased eGFR deterioration in the long-term. The differences between COLA3-5 and general CKD pregnancies underscore the importance of investigating pregnancy outcomes in specific kidney disease phenotypes to ensure adequate (pre-) pregnancy counselling and care.


2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Flávia Silveira ◽  
Káthia Zuntini ◽  
Márcia Silveira ◽  
Lohanna Tavares ◽  
Juliana Mendes ◽  
...  

OBJECTIVES: This study aims to present the confirmed cases of SARS-CoV-2 infection in pediatric patients with chronic and acute kidney diseases admitted to a tertiary pediatric hospital. METHODS: Descriptive and retrospective observational study with all children hospitalized between March and June 2020 who had, simultaneously, SARS-CoV-2 infection and renal pathologies. Of this total of patients, those who had another underlying disease besides the renal disease were excluded. RESULTS: During the period, nine children with kidney disease were admitted to the hospital and had infection confirmed by the new coronavirus through positive RT-PCR. Regarding the underlying disease, seven had only kidney disease, three of whom had stage 5 chronic kidney disease; one, with stage 1 chronic kidney disease; one, with cortic-sensitive nephrotic syndrome; and two, with acute kidney injury. Two patients in this study had already undergone kidney transplantation, used immunosuppressants and had their doses reduced due to the infectious condition. Only one required oxygen therapy and transfer to the intensive care unit, but was not intubated and returned to the ward within 24 hours. CONCLUSIONS: According to the cases described, the pediatric population with kidney disease, including those using immunosuppressants due to acute transplant rejection, seems to evolve without severe COVID-19, therefore there is no great divergence in relation to the population of the same healthy age group.


Sign in / Sign up

Export Citation Format

Share Document