scholarly journals Outcomes of membranous and proliferative lupus nephritis – analysis of a single-centre cohort with more than 30 years of follow-up

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3314-3323 ◽  
Author(s):  
Filipa Farinha ◽  
Ruth J Pepper ◽  
Daniel G Oliveira ◽  
Thomas McDonnell ◽  
David A Isenberg ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Renal Survival ◽  
Single Centre ◽  
Proliferative Lupus Nephritis ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Abstract Objectives To compare membranous lupus nephritis (MLN) and proliferative lupus nephritis (PLN) with respect to survival, demographic, clinical and laboratory characteristics; and to investigate predictors of renal and patient survival. Methods Single-centre retrospective observational study. Patients with biopsy-proven PLN, MLN and mixed lupus nephritis were included. Groups were compared using appropriate statistical tests and survival was analysed through the Kaplan-Meier method. Cox regression analysis was performed to investigate predictors of renal and patient survival. Results A total of 187 patients with biopsy-proven lupus nephritis (135 with PLN, 38 with MLN and 14 with mixed LN) were followed for up to 42 years (median 12 years). There was a higher proportion of MLN amongst Afro-Caribbeans than amongst Caucasians (31% vs 15%, P = 0.010). Patients with MLN had significantly lower anti-dsDNA antibodies (P = 0.001) and higher C3 levels (P = 0.018) at diagnosis. Cumulative renal survival rates at 5, 10, 15 and 20 years were 91, 81, 75 and 66% for PLN and 100, 97, 92 and 84% for MLN, respectively (P = 0.028). Cumulative patient survival at 5, 10, 15 and 20 years was 94, 86, 80 and 76%, with no difference between PLN and MLN. Urinary protein-creatinine ratio above 42 mg/mmol and eGFR below 76 ml/min/1.73 m2, one year after the diagnosis of LN, were the strongest predictors of progression to end-stage renal disease. eGFR below 77 ml/min/1.73 m2, at one year, development of end-stage renal disease and Afro-Caribbean ethnicity were associated with higher mortality. Conclusion Patients with MLN and PLN differ significantly regarding serological profiles and renal survival, suggesting different pathogenesis. Renal function at year one predicts renal and patient survival.

Intermittent Peritoneal Dialysis in the Treatment of Diabetics with End-stage Renal Disease

1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 15-16
Author(s):  
Stavros Karanicolas ◽  
Douglas Thompson
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Subcutaneous Insulin ◽  
Hospital Patients ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Intermittent peritoneal dialysis (IPD) in diabetics has varied outcomes. Sixteen patients with end-stage renal disease and diabetes were treated with IPD during the last four years at St. Joseph's Hospital. Patients received subcutaneous insulin besides small amounts intraperitoneally on the days of dialysis. One-year patient survival was 48%. Blood pressure, serum potassium, fluid and blood sugar control was poor compared to CAPD. However, for patients who can not be placed on CAPD, IPD still has its role. For this reason we should continue our efforts to improve the effectiveness of this mode of peritoneal dialysis.

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

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.

scholarly journals Lupus Nephritis in Males: Clinical Features, Course, and Prognostic Factors for End-Stage Renal Disease

2017 ◽  
Vol 2 (5) ◽  
pp. 905-912 ◽  
Author(s):  
Andrés Urrestarazú ◽  
Gabriela Otatti ◽  
Ricardo Silvariño ◽  
Mariela Garau ◽  
Ruben Coitiño ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lupus Nephritis ◽  
Renal Disease ◽  
Clinical Features ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals SO062PREDICTING ONE YEAR MORTALITY IN END-STAGE-RENAL DISEASE PATIENTS STARTING DIALYSIS; MODEL DEVELOPMENT AND VALIDATION

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii35-iii35
Author(s):  
Nynke Halbesma ◽  
Eve Miller-Hodges ◽  
Gurbey Ocak ◽  
Sarah Wild ◽  
Friedo Dekker ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Model Development ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage ◽  
Development And Validation

Management of the Diabetic Patients with End Stage Renal Disease

1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 6-10 ◽  
Author(s):  
Pablo Amair ◽  
Ramesh Khanna ◽  
Bernard Leibel ◽  
Andreas Pierratos ◽  
Stephen Vas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Intraperitoneal Administration ◽  
Good Control ◽  
Diabetic Patients ◽  
Serum Triglycerides ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Twenty diabetics with end-stage renal disease who had never previously received dialysis treatment were treated with continuous ambulatory peritoneal dialysis for periods of two to 36 months (average, 14.5). Intraperitoneal administration of insulin achieved good control of blood sugar Even though creatinine clearance decreased significantly (P = 0.001), contro of blood urea nitrogen and serum creatinine was adequate. Hemoglobin and serum albumin levels increased significantly (P = 0.005 and 0.04 respectively). Similarly, there was a significant increase in serum triglycerides and alkaline phosphatase (P = 0.02 and 0.05). Blood pressure became normal without medications in all but one of the patients. Retinopathy, neuropathy, and osteodystrophy remained unchanged. Peritonitis developed once in every 20.6 patient-months a rate similar to that observed in nondiabetics. The calculated survival rate was 92 per cent at one year; the calculated rate of continuation on ambulatory peritoneal dialysis was 87 per cent.

Sign in / Sign up

Export Citation Format

Share Document