CLINICAL CASE: STEROID-RESISTANT NEPHROTIC SYNDROME

2021 ◽  
pp. 13-17
Author(s):  
А.Е. Турсын
Keyword(s):  
Quality Of Life ◽  
Nephrotic Syndrome ◽  
Arterial Hypertension ◽  
Clinical Case ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Moderate Severity ◽  
Syndrome Diagnosis ◽  
Pathogenetic Therapy

Описан клинический случай пациент с нефротическим синдромом, стероид резистентный вариант, с артериальной гипертензией, осложненный полисерозитом (гидроторакс, асцит, плеврит). Пациент поступил в клинику в состоянии средней степени тяжести, с массивными отеками, полисерозитом, артериальной гипертензией и выраженным нефротическим синдромом. Диагноз: Гломерулярная болезнь. Нефротический синдром, стероид резистентный вариант. Функция почек снижена (СКФ- 84мл/мин по Шварцу). Двухсторонний экссудативный плеврит. Гидроторакс. Полисерозит (в рамках нефротического синдрома) был установлен на основании выраженного нефротического синдрома. Пациенту была проведена патогенетическая терапия. Отмечено улучшение состояния больного, в виде снижения отеков, нормализаций артериального давления, что в свою очередь поспособствовало сохранению и улучшению качества жизни пациента. A clinical case of a patient with nephrotic syndrome, steroidresistant variant, with arterial hypertension complicated by polyserositis (hydrothorax, ascites, pleurisy) is described. The patient was admitted to the clinic in a state of moderate severity, with massive edema, polyserositis, arterial hypertension, and severe nephrotic syndrome. Diagnosis: Glomerular disease. Nephrotic syndrome, steroidresistant variant. The kidney function is reduced (GFR - 84 ml/min according to Schwartz). Bilateral exudative pleurisy. Hydrothorax. Polyserositis (within the framework of nephrotic syndrome) was established based on the severe nephrotic syndrome. The patient underwent pathogenetic therapy. An improvement in the patient's condition was noted, in the form of a decrease in edema, normalization of blood pressure, which in turn contributed to the preservation and improvement of the patient's quality of life.

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

scholarly journals Differentiated approach to the choice of PPI in a patient with GERD in the practice of an outpatient (with a clinical case)

2020 ◽  
pp. 20-26
Author(s):  
I. G. Pakhomova ◽  
M. V. Malko-Skroz
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Clinical Case ◽  
Preventive Measures ◽  
Rational Approach ◽  
Functional Disorders ◽  
Pathogenetic Therapy ◽  
Dual Mechanism

In recent years, functional disorders of the gastrointestinal tract (GIT) are quite common. The most significant functional disorders are functional dyspepsia (FD), which is widespread in the population. In addition, in the clinical practice of outpatient doctors, the proportion of combined variants or overlap of several types of functional disorders or a combination of functional disorders with organic pathology has increased. So, according to systematic reviews, the combined course of gastroesophageal reflux disease (GERD) and FD occurs in at least one third of patients. At the same time, the combined functional pathology of the gastrointestinal tract changes the clinical picture of GERD, which complicates differential diagnosis, leads to inadequate and multiple prescription of drugs and often low effectiveness of the prescribed therapy. All this negatively affects the quality of life of patients. The tactics of managing patients with the combined course of GERD and FD sometimes presents certain difficulties, since there are no available recommendations for pathogenetic therapy and preventive measures. To date, possible links in the pathogenesis of both GERD and FD have been studied and described, which predetermine certain approaches to the treatment of various variants of these two diseases. Drug therapy for GERD includes the appointment of proton pump inhibitors (PPIs), antireflux drugs. In FD therapy, prokinetics and/or PPIs are effective. A rational approach in the treatment of the intersection of GERD and FD is the appointment of a drug with a dual mechanism of action, which contains both a prokinetic and a PPI. An example of this approach is the appointment of omeprazole and domperidone. The use of this drug is presented in a clinical case.

ARTERIAL HYPERTENSION AND COMORBIDITY (REVIEW)

2020 ◽  
Vol 2 (1) ◽  
pp. 9-13
Author(s):  
Irina Agababyan ◽  
◽  
Shukhrat Ziyadullaev ◽  
Jamshid Ismailov
Keyword(s):  
Quality Of Life ◽  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
The Metabolic Syndrome

Today, hypertension is considered by many authors within the framework of the manifestation of the metabolic syndrome. It has been established that in persons with hypertension in 60% of cases, various variants of MS are found. In addition, hypertension is a factor that reduces the quality of life of patients, especially those with comorbid pathology

A rare cause of steroid-resistant nephrotic syndrome in a child: Answers

2019 ◽  
Vol 35 (4) ◽  
pp. 621-623
Author(s):  
Lale Guliyeva ◽  
Yılmaz Tabel ◽  
Ali Düzova ◽  
Nusret Akpolat ◽  
Seza Özen ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome

scholarly journals Reliability of generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome: a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ann E. Aronu ◽  
Samuel N. Uwaezuoke ◽  
Uzoamaka V. Muoneke
Keyword(s):  
Quality Of Life ◽  
Nephrotic Syndrome ◽  
Children And Adolescents ◽  
Idiopathic Nephrotic Syndrome ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Generic Quality ◽  
Quality Of Life Instruments

Abstract Introduction Most of the studies reporting the negative impact of idiopathic nephrotic syndrome on health-related quality of life in children and adolescents were conducted with generic quality-of-life instruments rather than disease-specific instruments. The consistency of these studies' findings using these generic instruments is not well established. Aim This systematic review aims to determine the reliability of current generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome. Methods We searched the PubMed, MEDLINE, EMBASE, and Google Scholar databases for articles published between 2000 and 2020, using appropriate descriptors. We included primary studies that met the eligibility criteria, independently screened their titles and abstracts, and removed all duplicates during the study-selection process. We resolved disagreements until a consensus was reached on study selection. We independently retrieved relevant data, including the generic quality-of-life instruments and the subjects’ and controls’ aggregate health-related quality of life scores, using a preconceived data-extraction form. Results Ten original articles were selected for qualitative and quantitative analyses. Some of the studies reported the following significant findings. The mean health-related quality of life scores for children with prevalent and incident nephrotic syndrome were 68.6 (range, 52.6–84.6) and 73.7 (range, 55.9–91.5), respectively. Children with idiopathic nephrotic syndrome and their controls with other chronic diseases had median scores of 65 (interquartile range, 59–68.75) and 62.2 (interquartile range, 58.05–65.78). Patients on oral immunosuppressive drug and intravenous rituximab reportedly had median scores of 76.2 and 72.6 and mean scores of 71.4 (range, 55.4–87.4) and 61.6 (range, 42.1–81.1) respectively for quality-of-life assessment on the ‘school functioning domain.’ Conclusions The health-related quality of life scores in patients with idiopathic nephrotic syndrome are consistently low. Lower scores occur in prolonged disease duration and severe clinical phenotypes, whereas the scores are higher than the scores obtained in other chronic diseases. These consistent findings underscore the reliability of the current generic instruments in assessing health-related quality of life in patients with idiopathic nephrotic syndrome.

Assessment of the quality of life in the treatment approaches of patients with the comorbid course of arterial hypertension and metabolic disorders aimed at reducing cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Zlatkina ◽  
V Shkapo ◽  
A Nesen ◽  
T Starchenko
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Metabolic Disorders ◽  
Clinical Signs ◽  
Blood Analysis ◽  
Sf 36 ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Cardiovascular diseases (CVD) remain the leading cause of premature death worldwide. According to epidemiological studies CVD prevention is highly effective. A 50% reduction in mortality from coronary artery disease (CAD) is associated with exposure to risk factors and only 40% with improved treatment. Purpose.  To assess the quality of life (QOL) in patients with arterial hypertension (AH) and metabolic disorders, to establish its impact on therapy effectiveness. We examined 280 patients with AH and comorbidity - 171 women and 109 men aged 45-75 years. Along with AH, all patients had comorbidities: 72.6 % suffered from coronary artery disease (CAD), 10.5% after myocardial infarction (MI), 35 % had clinical signs of heart failure (HF), 22, 1% - type 2 diabetes mellitus (t2DM), 27.4% - chronic kidney disease (CKD). Methods. Anthropometry, blood pressure (BP) measurement, immunoassay (C-reactive protein), biochemical blood analysis (lipid, carbohydrate metabolism parameters, QOL determination (questionnaire Sf-36). Results. In patients with comorbidity of pathologies (presence of AH, t2DM, CKD, CAD, obesity), there was a decrease in assessments in almost all indicators of QOL, and especially significant limitations in the performance of daily activities due to both physical and mental state. Conclusion. The degree of AH in patients with t2DM decreased QOL of physical activity, role-physical functioning, pain and general health, reflecting physical health, as well as mental health, including vitality, social activity, role emotional functioning. T2DM in patients with AH significantly worsens QOL of this category of patients as in physical component summary and mental component summary. The indicators of QOL are significantly affected by the duration of t2DM, as well as the degree of compensation. Achievement of the target BP levels in patients with AH with t2DM shows an improvement in a number of QOL parameters and makes it possible to recommend the Sf-36 questionnaire as a criterion for the effectiveness of the therapy.

Whole-Exome Sequencing Solved over 2-Decade Kidney Disease Enigma

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Suramath Isaranuwatchai ◽  
Ankanee Chanakul ◽  
Chupong Ittiwut ◽  
Chalurmpon Srichomthong ◽  
Vorasuk Shotelersuk ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Kidney Disease ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Treatment Plan ◽  
Unknown Etiology ◽  
Pediatric Case ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Whole Exome

Chronic kidney disease of unknown etiology (CKDu) has been a problem in renal practice as indefinite diagnosis may lead to inappropriate management. Here, we report a 54-year-old father diagnosed with CKDu at 33 years old and his 8-year-old son with steroid-resistant nephrotic syndrome. Using whole-exome sequencing, both were found to be heterozygous for c.737G>A (p.Arg246Gln) in LMX1B. The diagnosis of LMX1B-associated nephropathy has led to changes in the treatment plan with appropriate genetic counseling. The previously reported cases with this particular mutation were also reviewed. Most children with LMX1B-associated nephropathy had nonnephrotic proteinuria with normal renal function. Interestingly, our pediatric case presented with steroid-resistant nephrotic syndrome at 8 years old and progressed to ESRD requiring peritoneal dialysis at the age of 15 years. Our report emphasized the need of genetic testing in CKDu for definite diagnosis leading to precise management.

scholarly journals EXPRESS: Association of daily physical activity with psychosocial aspects and functional capacity in patients with Pulmonary Arterial Hypertension: a cross-sectional study

2021 ◽  
pp. 204589402199995
Author(s):  
Layse Nakazato Lima ◽  
Felipe Mendes ◽  
Ilma Paschoal ◽  
Daniela Oliveira ◽  
Marcos Mello Moreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Functional Capacity ◽  
Daily Physical Activity ◽  
Cross Sectional ◽  
Pulmonary Arterial ◽  
The Mean

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 ± 2,351, and the mean activity time was 41.6 ± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

Sign in / Sign up

Export Citation Format

Share Document