Factors Associated with Improved Short Term Survival in Obese End Stage Renal Disease Patients

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 < 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.

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Clinical, Social and Demographics Factors Associated with Spiritual Wellbeing in End Stage Renal Disease

Advances in Experimental Medicine and Biology - GeNeDis 2016 ◽

10.1007/978-3-319-57379-3_8 ◽

2017 ◽

pp. 77-88 ◽

Cited By ~ 2

Author(s):

Evangelos C. Fradelos ◽

Konstantinos Tsaras ◽

Foteini Tzavella ◽

Evmorfia Koukia ◽

Ioanna V. Papathanasiou ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Spiritual Wellbeing ◽

Factors Associated ◽

Stage Renal Disease ◽

End Stage

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Insulin resistance in patients with end-stage renal disease on hemodialysis: effect of short-term erythropoietin therapy

Journal of The Egyptian Society of Nephrology and Transplantation ◽

10.4103/jesnt.jesnt_25_19 ◽

2020 ◽

Vol 20 (2) ◽

pp. 111

Author(s):

IslamS Shebl ◽

HebaE Kasem ◽

WalidAbd El-Mohsen Shehab-Eldin ◽

AhmedAbd El-Rahman Sonbol ◽

MaiA Kamel

Keyword(s):

Insulin Resistance ◽

Renal Disease ◽

End Stage Renal Disease ◽

Short Term ◽

Stage Renal Disease ◽

End Stage

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Incidence and risk factors for HPV-associated cancers in women with end-stage renal disease

Journal of Investigative Medicine ◽

10.1136/jim-2019-001262 ◽

2020 ◽

Vol 68 (5) ◽

pp. 1002-1010

Author(s):

Joan Han ◽

Jennifer L Waller ◽

Rhonda E Colombo ◽

Vanessa Spearman ◽

Lufei Young ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

General Population ◽

Renal Disease ◽

End Stage Renal Disease ◽

Dialysis Patients ◽

Herpes Infection ◽

Factors Associated ◽

Stage Renal Disease ◽

End Stage

Human papillomavirus (HPV) causes the majority of cervical, anal/rectal, and oropharyngeal cancers in women. End-stage renal disease (ESRD) is also associated with an increased risk of malignancy, but the incidence of and risk factors for HPV-associated cancers in US dialysis patients are not defined. We queried the US Renal Data System for women with HPV-associated cancers and assessed for incidence of cancer diagnosis and association of risk factors. From 2005 to 2011, a total of 1032 female patients with ESRD had 1040 HPV-associated cancer diagnoses. Patients had a mean age of 65 years, were mostly white (63%), and on hemodialysis (92%). Cervical cancer (54%) was the most common, followed by anal/rectal (34%), and oropharyngeal (12%). The incidence of HPV-associated cancers in patients with ESRD increased yearly, with up to a 16-fold increased incidence compared with the general population. Major risk factors associated with the development of any HPV-associated cancer included smoking (adjusted relative risk=1.89), alcohol use (1.87), HIV (2.21), and herpes infection (2.02). Smoking, HIV, and herpes infection were prominent risk factors for cervical cancer. The incidence of HPV-associated cancers in women with ESRD is rising annually and is overall higher than in women of the general population. Tobacco use is a universal risk factor. For cervical cancer, the presence of HIV and herpes are important comorbidities. Recognizing risk factors associated with these cancers may improve diagnosis and facilitate survival. The role of HPV vaccination in at-risk dialysis patients remains to be defined but warrants further study.

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