ANCA Vasculitis Recurrence in Hemodialysis Patients: The Role of Rituximab

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
João Oliveira ◽  
João Bernardo ◽  
José Fonseca ◽  
Filipe Marques ◽  
Joana Gameiro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Treatment Guidelines ◽  
Clinical Course ◽  
Hemodialysis Patients ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Common Cause ◽  
Anca Vasculitis ◽  
New Onset

Antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) is characterized by systemic inflammation and is the most common cause of new-onset glomerulonephritis in adults older than 50 years. Renal disease secondary to AAV can lead to chronic kidney disease (CKD) requiring renal replacement therapy in approximately 20–25% of patients. Relapses are infrequent in the population on dialysis, and treatment guidelines do not specify these patients. Reports regarding the clinical course, survival, or relapse rate after beginning dialysis are scarce. The authors present 3 cases of CKD patients on hemodialysis who presented with AAV relapse, successfully treated with rituximab, and provide a literature review on relapse treatment.

scholarly journals The Presence of Chronic Kidney Disease in Relation to Age and Duration of Diabetes Mellitus

2019 ◽  
Vol 70 (4) ◽  
pp. 1471-1476
Author(s):  
Ionela Mihaela Vladu ◽  
Tiberiu Stefanita Tenea Cojan ◽  
Alin Demetrian ◽  
Oana Mariana Cristea ◽  
Cristina Gabriela Ene ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Renal Transplantation ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
General Population ◽  
Renal Disease ◽  
Disease Stage ◽  
Common Cause ◽  
The Us

Chronic kidney disease (CKD) affects about 10-13% of the general population with a small proportion in the terminal renal disease stage requiring renal replacement therapy or renal transplantation. CKD is the new cause of mortality in the US. CKD�s prevalence increases with age. Diabetes mellitus is responsible for 50% of cases of chronic kidney disease being the most common cause.

scholarly journals Lanthionine, a Novel Uremic Toxin, in the Vascular Calcification of Chronic Kidney Disease: The Role of Proinflammatory Cytokines

2021 ◽  
Vol 22 (13) ◽  
pp. 6875
Author(s):  
Alessandra Fortunata Perna ◽  
Luigi Russo ◽  
Vittoria D’Esposito ◽  
Pietro Formisano ◽  
Dario Bruzzese ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Hemodialysis Patient ◽  
Calcium Score ◽  
Hemodialysis Patients ◽  
Agatston Score ◽  
Uremic Toxin ◽  
Total Calcium

Vascular calcification (VC) is a risk factor for cardiovascular events and mortality in chronic kidney disease (CKD). Several components influence the occurrence of VC, among which inflammation. A novel uremic toxin, lanthionine, was shown to increase intracellular calcium in endothelial cells and may have a role in VC. A group of CKD patients was selected and divided into patients with a glomerular filtration rate (GFR) of <45 mL/min/1.73 m2 and ≥45 mL/min/1.73 m2. Total Calcium Score (TCS), based on the Agatston score, was assessed as circulating lanthionine and a panel of different cytokines. A hemodialysis patient group was also considered. Lanthionine was elevated in CKD patients, and levels increased significantly in hemodialysis patients with respect to the two CKD groups; in addition, lanthionine increased along with the increase in TCS, starting from one up to three. Interleukin IL-6, IL-8, and Eotaxin were significantly increased in patients with GFR < 45 mL/min/1.73 m2 with respect to those with GFR ≥ 45 mL/min/1.73 m2. IL-1b, IL-7, IL-8, IL-12, Eotaxin, and VEGF increased in calcified patients with respect to the non-calcified. IL-8 and Eotaxin were elevated both in the low GFR group and in the calcified group. We propose that lanthionine, but also IL-8 and Eotaxin, in particular, are a key feature of VC of CKD, with possible marker significance.

scholarly journals THE ROLE OF MELATONIN DEFICIENCY IN THE GENESIS OF ARTERIAL HYPERTENSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 115 (1) ◽  
pp. 18-26
Author(s):  
Anna Petrova ◽  
Olena Karpenko
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hemodialysis Patients ◽  
Laboratory Studies ◽  
Healthy Individuals ◽  
Age Dependent ◽  
Salivary Melatonin ◽  
The Relationship

The study analyzed the prevalence of hypertension and impaired melatonin-forming function of the epiphysis in patients with stage 5 chronic kidney disease treated with hemodialysis. The relationship between epiphysis dysfunction and hypertension has been identified. 130 persons (50% of men) undergoing permanent hemodialysis treatment were examined. Controls were 20 healthy individuals. The determination of daytime and nighttime levels of melatonin in saliva and clinical and laboratory studies. As a result of the study it was found that for patients with stage 5 chronic kidney disease undergoing treatment, there is a frequent violation of melatonin-forming function of the pineal gland (84.6%) and hypertension (78%). In hemodialysis patients, blood pressure increases are age-dependent and are determined with salivary melatonin levels.

scholarly journals Role of Serum Proteinase 3 Antineutrophil Cytoplasmic Antibodies in the Diagnosis, Evaluation of Disease Severity, and Clinical Course of Ulcerative Colitis

Gut and Liver ◽  
2022 ◽  
Vol 16 (1) ◽  
pp. 92-100
Author(s):  
So Imakiire ◽  
Hidetoshi Takedatsu ◽  
Keiichi Mitsuyama ◽  
Hideto Sakisaka ◽  
Kozo Tsuruta ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Disease Severity ◽  
Clinical Course ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Proteinase 3

scholarly journals A case of ANCA-associated vasculitis presenting de novo in pregnancy, successfully treated with rituximab

2018 ◽  
Vol 13 (1) ◽  
pp. 41-44 ◽  
Author(s):  
A Pefanis ◽  
DS Williams ◽  
H Skrzypek ◽  
A Fung ◽  
K Paizis
Keyword(s):  
De Novo ◽  
Clinical Manifestations ◽  
Significant Morbidity ◽  
Pathogenic Role ◽  
Disease Pathogenesis ◽  
Anca Vasculitis ◽  
Anca Associated Vasculitis ◽  
In Pregnancy ◽  
New Onset

Antineutrophil cytoplasm antibody (ANCA)-associated vasculitides are rare small vessel vasculitides of unknown cause. The pathogenic role of MPO-ANCA in the vasculitides has been supported using various animal models, with B-cells playing a role in the disease pathogenesis. Pregnancy in the presence of an autoimmune disease such as vasculitis is often associated with significant morbidity. Little is known about the outcomes when women present with de novo vasculitis during pregnancy, and the appropriate management of such presentations is unclear. We describe a case of a 33-year-old female presenting in her second pregnancy with new onset ANCA vasculitis at 12 weeks’ gestation. She was successfully treated with prednisolone and rituximab, and delivered a healthy 2.8 kg boy at 36 weeks’ gestation with no clinical manifestations of vasculitis or neutropenia in the neonate.

scholarly journals The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis

2020 ◽  
Vol 14 ◽  
pp. 117954842095916 ◽  
Author(s):  
Raymond Pranata ◽  
Rudi Supriyadi ◽  
Ian Huang ◽  
Hikmat Permana ◽  
Michael Anthonius Lim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Mechanical Ventilator ◽  
Poor Outcome ◽  
New Onset

Objective: The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients. Methodology: A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator. Results: Nineteen studies with a total of 7216 patients were included. CKD was associated with increased composite poor outcome (RR 2.63 [1.33, 5.17], P = .03; I2 = 51%, P = .01) and its subgroup, consisting of mortality (RR 3.47 [1.36, 8.86], P = .009; I2 = 14%, P = .32) and severe COVID-19 (RR 2.89 [0.98, 8.46], P = .05; I2 = 57%, P = .04). RRT was associated with increased composite poor outcome (RR 18.04 [4.44, 73.25], P < .001; I2 = 87%, P < .001), including mortality (RR 26.02 [5.01, 135.13], P < .001; I2 = 60%, P = .06), severe COVID-19 (RR 12.95 [1.93, 86.82], P = .008; I2 = 81%, P < .001), intensive care (IC) (RR 14.22 [1.76, 114.62], P < .01; I2 = 0%, P < .98), and use of mechanical ventilator (RR 34.39 [4.63, 255.51], P < .0005). Conclusion: CKD and new-onset RRT were associated with poor outcome in patients with COVID-19.

Potential effect of pharmaceutical care to improve outcomes in patients with chronic kidney disease-mineral bone disorder in Sulaimani dialysis centers

2020 ◽  
pp. 82-94
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pharmaceutical Care ◽  
Biochemical Parameters ◽  
Positive Impact ◽  
Potential Effect ◽  
Care Group ◽  
Mineral Bone Disorder ◽  
Bone Disorder

Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD) screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL.

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