IgA nephritic patients of Pacific Asian origin with increased risk of progression to end-stage renal disease

Objective. To review the contribution of vesicoureteral reflux and reflux nephropathy to end-stage renal disease.Data Source. Published research articles and publicly available registries.Results. Vesicoureteral reflux (VUR) is commonly identified in pediatric patients and can be associated with reflux nephropathy (RN), chronic kidney disease (CKD), and rarely end-stage renal disease (ESRD). Patients with reduced GFR, bilateral disease, grade V VUR, proteinuria, and hypertension are more likely to progress to CKD and ESRD. Because progression to ESRD is rare in VUR and often requires many decades to develop, there are limited prospective, randomized, controlled trials available to direct therapy to prevent progression to ESRD.Conclusions. Identification of patients with increased risk of progression to CKD and ESRD should be the goal of clinical, biochemical, and radiological evaluation of patients with VUR. Treatment of patients with VUR should be directed at preventing new renal injury and preserving renal function.

Download Full-text

Faculty Opinions recommendation of Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy--A Retrospective Registry-Based Cohort Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726295475.793520368 ◽

2016 ◽

Author(s):

Luis Ruilope ◽

Enrique Morales

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Renal Disease ◽

Iga Nephropathy ◽

End Stage Renal Disease ◽

Risk Of Progression ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Could Antioxidant Supplementation Delay Progression of Cardiovascular Disease in End-Stage Renal Disease Patients?

Current Vascular Pharmacology ◽

10.2174/1570161118666200317151553 ◽

2020 ◽

Vol 19 (1) ◽

pp. 41-54 ◽

Cited By ~ 1

Author(s):

Stefanos Roumeliotis ◽

Athanasios Roumeliotis ◽

Xenia Gorny ◽

Peter R. Mertens

Keyword(s):

Oxidative Stress ◽

Renal Disease ◽

End Stage Renal Disease ◽

Close Association ◽

Omega 3 ◽

Endstage Renal Disease ◽

Increased Risk ◽

Underlying Mechanisms ◽

Stage Renal Disease ◽

End Stage

In end-stage renal disease patients, the leading causes of mortality are of cardiovascular (CV) origin. The underlying mechanisms are complex, given that sudden heart failure is more common than acute myocardial infarction. A contributing role of oxidative stress is postulated, which is increased even at early stages of chronic kidney disease, is gradually augmented in parallel to progression to endstage renal disease and is further accelerated by renal replacement therapy. Oxidative stress ensues when there is an imbalance between reactive pro-oxidants and physiologically occurring electron donating antioxidant defence systems. During the last decade, a close association of oxidative stress with accelerated atherosclerosis and increased risk for CV and all-cause mortality has been established. Lipid peroxidation has been identified as a trigger for endothelial dysfunction, the first step towards atherogenesis. In order to counteract the deleterious effects of free radicals and thereby ameliorate, or delay, CV disease, exogenous administration of antioxidants has been proposed. Here, we attempt to summarize existing data from studies that test antioxidants for CV protection, such as vitamins E and C, statins, omega-3 fatty acids and N-acetylcysteine.

Download Full-text

Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy—A Retrospective Registry-Based Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0153819 ◽

2016 ◽

Vol 11 (4) ◽

pp. e0153819 ◽

Cited By ~ 13

Author(s):

Paschal Ruggajo ◽

Einar Svarstad ◽

Sabine Leh ◽

Hans-Peter Marti ◽

Anna Varberg Reisæther ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Renal Disease ◽

Iga Nephropathy ◽

End Stage Renal Disease ◽

Risk Of Progression ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Increased risk of end-stage renal disease in patients with systemic sclerosis

Scandinavian Journal of Rheumatology ◽

10.1080/03009742.2021.1917143 ◽

2021 ◽

pp. 1-8

Author(s):

C-Y Lin ◽

Y-J Su ◽

T-T Cheng ◽

C-H Wu ◽

J-F Chen ◽

...

Keyword(s):

Systemic Sclerosis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Increased Risk ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Anticoagulation in Patients with End-Stage Renal Disease and Atrial Fibrillation: Confusion, Concerns and Consequences

Journal of Stroke ◽

10.5853/jos.2020.01886 ◽

2020 ◽

Vol 22 (3) ◽

pp. 306-316

Author(s):

Narender Goel ◽

Deepika Jain ◽

Danny B. Haddad ◽

Divya Shanbhogue

Keyword(s):

Atrial Fibrillation ◽

Renal Disease ◽

End Stage Renal Disease ◽

Clinical Decision Making ◽

Controlled Trial ◽

Oral Anticoagulants ◽

Increased Risk ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End-stage renal disease (ESRD) patients have a higher prevalence of diabetes mellitus, hypertension, congestive heart failure and advanced age, along with an increased incidence of non-valvular atrial fibrillation (AF), thereby increasing the risk for cerebrovascular accidents. Systemic anticoagulation is therefore recommended in patients with ESRD with AF to reduce the risk and complications from thromboembolism. Paradoxically, these patients are at an increased risk of bleeding due to great degree of platelet dysfunction and impaired interaction between platelet and endothelium. Currently, CHA2DS2-VASc and Hypertension, Abnormal liver/kidney function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol (HAS-BLED) are the recommended models for stroke risk stratification and bleeding risk assessment in patients with AF. There is conflicting data regarding benefits and risks of medications such as antiplatelet agents, warfarin and direct oral anticoagulants in ESRD patients with AF. Moreover, there is no randomized controlled trial data to guide the clinical decision making. Hence, a multi-disciplinary approach with annual re-evaluation of treatment goals and risk-benefit assessment has been recommended. In this article, we review the current recommendations with risks and benefits of anticoagulation in patients with ESRD with AF.

Download Full-text

Increased Risk of End-Stage Renal Disease in Familial IgA Nephropathy

Journal of the American Society of Nephrology ◽

10.1681/asn.v132453 ◽

2002 ◽

Vol 13 (2) ◽

pp. 453-460

Author(s):

Francesco Paolo Schena ◽

Giuseppina Cerullo ◽

Michele Rossini ◽

Salvatore Giovanni Lanzilotta ◽

Christian D’Altri ◽

...

Keyword(s):

Renal Disease ◽

Iga Nephropathy ◽

End Stage Renal Disease ◽

Upper Respiratory Tract ◽

Renal Survival ◽

First Degree Relatives ◽

Increased Risk ◽

Stage Renal Disease ◽

Tract Infections ◽

End Stage

ABSTRACT. Primary IgA nephropathy (IgAN) is characterized by recurrent episodes of macroscopic hematuria accompanied by upper respiratory tract infections or persistent asymptomatic microscopic hematuria with or without proteinuria. IgAN may involve one or more members of a family. Three generations of a cohort of 110 patients with biopsy-proven IgAN, living in Southern Italy, were checked for urinalysis, and the relative risk (RR) of developing the disease was evaluated. A total of 19 unrelated familial, 37 suspected, and 54 sporadic cases of IgAN were identified. Renal survival was estimated by the Kaplan-Meier method for censored data and compared by use of the log-rank test. More than 50% of the patients with IgAN clustered in kindred with more than two probably affected relatives. In 19 unrelated IgAN families, 8 had single-generation (SG) and 11 multigenerational (MG) involvement showing a prevalent vertical transmission of the trait. The RR was 16 times higher in first-degree relatives (odds ratio [OR], 16.4; 95% confidence interval [CI], 5.7 to 47.8; P < 0.0001) and >2 times higher, even if NS, in second-degree relatives (OR, 2.4; 95 % CI, 0.7 to 7.9; P = 0.145). The clinical and histologic picture of familial and sporadic IgAN appeared to be similar. The 20-yr renal survival rate from the apparent onset of the disease was significantly poorer in patients with familial (41%) than in patients with sporadic (94%) IgAN (P = 0.003). Furthermore, 15-yr renal survival from the time of renal biopsy was significantly worse in familial IgAN (P = 0.02); end-stage renal disease was present in 64% of familial and only in 8% of patients with sporadic IgAN. Finally, renal survival was significantly worse in patients belonging to families with SG rather than with MG involvement (P = 0.03). These data show, for the first time, that familial IgAN may be considered a nonbenign disease that occurs frequently in first-degree relatives. Familial IgAN has a poorer outcome than sporadic IgAN. Therefore, an accurate family history and urinalysis in all family members is urgently recommended in clinical practice. This procedure might avoid late referral of subjects with persistent and underestimated urinary abnormalities and late diagnosis of the disease.

Download Full-text