International Journal of Nephrology最新文献

{"title":"Ameliorative Effect of <i>Olea europaea</i> Leaf Extract on Cisplatin-Induced Nephrotoxicity in the Rat Model.","authors":"Doa'a Ibrahim,&nbsp;Abdulsalam Halboup,&nbsp;Mohammed Al Ashwal,&nbsp;Amani Shamsher","doi":"10.1155/2023/2074498","DOIUrl":"https://doi.org/10.1155/2023/2074498","url":null,"abstract":"<p><strong>Background: </strong><i>Olea europaea</i> leaf extract (OELE) has potential health benefits and protects against cytotoxicity. This study investigated the possible ameliorative effect of OELE on cisplatin-induced nephrotoxicity in rats.</p><p><strong>Methods: </strong>Rats were assigned into six groups; two groups received 150 mg/kg or 300 mg/kg of OELE, one group received a single dose of cisplatin (6 mg/kg) IP on the first day of the experiment, two groups received a single dose of cisplatin 150 mg/kg or 300 mg/kg of OELE on the first day then starting from the fifth day for 10 consecutive days, and one group acted as a control. <i>Results and Conclusion</i>. The findings showed that cisplatin-induced nephrotoxicity was evidenced by a significant increase in serum creatinine blood urea nitrogen (BUN) and a significant decrease in estimated creatinine clearance and potassium level, which corresponded with the alterations in the histopathology of the renal tissue. OELE significantly ameliorated the nephrotoxic effects of cisplatin as dose-dependent.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"2074498"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Growing Challenge of Chronic Kidney Disease: An Overview of Current Knowledge.","authors":"Rikke Borg,&nbsp;Nicholas Carlson,&nbsp;Jens Søndergaard,&nbsp;Frederik Persson","doi":"10.1155/2023/9609266","DOIUrl":"https://doi.org/10.1155/2023/9609266","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is becoming one of the world's most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium-glucose cotransporter 2 inhibitors, there are now new effective treatments to add to standard therapy. This will also be relevant for primary care physicians as many patients with CKD have their family physician as their primary health care professional handling kidney function preservation. In the future, more precise and less invasive diagnostic methods may not only improve the determination of the underlying cause of CKD but may also carry information regarding which treatment to use (i.e. personalized medicine). This could lead to a reduced number of preventive treatments per individual, while at the same time improving the prognosis. This review summarizes ongoing efforts in this area.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"9609266"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Anaemia on Outcomes, Admissions, and Costs in Patients with Chronic Kidney Disease in Two Public Nephrology Practices in Queensland: A CKD.QLD Registry Study.","authors":"Jianzhen Zhang,&nbsp;Vishal Diwan,&nbsp;Zaimin Wang,&nbsp;Helen G Healy,&nbsp;Sree Krishna Venuthurupalli,&nbsp;Rajitha Abeysekera,&nbsp;Wendy E Hoy","doi":"10.1155/2023/8720293","DOIUrl":"https://doi.org/10.1155/2023/8720293","url":null,"abstract":"<p><strong>Aim: </strong>Anaemia among patients with chronic kidney disease (CKD) leads to poor overall outcomes. This study explores anaemia and its impact on nondialysis CKD (NDD-CKD) patients.</p><p><strong>Methods: </strong>2,303 adults with CKD from two CKD.QLD Registry sites were characterised at consent and followed until start of kidney replacement therapy (KRT), death, or censor date. Mean follow-up was 3.9 (SD 2.1) years. Analysis explored the impact of anaemia on death, KRT start, cardiovascular events (CVE), admissions, and costs in these NDD-CKD patients.</p><p><strong>Results: </strong>At consent, 45.6% patients were anaemic. Males were more often anaemic (53.6%) than females, and anaemia was significantly more common over the age of 65 years. The prevalence of anaemia was highest among CKD patients with diabetic nephropathy (27.4%) and renovascular disease (29.2%) and lowest in patients with genetic renal disease (3.3%). Patients with admissions for gastrointestinal bleeding had more severe anaemia, but accounted for only the minority of cases overall. Administration of ESAs, iron infusions, and blood transfusions were all correlated with more severe degrees of anaemia. The number of hospital admissions, length of stay, and hospital costs were all strikingly higher with more severe degrees of anaemia. Adjusted hazard ratios (CI 95%) of patients with moderate and severe anaemia vs. no anaemia for subsequent CVE, KRT, and death without KRT were 1.7 (1.4-2.0), 2.0 (1.4-2.9), and 1.8 (1.5-2.3), respectively.</p><p><strong>Conclusion: </strong>Anaemia is associated with higher rates of CVE, progression to KRT and death in NDD- CKD patients, and with greater hospital utilisation and costs. Preventing and treating anaemia should improve clinical and economic outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"8720293"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose.","authors":"Jorge Rico-Fontalvo,&nbsp;José Correa-Guerrero,&nbsp;María Cristina Martínez-Ávila,&nbsp;Rodrigo Daza-Arnedo,&nbsp;Tomás Rodriguez-Yanez,&nbsp;Amilkar Almanza-Hurtado,&nbsp;José Cabrales,&nbsp;Carmen Julia Mendoza-Paternina,&nbsp;Alvaro Frías-Salazar,&nbsp;Julio Morales-Fernández","doi":"10.1155/2023/6059079","DOIUrl":"https://doi.org/10.1155/2023/6059079","url":null,"abstract":"<p><p>Renal hyperfiltration (RHF) is a prevalent phenomenon in critically ill patients characterized by augmented renal clearance (ARC) and increased of elimination of renally eliminated medications. Multiple risk factors had been described and potential mechanisms may contribute to the occurrence of this condition. RHF and ARC are associated with the risk of suboptimal exposure to antibiotics increasing the risk of treatment failure and unfavorable patient outcomes. The current review discusses the available evidence related to the RHF phenomenon, including definition, epidemiology, risk factors, pathophysiology, pharmacokinetic variability, and considerations for optimizing the dosage of antibiotics in critically ill patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"6059079"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9086353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Disparity in Expression of Sarcopenia in Haemodialysis Recipients: Analysis from the FITNESS Cohort.","authors":"Benjamin M Anderson,&nbsp;Daisy V Wilson,&nbsp;Muhammad Qasim,&nbsp;Gonzalo Correa,&nbsp;Felicity Evison,&nbsp;Suzy Gallier,&nbsp;Charles J Ferro,&nbsp;Thomas A Jackson,&nbsp;Adnan Sharif","doi":"10.1155/2023/5885059","DOIUrl":"https://doi.org/10.1155/2023/5885059","url":null,"abstract":"<p><strong>Background: </strong>There has been little exploration of the interplay between sarcopenia and frailty in haemodialysis, particularly regarding gender difference. We aimed to (1) assess whether ultrasound-derived low muscle mass (LMM) and sarcopenia are more common in male or female haemodialysis recipients; (2) assess whether age influences any observed gender difference, and (3) explore the interplay between sarcopenia, frailty, and gender in haemodialysis recipients.</p><p><strong>Methods: </strong>This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis with frailty phenotype (FP) scores. Bilateral anterior thigh thickness (BATT) was obtained according to an established ultrasound protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, LMM, and sarcopenia with a priori covariables, stratified by gender.</p><p><strong>Results: </strong>In total of 223 studies, participants had ultrasound measurements. Males showed greater prevalence of LMM. On adjusted analyses, LMM was associated with lower hand grip strength in males (<i>β</i> = -4.17; 95% C.I. -7.57 to -0.77; <i>P</i>=0.02), but not females (<i>β</i> = -1.88; 95% C.I. -5.41 to 1.64; <i>P</i>=0.29). LMM was also associated with slower walking speed in both males (<i>β</i> = -0.115; 95% C.I. -0.258 to -0.013; <i>P</i>=0.03) and females (<i>β</i> = -0.152; 95% C.I. -0.300 to -0.005; <i>P</i>=0.04). Sarcopenia was associated with greater odds of frailty on adjusted models in males (OR = 9.86; 95% C.I. 1.8 to 54.0; <i>P</i>=0.01), but not females (OR = 5.16; 95% C.I. 0.22 to 124; <i>P</i>=0.31).</p><p><strong>Conclusions: </strong>The clinical expression and significance of sarcopenia differ substantially between males and females on haemodialysis. Further work is required to elucidate underlying mechanisms and guide tailored treatment.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"5885059"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10094972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Comparison of Clinical Presentation and Outcomes of Kidney Transplant Recipients with COVID-19 during Wave 1 versus Wave 2 at a Tertiary Care Center, India","authors":"S. Jasuja, G. Sagar, A. Bahl, Neharita Jasuja, R. Chawla, A. Bansal, M. Kanwar, S. Kansal, N. Modi, A. Ansari, Viny Kantroo, P. Dhar, C. Chatterjee, N. Ghonge, Samir Tawakley, Shalini Verma","doi":"10.1155/2022/9088393","DOIUrl":"https://doi.org/10.1155/2022/9088393","url":null,"abstract":"Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48441133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laboratory Diagnosis of Urinary Tract Infections Based on Leukocyte and Bacterial Parameters Using Standardized Microscopic and Flow Cytometry Methods","authors":"Priskila Christy, H. Sidjabat, Anggia Augustasia Lumban Toruan, E. Moses, N. Mohd Yussof, Yessy Puspitasari, M. R. Fuadi, Aryati, F. R. Marpaung","doi":"10.1155/2022/9555121","DOIUrl":"https://doi.org/10.1155/2022/9555121","url":null,"abstract":"Background Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic. Methods A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture. Results A leukocyte cutoff value of 87.2/μL had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/μL. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung (k = 0.959, p < 0.001 and k = 0.939, p < 0.001, respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result (k = 0.880, p < 0.001). Conclusions The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44932771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate.","authors":"Kjellbjørn Jakobsen, Bjørn O Eriksen, Ole M Fuskevåg, Stephen J Hodges, Lars M Ytrebø","doi":"10.1155/2022/8267829","DOIUrl":"10.1155/2022/8267829","url":null,"abstract":"<p><p>Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2022 1","pages":"8267829"},"PeriodicalIF":1.7,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9155923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41340962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Risk Perceptions of Chronic Kidney Disease Risk Factors among Women of Childbearing Age in Lagos State, Nigeria: From a Health Demography Approach","authors":"M. Akokuwebe, E. Idemudia","doi":"10.1155/2022/5511555","DOIUrl":"https://doi.org/10.1155/2022/5511555","url":null,"abstract":"Background Kidney disease (KD), also known as chronic kidney disease (CKD), is a long-term underrecognized public health concern and one of the eight leading causes of death in women. Despite that, little is known about women's knowledge, perceived risk, and perceptions of CKD risk factors. In this study, we assessed knowledge, perceived risk, and perceptions of CKD risk factors among women of childbearing age in Lagos State, Nigeria. Methods Administering a pretested and structured questionnaire among 825 women aged 15–49 years, we conducted a cross-sectional descriptive study to evaluate knowledge, self-reported CKD risk factors, and risk perception among women of childbearing age in urban and semiurban communities in Lagos State, Nigeria. We used descriptive (mean, frequencies, and percentages) and bivariate statistics (chi-square) to assess sociodemographic factors influencing knowledge and perceptions of CKD risk factors. Binary and multinomial logistic regressions were further employed to assess risk perceptions of CKD factors associated with knowledge. Results Five hundred and forty (65.5%) out of 825 women reported being knowledgeable of CKD risk factors with majority of the younger adult women (15–29 years) having good knowledge than other age cohorts, with a mean age of 33.5 ± 11.5 years. The women's knowledge of CKD was found to be significantly associated with independent and dependent risk factors (p < 0.05). The major self-reported independent CKD risk factors were misuse of analgesics (NSAIDs) (OR = 1.20; p < 0.05), herbal drinks (OR = 2.30; p < 0.05), and herbal supplements (OR = 1.37; p < 0.05), while self-reported dependent CKD risk factors were hypertension (OR = 2.14; p < 0.05), family history of KD ailments (OR = 1.30; p < 0.05), and high cholesterol (OR = 1.44; p < 0.05). Similarly, majority of the women had low perceived CKD risk (54.8%), while women with CKD risk factors (independent and dependent) view themselves at decreased perceived risk for the disease compared to those who are not associated with CKD risk factors (p < 0.05). Also, findings revealed that women had poor perception of risk factors associated with CKD. The multivariate analysis of perceived risk showed that demographic factors (younger aged adults, high education, and high income), independent risk factors of CKD (misuse of NASAIDs and excessive use of herbal drink and herbal supplement), and dependent risk factors (hypertension and family history of KD ailments) were significantly associated with knowledge of CKD (p < 0.05). Conclusion Our study reveals high knowledge of CKD risk factors but low perceived risk and poor perception of the link between CKD risk factors and its ailments. Given this, there is a call for urgent measures to create sensitization and provide public CKD behavioural health interventions as well as easy communication strategies for women to secure better access to awareness intervention programmes and healthcare services.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44466361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center","authors":"T. Nakakita, K. Akiyama, Kazunori Karasawa, Yoei Miyabe, T. Moriyama, K. Uchida, K. Nitta","doi":"10.1155/2022/1749548","DOIUrl":"https://doi.org/10.1155/2022/1749548","url":null,"abstract":"Background The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48087537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}