29 research outputs found
Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom.
Despite the current diagnostic and serologic testing for SLE, the interval between the onset of symptoms and the diagnosis is still long. In this study, we aimed to show the interval between the initial symptoms and the diagnosis of SLE and to investigate the presence of any relationship between the interval and the initial symptoms. One hundred and thirty-six patients were diagnosed with SLE using the 1982 ARA criteria. The mean age of the patients at diagnosis was 29.9 +/- 10.5 years. The mean interval between the onset of symptoms and the diagnosis of SLE was 21.82 +/- 30.32 months. The subjects were evaluated twice, at intervals of < or = 3 and < or = 12 months after the onset of symptoms. Although arthritis and/or arthralgia were the most common initial symptoms (60.3%), only 26.8% of the patients with these symptoms were diagnosed earlier than 3 months after the onset. If the first initial symptoms were butterfly rash or pericarditis, pleuritis, spontaneous abortion or cognitive dysfunction, they led to early diagnosis. In conclusion, since arthritis and/or arthralgia are the most common initial symptoms of the disease, every young woman with these symptoms should be carefully evaluated for SLE.</p
Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial.
Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron. A post hoc analysis of adverse event rates per 100 patient-years was performed to assess the safety of FCM versus oral iron over an extended period. Results: The safety population included 616 patients. The incidence of one or more adverse events was 91.0, 100.0 and 105.0 per 100 patient-years in the high ferritin FCM, low ferritin FCM and oral iron groups, respectively. The incidence of adverse events with a suspected relation to study drug was 15.9, 17.8 and 36.7 per 100 patient-years in the three groups; for serious adverse events, the incidence was 28.2, 27.9 and 24.3 per 100 patient-years. The incidence of cardiac disorders and infections was similar between groups. At least one ferritin level ≥800 µg/L occurred in 26.6% of high ferritin FCM patients, with no associated increase in adverse events. No patient with ferritin ≥800 µg/L discontinued the study drug due to adverse events. Estimated glomerular filtration rate remained the stable in all groups. Conclusions: These results further support the conclusion that correction of iron deficiency anemia with IV FCM is safe in patients with nondialysis-dependent CKD
Hypervolemia and high tumor necrosis factor-α: An interesting finding during the first six months' posttransplant period in kidney transplant recipients with good renal function
Renal transplantation is the treatment of choice for the end-stage renal disease. Hypervolemia and inflammation are commonly overlooked. We investigated whether hyper-volemia develops in kidney transplant recipients with estimated glomerular filtration rate (eGFR) >70 mL/min and if there is there any correlation between inflammatory cytokines and hypervolemia in the 1st month and at six months after transplantation. We measured serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, and body composition indices in 11 healthy volunteers and 19 kidney transplant recipients (KTRs) with eGFR >70 mL/min at one month and six months posttransplant. At baseline, body mass index (BMI) and fat tissue index (FTI) were significantly higher and overhydration improved (P = 0.006) at 6th month in KTRs. There was no difference in BMI, FTI, lean tissue index (LTI), and serum levels of IL-1 and IL-6 in controls and KTRs at six months posttransplant. Volume overload and serum TNF-α levels were significantly lower in controls than KTRs. There was positive correlation between volume overload and serum TNF-α levels in KTRs. Compared to baseline, parameters including volume overload, BMI, and FTI were found to be improved at six months' posttransplant in KTRs. Interestingly, volume overload and high levels of serum TNF-α continued at least six months after transplantation
THE COMPARISON OF SPOUSAL DONOR TRANSPLANTATION WITH ANTITHYMOCYTE GLOBULIN INDUCTION THERAPY AND LIVING RELATED DONOR TRANSPLATATION WITH STANDARD IMMONOSUPPRESSION
52nd Congress of the European-Renal-Association-European-Dialysis-and-Transplant-Assocation -- MAY 28-31, 2015 -- London, ENGLANDWOS: 000361215103089…European Renal Assoc, European Dialysis & Transplant Asso
Comparison between spousal donor transplantation treated with anti-thymocyte globulin induction therapy and, living related donor transplantation treated with standard immunosuppression
The worldwide shortage of organs available for transplantation has led to the use of living-unrelated kidney donors. In this context, spouses represent an important source of organ donors. We compared the allograft outcomes of spousal donor transplantation (SDT) with anti-thymocyte globulin (ATG) induction therapy and living related donor transplantation (LRDT) with triple immonosuppression and basiliximab, in addition. Among the 335 living and deceased donor kidney transplantations performed between April 2001 and June 2010, there were 274 living donor kidney transplantations including 34 SDT and 240 LRDT. The minimum follow-up period was 36 months. All recipients of SDT received ATG (1.5 mg/kg) induction therapy, which was stopped five to seven days after surgery. Maintenance immunosuppression included tacrolimus (TAC), mycophenolate mofetil (MMF) and prednisolone. LRDT recipients received triple immunosuppressive protocol consisting of cyclosporine or TAC, MMF and prednisolone, in addition to basiliximab. There was a significant difference between the two groups in recipient age, while pre-operative duration on dialysis, recipient sex and donor age and sex were not significantly different. There was also a significant difference between the two groups in the number of human leukocyte antigen (HLA) mismatches. The 1-, 3- and 5-year graft survival rates of SDT were 94.1%, 88.2% and 79.4%, respectively, and the frequency of acute rejection episodes was 5.8% (two cases). The 1-, 3- and 5-year graft survival rates of LRDT were 95.8%, 91.6% and 83.3%, respectively, with the frequency of acute rejection being 16.2%. The graft survival rates of SDT were as good as LRDT, while the acute rejection rates in SDT were lower than in LRDT, although the difference was not statistically different (P = 0.13)
BASELINE PLATELET TO LYMPHOCYTE RATIO: IS IT CAN BE A PREDICTOR OF MORTALITY IN HEMODIALYSIS PATIENTS
55th Congress of the European-Renal-Association (ERA) and European-Dialysis-and-Transplantation-Association (EDTA) -- MAY 24-27, 2018 -- Copenhagen, DENMARKWOS: 000433059801738…European Renal Assoc, European Dialysis & Transplant Asso
Pseudotumor Cerebri Associated with Uremia and NSAIDs
WOS: 000372889300030PubMed ID: 26022039
The Efficacy of Dipyridamole in the Treatment of Hypophosphatemia-Hypocalcemia for Hungry Bone Syndrome in a Hemodialysis Patient
WOS: 000372886700026PubMed ID: 25758891
Milk alkali syndrome induced by calcitriol and calcium bicarbonate in a patient with hypoparathyroidism
The milk-alkali syndrome (MAS) was a common cause of hypercalcemia, metabolic alkalosis, and renal failure in the early 20 th century. This syndrome was first recognized secondary to treatment of peptic ulcer disease with milk and absorbable alkali. Its incidence fell after the introduction of H2-blocker and proton pump inhibitor. Persistent ingestion of calcium carbonate and vitamin D caused MAS. We report a patient presenting with a triad of hypercalcemia, metabolic alkalosis and renal failure secondary to treatment of idiopathic hypoparathyroidism
Acute renal failure secondary to drug-related crystalluria and/or drug reaction with eosinophilia and systemic symptom syndrome in a patient with metastatic lung cancer
Drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity is a severe adverse drug-induced reaction. Aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, and some drugs, can induce DRESS. Atypical crystalluria can be seen in patients treated with amoxycillin or some drugs and can cause acute renal failure. We describe a 66-year-old man who presented fever and rash and acute renal failure three days after starting amoxycillin. He was also using phenytoin because of cerebral metastatic lung cancer. Investigation revealed eosinophilia and atypical crystalluria. The diagnosis of DRESS syndrome was made, amoxicillin was stopped, and dose of phenytoin was reduced. No systemic corticosteroid therapy was prescribed. Symptoms began to resolve within three to four days. The aim of this paper is to highlight the importance of microscopic examination of urine in a case with acute renal failure and skin lesions to suspect DRESS syndrome