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Dialysis and lupus

Ellen P Carlin, Nichole Giller, Rebecca Katz
OBJECTIVE: To quantify the population at risk of serious adverse reactions to replicating smallpox vaccine. DESIGN AND SAMPLE: Conditions known or suspected to carry risk were identified via Centers for Disease Control and Prevention planning documents, other federal publications, and peer-reviewed literature. Conditions identified were categorized as historically recognized risks or more recently recognized immunocompromised states that may pose risk. Major historical risk factors were as follows: eczema/atopic dermatitis, pregnancy, HIV, and primary immunodeficiency...
October 13, 2016: Public Health Nursing
Stephen M Korbet, William L Whittier, Edmund J Lewis
BACKGROUND/AIM: We assess the impact of serum creatinine at baseline on complete remission rate and long-term outcome in severe lupus nephritis (SLN). METHODS: A total of 86 adult patients with SLN [International Society of Nephrology/Renal Pathology Society (ISN/RPS) class IV lesions] were evaluated based on baseline serum creatinine levels (≤1.0, 1.01-1.5, 1.51-2.0, 2.01-3.0, and >3.0 mg/dl; n = 22, 23, 16, 12, and 13, respectively). The complete remission rates (serum creatinine level of ≤1...
May 2016: Nephron Extra
S K Rampelli, N G Rajesh, B H Srinivas, K T Harichandra Kumar, R P Swaminathan, P S Priyamvada
There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN) in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 31; 77.5%) followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20%) and anti-glomerular basement membrane disease (n = 1; 2...
July 2016: Indian Journal of Nephrology
Li-Yang Wu, Hang Liu, Wei Liu, Han Li, Xiao-Dong Zhang
Kidney transplantation after liver transplantation (KALT) offers longer survival and a better quality of life to liver transplantation recipients who develop chronic renal failure. This article aimed to discuss the efficacy and safety of KALT compared with other treatments. The medical records of 5 patients who had undergone KALT were retrospectively studied, together with a literature review of studies. Three of them developed chronic renal failure after liver transplantation because of calcineurin inhibitor (CNI)-induced nephrotoxicity, while the others had lupus nephritis or non-CNI drug-induced nephrotoxicity...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
M A Gianfrancesco, L Balzer, K E Taylor, L Trupin, J Nititham, M F Seldin, A W Singer, L A Criswell, L F Barcellos
Systemic lupus erythematous (SLE) is a chronic autoimmune disease associated with genetic and environmental risk factors. However, the extent to which genetic risk is causally associated with disease activity is unknown. We utilized longitudinal-targeted maximum likelihood estimation to estimate the causal association between a genetic risk score (GRS) comprising 41 established SLE variants and clinically important disease activity as measured by the validated Systemic Lupus Activity Questionnaire (SLAQ) in a multiethnic cohort of 942 individuals with SLE...
September 2016: Genes and Immunity
Laura C Plantinga, S Sam Lim, Rachel E Patzer, Stephen O Pastan, Cristina Drenkard
BACKGROUND: U.S. hemodialysis patients with systemic lupus erythematosus (SLE) and end-stage renal disease (ESRD) are less likely than other ESRD patients to have a permanent vascular access (fistula or graft) in place at the dialysis start. We examined whether vascular access outcomes after dialysis start differed for SLE vs. other ESRD patients. METHODS: Among U.S. patients initiating hemodialysis in 2010 with only a catheter (n = 40,911; 384 with SLE) and using a permanent access on first dialysis (n = 13,073; 48 with SLE), we examined the association of SLE status with time to first placement of a permanent access (among catheter-only patients) and to loss of access patency (among patients using a permanent access on first dialysis), both censored 1 year after dialysis start, using multivariable Cox proportional hazards models...
2016: BMC Nephrology
El-Hussein E A El-Hassan, Mohamed B Ghalib, Azam I S Ibrahim, Bethan Phillips, Aled Owain Phillips
BACKGROUND: Acute kidney injury (AKI) is a relatively common clinical condition, associated with high rates of mortality. Although there is extensive literature on the nature and consequence of AKI in the developed world, much less is known in the developing world and more specifically in sub-Saharan Africa (SSA). OBJECTIVES: To describe the demographics, histological diagnosis and clinical course of patients presenting with AKI to a single centre in Sudan. METHODS: Retrospective data were collected on 100 consecutive patients with AKI and an active urinary sediment, who underwent diagnostic native percutaneous renal biopsy...
July 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Eve M D Smith, Michael W Beresford
Juvenile-onset systemic lupus erythematosus (JSLE) is a rare, severe multisystem autoimmune disease affecting the kidney (Lupus Nephritis, LN) in up to 80% of children. LN is more severe in children than adults, with potential for irreversible kidney damage requiring dialysis or transplant. Renal biopsy is currently the gold standard for diagnosing and monitoring LN, however, it is invasive and associated with complications. Urine biomarkers have been shown to be better than serum biomarkers in differentiating renal disease from other organ manifestations...
June 29, 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Rosalind Ramsey-Goldman, Amarpali Brar, Carrie Richardson, Moro O Salifu, Ann Clarke, Sasha Bernatsky, Dimitre G Stefanov, Rahul M Jindal
OBJECTIVE: We investigated malignancy risk after renal transplantation in patients with and without systemic lupus erythematosus (SLE). METHODS: Using the United States Renal Data System from 2001 to 2009, 143 652 renal transplant recipients with and without SLE contributed 585 420 patient-years of follow-up to determine incident cancers using Medicare claims codes. We calculated standardised incidence ratios (SIRs) of cancer by group using age, sex, race/ethnicity-specific and calendar year-specific cancer rates compared with the US population...
2016: Lupus Science & Medicine
A Filipovic-Pierucci, A Rigault, A Fagot-Campagna, P Tuppin
BACKGROUND: This study uses healthcare consumption to compare the health status of beneficiaries of the French national health insurance general scheme between individuals living in French overseas territories (FOT) and those living in metropolitan France. METHODS: Data were extracted from the French national health insurance database (Sniiram) for 2012, using algorithms, 56 groups of diseases and 27 groups of hospital activity were isolated. Standardized morbidity ratio for age and sex (SMR) were used to compare FOT to mainland France...
June 2016: Revue D'épidémiologie et de Santé Publique
Martine T P Besouw, Johan G Vande Walle, Mohamad I Ilias, Ann M Raes, Agnieszka A Prytula, Lieve Claeys, Jo L Dehoorne
A 12-year-old Congolese girl presented with acute renal failure, edema, hypertension, hemoptysis, hematuria, and proteinuria after a history of throat infection. Renal ultrasound showed kidneys of normal size, with increased echogenicity of the cortical parenchyma and decreased corticomedullary differentiation. Other additional investigations showed pancytopenia with decreased complement (low C3 and C4). Antinuclear antibodies were strongly positive, including anti-double stranded DNA. Renal biopsy confirmed severe grade IV lupus nephritis...
May 12, 2016: Acta Clinica Belgica
Lei Zhang, Gavin Lee, Xusheng Liu, Elaine M Pascoe, Sunil V Badve, Neil C Boudville, Philip A Clayton, Carmel M Hawley, John Kanellis, Stephen P McDonald, Chen Au Peh, Kevan R Polkinghorne, David W Johnson
Patient outcomes in end-stage kidney disease (ESKD) secondary to lupus nephritis have not been well described. To help define this we compared dialysis and transplant outcomes of patients with ESKD due to lupus nephritis to all other causes. All patients diagnosed with ESKD who commenced renal replacement therapy in Australia and New Zealand (1963-2012) were included. Clinical outcomes were evaluated in both a contemporary cohort (1998-2012) and the entire 50-year cohort. Of 64,160 included patients, 744 had lupus nephritis as the primary renal disease...
June 2016: Kidney International
David Herrera van Oostdam, Marco U Martínez Martínez, Cuauhtémoc Oros-Ovalle, David Martínez-Gala, Gerardo T Jaimes Piñón, Carlos Abud Mendoza
The aim of this study is to determine the frequency and prognosis of IgG4 deposits in renal biopsy of patients with membranous lupus nephritis (MLN). This is a retrospective cohort study in which we included patients with class V alone or combined (III/V or IV/V) of lupus nephritis according to the 2004 ISN/RPS. All the patients included must have availability of renal tissue for immunohistochemistry analyses. We excluded other classes of lupus nephritis. The renal tissue was examined by a nephro-pathologist...
June 2016: Clinical Rheumatology
María Galindo-Izquierdo, Esther Rodriguez-Almaraz, José M Pego-Reigosa, Francisco J López-Longo, Jaime Calvo-Alén, Alejandro Olivé, Antonio Fernández-Nebro, Víctor Martinez-Taboada, Paloma Vela-Casasempere, Mercedes Freire, Francisco J Narváez, José Rosas, Mónica Ibáñez-Barceló, Esther Uriarte, Eva Tomero, Antonio Zea, Loreto Horcada, Vicenç Torrente, Iván Castellvi, Joan Calvet, Raúl Menor-Almagro, María A Aguirre Zamorano, Enrique Raya, Elvira Díez-Álvarez, Tomás Vázquez-Rodríguez, Paloma García de la Peña, Atusa Movasat, José L Andreu, Patricia Richi, Carlos Marras, Carlos Montilla-Morales, Blanca Hernández-Cruz, José L Marenco de la Fuente, María Gantes, Eduardo Úcar, Juan J Alegre-Sancho, Javier Manero, Jesús Ibáñez-Ruán, Manuel Rodríguez-Gómez, Víctor Quevedo, José Hernández-Beriaín, Lucía Silva-Fernández, Fernando Alonso, Sabina Pérez, Iñigo Rúa-Figueroa
The aim of the study was to profile those patients included in the RELESSER registry with histologically proven renal involvement in order to better understand the current state of lupus nephritis (LN) in Spain. RELESSER-TRANS is a multicenter cross-sectional registry with an analytical component. Information was collected from the medical records of patients with systemic lupus erythematosus who were followed at participating rheumatology units. A total of 359 variables including demographic data, clinical manifestations, disease activity, severity, comorbidities, LN outcome, treatments, and mortality were recorded...
March 2016: Medicine (Baltimore)
I G Okpechi, O I Ameh
Lupus nephritis (LN) is a significant cause of morbidity and mortality in patients with systemic lupus erythematosus. Delayed recognition and diagnosis of LN may be a common cause of chronic kidney disease among South Africans. Renal biopsy is the gold standard of diagnosing LN; however, this service is not available in many centres and the use of urinalysis, urine microscopic examination and other serological tests can be useful in identifying patients with proliferative LN. Proliferative types of LN (class III, class IV and mixed class V)comprise the larger proportion of patients with this condition...
December 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Rishi Pruthi, Mark McClure, Anna Casula, Paul J Roderick, Damian Fogarty, Mark Harber, Rommel Ravanan
Glomerulonephritis (GN) is the primary diagnosis in 20% to 40% of patients receiving a renal transplant. Here we studied patient survival and graft outcomes in patients with GN transplanted in the UK. UK Renal Registry data were used to analyze patient survival and graft failure in incident transplant patients between 1997 to 2009 who had a diagnosis of primary GN, in comparison to patients transplanted with adult polycystic kidney disease (APKD) or diabetes. Multivariable regression analysis adjusted for age, sex, donor type, ethnicity, donor age, time on dialysis, human leukocyte antigen mismatch, cold ischemic time, and graft failure (for patient survival)...
April 2016: Kidney International
Monique Bethel, Frances M Yang, Shuang Li, N Stanley Nahman, Alyce M Oliver, Wambui Machua, Laura D Carbone
OBJECTIVES: To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). METHODS: This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710...
April 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
J Buček, R Staffa, Z Kříž, R Vlachovský
The authors describe the case report of a 63 years old female patient with chronic renal failure in systemic lupus erythematosus. Vascular dialysis access in upper limbs could no more be used. The condition was approached by constructing an arteriovenous (AV) fistula in the thigh with transposed superficial femoral vein as the first procedure in the Czech Republic.
November 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Sudheer Kumar Reddy, Afsana Jahan, Swasti Chaturvedi, Indira Agarwal
BACKGROUND: Outcome data in paediatrics regarding the use of plasmapheresis for immunological kidney disease are scarce. OBJECTIVES: We aimed to evaluate the role of plasmapheresis in children presenting with severe renal impairment secondary to immunological kidney diseases. METHODS: A retrospective chart review of children admitted between January 2009 and August 2013 to the Paediatric Nephrology Unit, Christian Medical College, Vellore, India, and requiring plasma exchange was undertaken...
December 2015: Clinical Kidney Journal
Michelle M O'Shaughnessy, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD), while peritoneal dialysis affords certain benefits over hemodialysis. Distributions and determinants of first ESRD treatment modality have not been compared across glomerulonephritis (GN) subtypes. METHODS: We identified all adult (18-75 years) patients with ESRD attributed to any of six GN subtypes [focal segmental glomerulosclerosis (FSGS), IgA nephropathy (IgAN), membranous nephropathy (MN), membranoproliferative GN (MPGN), lupus nephritis (LN) and vasculitis] who were first registered in the US Renal Data System (USRDS) between 1996 and 2011...
February 2016: Nephrology, Dialysis, Transplantation
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