Objective: Despite the increasing use of rituximab in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), it remains unclear what the optimal dosing is, especially for maintenance of remission. A deeper understanding of post-rituximab B-cell repopulation patterns may aid better-tailored treatment.
Methods: This is a monocentric, retrospective study including ANCA-positive AAV patients receiving a single course of rituximab induction.
In the last decades there have been important changes in the epidemiology and natural history of bacterial infection-related glomerulonephritides. Once defined as an infancy-onset acute nephritic syndrome following a streptococcal infection, and characterized by a relative benign course, infection-related glomerulonephritis nowadays also affects the adult population, particularly the elderly and the chronically ill. The infectious agents and infection sites have become more diversified, and the prognosis is burdened by a higher rate of mortality, chronic kidney disease, end-stage renal disease and acute overload complications.
View Article and Find Full Text PDFThe outcome of kidney transplant patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still unclear. Here we describe the clinical characteristics, disease outcome, and risk factors for acute respiratory distress syndrome (ARDS) and death of a cohort of 53 kidney transplant patients with coronavirus disease 2019 (COVID-19). Eight of 53 have been handled as outpatients because of mild disease, on average with immunosuppression reduction and the addition of hydroxychloroquine and azithromycin; no patients required admission, developed ARDS, or died.
View Article and Find Full Text PDFThe shortage of donors in the face of the increasing number of patients wait-listed for renal transplantation has prompted several strategies including the use of kidneys with a tumor, whether found by chance on harvesting from a deceased donor or intentionally removed from a living donor and transplanted after excision of the lesion. Current evidence suggests that a solitary well-differentiated renal cell carcinoma, Fuhrman nuclear grade I-II, less than 1 cm in diameter and resected before grafting may be considered at minimal risk of recurrence in the recipient who, however, should be informed of the possible risk and consent to receive such a graft.
View Article and Find Full Text PDFBackground: Inflammation and increased erythropoiesis stimulating agents (ESA) requirement are frequently associated in patients on dialysis. On-line hemodiafiltration (ol-HDF), putting together high levels of diffusion, and convection could improve both conditions. However, it is still not known which depurative component plays a major role in determining this result.
View Article and Find Full Text PDFRenal cancer occurs more frequently in renal transplanted patients than in the general population, affecting native kidneys in 90% of cases and the graft in 10 %. In addition to general risk factors, malignancy susceptibility may be influenced by immunosuppressive therapy, the use of calcineurin inhibitors (CNI) as compared with mammalian target of rapamycin inhibitors, and the length of dialysis treatment. Acquired cystic kidney disease may increase the risk for renal cancer after transplantation, while autosomal dominant polycystic kidney disease does not seem to predispose to cancer development.
View Article and Find Full Text PDFWaldenström's macroglobulinemia (WM) is a rare lymphoid neoplasia, accounting for 2% of all hematological malignancies. Renal complications occur rather rarely compared to multiple myeloma. The most common renal manifestations are mild proteinuria and microhematuria.
View Article and Find Full Text PDFChronic lymphocytic leukemia (CLL) is the most frequent form of leukemia in Western countries. Despite its relative frequency, the association of glomerular disease is extremely rare. We present a case of membranous nephropathy (MN) during CLL treated with fludarabine.
View Article and Find Full Text PDFThe collection of data about renal biopsies is an important starting point for clinical and epidemiological studies about kidney disease. The aim of this study was the evaluation of the frequency of the different kidney diseases, their clinical presentation and the demographic features of the population based on renal biopsies performed at our center during the years 2000-2008. Clinical presentations were defined as nephrotic syndrome (NS), urinary abnormalities, macroscopic hematuria, acute renal failure (ARF) and chronic renal failure (CRF).
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