Characteristics of Adult Patients with Idiopathic Retroperitoneal Fibrosis and Assessment of Risk of Relapse at Diagnosis

Objectives: To compare adult patients’ characteristics suffering from idiopathic retroperitoneal fibrosis between “relapse-free” and relapsing patients at the diagnosis and identify factors associated with relapse at initial presentation. Methods: We conducted a retrospective multicentric study in four hospitals in Eastern France, from 1993 to 2020, of adult patients suffering from idiopathic retroperitoneal fibrosis. We analyzed clinical, biological, and radiological features at diagnosis and during a forty-month follow-up. Results: Of 47 patients suffering from retroperitoneal fibrosis, 21 patients had idiopathic retroperitoneal fibrosis. Among them, 13 experienced one or more relapses during follow-up. At diagnosis, clinical characteristics, relevant comorbidities, biological and radiological features were similar between groups. Smoking cessation seems associated with decreased relapse risk (p: 0.0624). A total of 8 patients developed chronic renal failure during follow-up. Ureteral infiltration at diagnosis was associated with evolution to chronic renal failure (p: 0.0091). Conclusion: No clinical, biological, or radiological features could predict relapse at retroperitoneal fibrosis diagnosis, but smoking cessation may prevent relapse.

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A Rare Cause of Acute Renal Failure: Retroperitoneal Fibrosis

Journal of Clinical Case reports and Images ◽

10.14302/issn.2641-5518.jcci-19-3098 ◽

2019 ◽

Vol 1 (4) ◽

pp. 1-4

Author(s):

Yılmaz Omer ◽

Kizilkan Yunus Emre ◽

Temel Muhammed Cihan ◽

Ediz Caner ◽

Ozcelik Fatih

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Retroperitoneal Fibrosis ◽

Foley Catheter ◽

Idiopathic Retroperitoneal Fibrosis ◽

Fibrotic Tissue ◽

Abdominal Magnetic Resonance Imaging ◽

Grade 3 ◽

Loss Of Appetite

Idiopathic retroperitoneal fibrosis also known as Ormonds disease is a rare disorder characterized by the development of fibrotic tissue in the retroperitoneum. The fibrotic tissue may compress ureters, leading to obstructive nephrouropathy and renal failure. A 58-year-old man with fatigue, loss of appetite and unable to urinate was admitted to our clinic. Because of the serum creatinine value of 5.3 mg/dl, urinary ultrasonography was performed and bilateral grade 3 hydronephrosis with moderate level urine in bladder was detected. Hydronephrosis did not regress by transurethral foley catheter and suspicious appearance in the retroperitoneal area was found in abdominal magnetic resonance imaging. Tru-cut biopsy result of the current lesion was finally reported as a connective tissue. Bilateral double j catheter insertion was performed and started to immunosuppression therapy with corticosteroid. Two months later, double j catheters were removed and hydronephrosis was not detected in follow-up. In this case report, we tried to explain that, retroperitoneal fibrosis should be considered in the differential diagnosis of postrenal acute renal failure, even in patients without a classic symptom such as pain. In addition, early surgical intervention should be avoided in such patients.

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Successful treatment of idiopathic retroperitoneal fibrosis with combined immunosuppressive therapy

Vojnosanitetski pregled ◽

10.2298/vsp170714008o ◽

2019 ◽

Vol 76 (10) ◽

pp. 1014-1021

Author(s):

Katarina Obrencevic ◽

Dejan Petrovic ◽

Predrag Aleksic ◽

Marijana Petrovic ◽

Nemanja Rancic ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Chronic Renal Failure ◽

Retroperitoneal Fibrosis ◽

Oral Prednisone ◽

Obstructive Nephropathy ◽

Idiopathic Retroperitoneal Fibrosis ◽

Severe Renal Failure ◽

The Mean ◽

Systemic Symptoms

Background/Aim. Idiopathic retroperitoneal fibrosis (IRF) is characterized by the fibroinflammatory periaortic tissue that affects the ureters, causing obstructive nephropathy and variable impairment of renal function. The findings strongly suggest an autoimmune etiology. The optimal treatment has not been established. The aim of this study was to analyze a long-term efficacy of combined corticosteroid therapy with mycophenolate mofetil (MMF) in the patients with IRF. Methods. We retrospectively followed 13 patients (8 males and 5 females) with IRF. All patients received corticosteroids and MMF. For the patients with severe renal failure, an initial ureteral decompression was made and prednisone was started orally 0.5 mg/kg with fast tapering. In cases with a mild renal failure corticosteroids were administrated as intravenous methylprednisolone pulses for 3 days, followed by oral prednisone. The dose of MMF was 1000 mg twice a day. MMF was stopped after 18 months and prednisone after 48 months. Results. Systemic symptoms resolved in all patients. Erythrocyte sedimentation (SE) rate declined from the mean of 67.6 to 26.3 mm/h and C-reactive protein (CRP) from the mean of 18.5 to 6.3 mg/L. In 7 out of 8 patients, the ureteral stents were successfully removed 13 weeks on average. Seven patients had 100% of reduction in the periaortic mass, and the average percent reduction was 76.9%. The kidney function improved and remained normal in 6 treated patients. In 4 patients a mild chronic renal failure remained due to afunction of one kidney. Three patients, with a prior chronic renal failure, did not get worse renal function. The disease recurred in 3 patients. There were no treatment side effects noted. Conclusion. Combination of corticosteroids and MMF is a potentially effective treatment in restoring the renal function and reducing the fibrotic tissue in the patients with idiopathic retroperitoneal fibrosis. It could prevent the need for ureteral stenting and surgery. Longer treatment may reduce a possibility of recurrence.

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Long-term follow-up in patients with chronic renal failure; application of the H reflex of the posterior tibial nerve

Electroencephalography and Clinical Neurophysiology ◽

10.1016/0013-4694(87)91847-5 ◽

1987 ◽

Vol 66 (5) ◽

pp. S22

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Tibial Nerve ◽

H Reflex ◽

Posterior Tibial Nerve ◽

Posterior Tibial ◽

Long Term Follow Up

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Residual renal function and blood count in patients on continuous ambulatory peritoneal dialysis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0612503j ◽

2006 ◽

Vol 134 (11-12) ◽

pp. 503-508

Author(s):

Natasa Jovanovic ◽

Mirjana Lausevic ◽

Biljana Stojimirovic

Keyword(s):

Renal Failure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Chronic Renal Failure ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Blood Count ◽

Residual Renal Function ◽

Co Morbidity ◽

Positive Correlations

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.

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Idiopathic retroperitoneal fibrosis: A report on 15 patients

Vojnosanitetski pregled ◽

10.2298/vsp140426076h ◽

2015 ◽

Vol 72 (10) ◽

pp. 928-931 ◽

Cited By ~ 2

Author(s):

Jovan Hadzi-Djokic ◽

Tomislav Pejcic ◽

Dragoslav Basic ◽

Ivana Vukomanovic ◽

Zoran Dzamic ◽

...

Keyword(s):

Surgical Procedures ◽

Retroperitoneal Fibrosis ◽

Early Recognition ◽

Signs And Symptoms ◽

Omental Flap ◽

Definitive Treatment ◽

Pathological Examination ◽

Idiopathic Retroperitoneal Fibrosis ◽

The Mean

Background/Aim. Retroperitoneal fibrosis (RPF) represents a chronic pathological process characterized by fibrosis which entraps and compresses the ureters and the great blood vessels in the retroperitoneal space. A specific form of RPF is idiopathic RPF, an uncommon collagen vascular disease of unclear etiology. The series of 15 patients which underwent open surgical repair due to idiopathic RPF is presented herein. Methods. From 1989 to 2012, 11 male and 4 female patients underwent surgery due to primary RPF. The ureters were entrapped unilaterally (7 patients), or bilaterally (8 patients). Major symptoms included low back pain due to hydronephrosis (9 patients), uremia (4 patients), and urinary tract infection (2 patients). The diagnosis was based on intravenous urography (IVU), retrograde ureteropyelography and computed tomography (CT). Results. Surgical procedures included intraperitoneal ureteral displacement (8 patients) and ureteral wrapping with omental flap (6 patients). One patient underwent bilateral ureteral stenotic segments resection and oblique ureterography, followed by wrapping with omental flap. Pathological examination confirmed primary RPF in all patients. The mean operative time was 3.5 h (range 2.5-4.5 h). The average intrahospital stay was 21 days (range 16-26 days). The mean follow up was 32 months (6-46 months). During the follow up, 12 patients had improvement on IVU. Conclusion. Early recognition of signs and symptoms of RPF is of the utmost importance for the outcome. Surgical procedures, including ureteral wrapping with omental flap, or intraperitoneal ureteral displacement, usually represent definitive treatment.

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Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow-up

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2007.03210.x ◽

2007 ◽

Vol 25 (7) ◽

pp. 849-855 ◽

Cited By ~ 8

Author(s):

E. O. MORAIS ◽

M. R. RESENDE ◽

A. M. OLIVEIRA ◽

V. M. SINKOC ◽

M. T. GARCIA ◽

...

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Hepatitis B ◽

Hepatitis B Vaccination

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Ten Years’ Experience with Chronic Peritoneal Dialysis at a Community Hospital

Peritoneal Dialysis International ◽

10.1177/089686088000100705 ◽

1980 ◽

Vol 1 (7) ◽

pp. 124-129 ◽

Cited By ~ 3

Author(s):

S. Paul Handa ◽

Sheila Greer

Keyword(s):

Renal Failure ◽

Peritoneal Dialysis ◽

Chronic Renal Failure ◽

Kidney Transplant ◽

Community Hospital ◽

Patient Survival ◽

Chronic Peritoneal Dialysis ◽

Better Than

This paper describes the experience of a community hospital in the treatment of chronic renal failure with intermittent (IPD) and continuous ambulatory peritoneal dialysis (CAPD) in 61 adult patients over a 10 year period. In the earlier years of this decade, 14 patients, dialysed through temporary catheters, were transferred to hemodialysis or received a kidney transplant. Later, a long-term IPD and CAPD treatment through permanent peritoneal catheters was instituted in 25 and 22 patients respectively. Over a similar but not simultaneous follow-up period, the patient survival with CAPD was better than with IPD.

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Kaposi's Sarcoma in Young Patients Treated with Orthovoltage Irradiation and Having a Minimum Follow-Up of Forty-Six Years

Tumori Journal ◽

10.1177/030089160909500309 ◽

2009 ◽

Vol 95 (3) ◽

pp. 325-328 ◽

Cited By ~ 1

Author(s):

Stefano Pergolizzi ◽

Anna Santacaterina ◽

Michele Gaeta ◽

Alfredo Blandino

Keyword(s):

Renal Failure ◽

Radiation Therapy ◽

Chronic Renal Failure ◽

Clinical Outcome ◽

Kaposi's Sarcoma ◽

Young Patients ◽

Kaposi’S Sarcoma ◽

Orthovoltage Radiotherapy

Purpose To describe the clinical outcome and to evaluate the role of orthovoltage radiotherapy in the treatment of young (less than 30 years old) Mediterranean men with Kaposi's sarcoma. Patients and methods We reviewed the records of 198 consecutive patients with Kaposi's sarcoma treated with orthovoltage radiation therapy at our department between January 1920 and December 1987. Result We found three young shepherds, aged less than 30 years, with an available follow-up ranging from 45 to 67 years. One patient died at the age of 84 years of chronic renal failure while suffering from cutaneous Kaposi's sarcoma; two patients are still alive with recurrent Kaposi's sarcoma. Conclusions We presume that an indolent form of Kaposi's sarcoma may occur in young men. This very indolent form can be controlled for the duration of the patient's life by judiciously applied radiation therapy.

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