10 research outputs found
Characteristics and Prognosis of Chinese Patients with Anti-Glomerular Basement Membrane Disease
Anti-glomerular basement membrane antibody disease is an uncommon cause of end-stage renal disease
There are few reports regarding outcomes of anti-glomerular basement membrane (GBM) disease in patients who underwent renal replacement therapy. To help define this we studied all patients with anti-GBM disease who started renal replacement therapy for end-stage renal disease (ESRD) in Australia and New Zealand (ANZDATA Registry) between 1963 and 2010 encompassing 449 individuals (0.8 percent of all ESRD patients). The median survival on dialysis was 5.93 years with death predicted by older age and a history of pulmonary hemorrhage. Thirteen patients recovered renal function, although 10 subsequently experienced renal death after a median period of 1.05 years. Of the 224 patients who received their first renal allograft, the 10-year median patient and renal allograft survival rates were 86% and 63%, respectively. Six patients experienced anti-GBM disease recurrence in their allograft, which led to graft failure in two. Using multivariable Cox regression analysis, patients with anti-GBM disease had comparable survival on dialysis or following renal transplantation (hazard ratios of 0.86 and 1.03, respectively) compared to those with ESRD due to other causes. Also, renal allograft survival (hazard ratio of 1.03) was not altered compared to other diseases requiring a renal transplant. Thus, anti-GBM disease was an uncommon cause of ESRD, and not associated with altered risks of dialysis, transplant or first renal allograft survival. Death on dialysis was predicted by older age and a history of pulmonary hemorrhage.Wen Tang, Stephen P. McDonald, Carmel M. Hawley, Sunil V. Badve, Neil C. Boudville, Fiona G. Brown, Philip A. Clayton, Scott B. Campbell, Janak R. de Zoysa and David W. Johnso
Atypical anti-glomerular basement membrane disease complicated by methicillin-susceptible Staphylococcus aureus infection-related rapidly progressive glomerulonephritis: a case report and literature review
Anti-glomerular basement membrane (GBM) antibody nephritis associated with acute pyelonephritis in a patient with unilateral hydronephrosis
Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey
Abstract Background This study aimed to investigate clinical characteristics of Korean PAP patients and to examine the potential risk factors of PAP. Methods We retrospectively reviewed medical records of 78 Korean PAP patients diagnosed between 1993 and 2014. Patients were classified into two groups according to the presence/absence of treatment (lavage). Clinical and laboratory features were compared between the two groups. Results Of the total 78 PAP patients, 60% were male and median age at diagnosis was 47.5ย years. Fifty three percent were ever smokers (median 22 pack-years) and 48% had a history of dust exposure (metal 26.5%, stone or sand 20.6%, chemical or paint 17.7%, farming dust 14.7%, diesel 14.7%, textile 2.9%, and wood 2.9%). A history of cigarette smoking or dust exposure was present in 70.5% of the total PAP patients, with 23% having both of them. Patients who underwent lavage (nโ=โ38) presented symptoms more frequently (38/38 [100%] vs. 24/40 [60%], Pโ<โ0.001) and had significantly lower PaO2 and DLCO with higher D(A-a)O2 at the onset of disease than those without lavage (nโ=โ40) (Pโ=โ0.006, Pโ<โ0.001, and Pโ=โ0.036, respectively). Correspondingly, the distribution of disease severity score (DSS) differed significantly between the two groups (Pโ=โ0.001). Based on these, when the total patients were categorized according to DSS (low DSS [DSS 1โ2] vs. high DSS [DSS 3โ5]), smoking status differed significantly between the two groups with the proportion of current smokers significantly higher in the high DSS group (11/22 [50%] vs. 7/39 [17.9%], Pโ=โ0.008). Furthermore, current smokers had meaningfully higher DSS and serum CEA levels than non-current smokers (Pโ=โ0.011 and Pโ=โ0.031), whereas no difference was found between smokers and non-smokers. Regarding type of exposed dust, farming dust was significantly associated with more severe form of PAP (Pโ=โ0.004). Conclusion A considerable proportion of PAP patients had a history of cigarette smoking and/or dust exposure, suggestive of their possible roles in the development of PAP. Active cigarette smoking at the onset of PAP is associated with the severity of PAP