| 1. |
|
|
| 2. |
- Hadimeri, U., et al.
(författare)
-
Membranoproliferative Glomerulonephritis and Inflammatory Pseudotumour of the Spleen
- 2013
-
Ingår i: Case Reports in Oncology. - : S. Karger. - 1662-6575. ; 6:1, s. 84-89
-
Tidskriftsartikel (refereegranskat)abstract
- Inflammatory pseudotumour is a rare condition that can affect various organs. The clinical and histologic appearance of the pseudotumour may mimic haematological, lymphoproliferative, paraneoplastic or malignant processes. A previously healthy 39-year-old man presented with nephrotic syndrome. He had a history of headaches, nausea and swollen ankles. Computed tomography of the abdomen revealed a 6-cm mass in the spleen. Following a renal biopsy, a diagnosis of membranoproliferative glomerulonephritis (MPGN) type I was made. Splenectomy was performed and the examination revealed a mixed population of lymphocytes with predominantly T-cells, B-cells and lymphoplasmacytoid cells. Immunostaining confirmed that the small cells were mostly T-cells positive for all T-cell markers including CD2, CD3, CD4, CD5, CD7 and CD8. A diagnosis of inflammatory pseudotumour was established. The removal of the spleen was followed by remission of glomerulonephritis, but it was complicated by a subphrenic abscess and pneumonia. This association between an inflammatory pseudotumour of the spleen and MPGN has not been previously described. Abnormal immune response due to the inflammation leading to secondary glomerulonephritis might be the main pathogenic mechanism.
|
|
| 3. |
|
|
| 4. |
- Backman, L., et al.
(författare)
-
Steroid-free immunosuppression in kidney transplant recipients and prograf monotherapy: an interim analysis of a prospective multicenter trial
- 2006
-
Ingår i: Transplantation proceedings. - : Elsevier BV. - 0041-1345. ; 38:8, s. 2654-6
-
Tidskriftsartikel (refereegranskat)abstract
- This report described an interim analysis of a investigator-driven multicenter trial in renal transplant recipients: the Prospective Quality of life Renal Transplantation Switch Study; Tacrolimus-based immunosuppression ("PQRST study"). Patients included in the trial initially treated with cyclosporine-based immunosuppression after renal transplantation who experienced side effects, such as hypertension, hyperlipidemia, hypertrichosis, or other adverse reactions, were converted to a tacrolimus-based immunosuppressive regimen (n = 31). Steroids were subsequently discontinued between 3 and 6 months after the conversion. As of today 19/31 (50%) patients have been successfully weaned off steroids with the remaining patients in this process. In this interim analysis, with a follow-up ranging from 1 to 18 months both patient and graft survivals were 100%. No patient experienced an acute rejection episode; none of the grafts were lost. Blood pressure decreased in 22/31 (71%) of the patients. No patient developed de novo diabetes or other serious side effect related to the conversion. Three patients were withdrawn from the trial because of side effects: bleeding, depression, and proteinuria. However, none of these adverse events were felt to be directly related to the change of the immunosuppressive regimen to tacrolimus monotherapy. In conclusion, conversion from cyclosporine to tacrolimus-based therapy was safe and well tolerated; it may improve the cardiovascular risk profile after kidney transplantation.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Peters, Björn, et al.
(författare)
-
Desmopressin (Octostim (R)) before a native kidney biopsy can reduce the risk for biopsy complications in patients with impaired renal function: A pilot study
- 2018
-
Ingår i: Nephrology. - : Wiley. - 1320-5358 .- 1440-1797. ; 23:4, s. 366-370
-
Tidskriftsartikel (refereegranskat)abstract
- AimTo evaluate whether the administration of desmopressin alters the risk for renal biopsy complications. MethodsA multicenter registry containing 576 native kidney biopsies (NKb) with a serum creatinine above 150mol/L in 527 patients (372 men and 155 women, median age 61years) was used. Most of the data were prospective. At one of the hospitals all biopsies with creatinine above 150mol/L received desmopressin before biopsies (NKb 204). These were compared to outcome of biopsy complications against other centres where desmopressin was not given (NKb 372). Fisher's exact test, (2) analyses, univariate and multiple binary logistic regression were used. Data were given as odds ratio (OR) and confidence interval (CI). A two sided P-value of <0.05 was considered significant. ResultsIn NKb with creatinine >150mol/L, those with desmopressin had less overall (3.4% vs 8.4%, OR 0.39, CI 0.17-0.90) whereas major or minor complications were not different. While desmopressin did not exhibit difference in complications in men, women received less major (0% vs 8.6%, P=0.03) and overall complications (0% vs 12.1%, P=0.006). A multiple logistic regression revealed that, after adjusting for BMI, age and sex, prophylaxis with desmopressin showed less major (OR 0.38, CI 0.15-0.96) and overall complications (OR 0.36, CI 0.15-0.85). ConclusionDesmopressin given before a native kidney biopsy in patients with impaired renal function can reduce the risk for complications.
|
|
| 8. |
- Peters, Björn, et al.
(författare)
-
High Resistive Index in Transplant Kidneys Is a Possible Predictor for Biopsy Complications
- 2016
-
Ingår i: Transplantation Proceedings. - : Elsevier BV. - 0041-1345 .- 1873-2623. ; 48:8, s. 2714-2717
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Transplant kidney biopsies are performed to determine a histological diagnosis for specific patient treatment. The aim of this study was to investigate if Resistive Index (RI) could be a predictor for biopsy complications. Methods. In this study, 220 consecutive transplant kidney biopsies (136 men and 84 women; median age, 55.5 years) were prospectively included. RI (median, 0.7) was measured by use of ultrasound. Histological diagnoses and biopsy complications were registered. Biopsy needles were either 16- or 18-gauge. Biopsies were performed by radiologists and were carried out as an outpatient procedure (70%) or an inpatient procedure (30%). Usually three passes per biopsy were performed. Results. The overall complication rate was 6.8%, divided into major (4.5%) and minor (2.3%) complications. An RI >= 0.8 predicts major (13.3% versus 3.2%; risk ratio [RR], 4.2; confidence interval [CI], 1.3-14.1; P=.03) and overall biopsy complications (16.7% versus 5.3%; RR, 3.2; CI, 1.2-8.6; P=.04) compared with RI <0.8. In the group <0.8, RI correlated with age (r(s) = 0.28, P<.001) and systolic blood pressure (r(s) = 0.18, P=.02). In the group >= 0.8, RI correlated with degree of interstitial fibrosis (r(s) = 0.65, P=.006) and systolic blood pressure (r(s) = 0.40, P =.03). The multiple regression analysis showed that in the group <0.8, the RI correlated only with age (P<.001), whereas in the group >= 0.8, RI correlated only with the degree of interstitial fibrosis (P=.003). Conclusions. An RI >= 0.8 indicates greater risk for major and overall biopsy complications and should result in greater caution after biopsy.
|
|
| 9. |
- Stegmayr, Bernd, et al.
(författare)
-
Low-dose atorvastatin in severe chronic kidney disease patients : a randomized, controlled endpoint study
- 2005
-
Ingår i: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. ; 39:6, s. 489-497
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. There have been no endpoint studies with statins for patients with severe renal failure. The purpose of this prospective, open, randomized, controlled study was to investigate whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance < 30 ml/min).Material and methods. The study subjects comprised 143 patients who were randomized either to placebo (controls; n=73; mean age 69.5 years) or to treatment with atorvastatin (n=70; mean age 67.9 years). The patients included were either non-dialysis (n=33), haemodialysis (n=97) or peritoneal dialysis (n=13) patients. Analysis focused on the primary endpoints of all-cause mortality, non-lethal acute myocardial infarction, coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. Statistical analysis for endpoint data was mainly by intention-to-treat.Results. Primary endpoints occurred in 74% of the subjects. There was no difference in outcome between the control and atorvastatin groups. The 5-year endpoint-free survival rate from study entry was 20%. Atorvastatin was withdrawn in 20% of patients due to unacceptable side-effects. In the atorvastatin group, low-density lipoprotein (LDL) cholesterol was reduced by 35% at 1 month and then sustained. The controls showed a progressive reduction in LDL cholesterol until 36 months.Conclusions. Although atorvastatin reduced total and LDL cholesterol effectively it was not beneficial regarding the long-term outcomes of cardiovascular endpoints or survival. In contrast to other patient groups, patients with severe chronic kidney disease, especially those on dialysis, seem to derive limited benefit from this lower dose of atorvastatin.
|
|
| 10. |
|
|
