AI Article Synopsis
- IgA nephropathy (IgAN) shows a wide range of clinical outcomes, with baseline proteinuria being a key risk factor for progression; however, time-average proteinuria (TAp) during follow-up is identified as a stronger indicator of kidney health and treatment response.
- *In a study analyzing 325 IgAN patients from 1989 to 2005, findings reveal that lower TAp correlates with improved renal survival, with a notable 16.6% experiencing significant kidney function decline.
- *Key factors influencing lower TAp and better kidney outcomes include female gender, use of corticosteroids, lower initial protein levels, and blood pressure management, suggesting that a 6-month corticosteroid treatment is effective at improving kidney function
Article Abstract
The clinical course of IgA nephropathy (IgAN) and its outcome are extremely variable. Proteinuria at baseline has been considered one of the most important risk factors. More recently, mean proteinuria of follow-up (time-average proteinuria: TAp) was described as a stronger marker of renal survival, suggesting to consider it as a marker of disease activity and response to treatment. We evaluated predictors of renal survival in IgAN patients with different degrees of renal dysfunction and histological lesions, focusing on the role of the therapy in influencing TAp. We performed a retrospective analysis of three prospective, randomized, clinical trials enrolling 325 IgAN patients from 1989 to 2005. Patients were divided into 5 categories according to TAp. The primary endpoint of the 100% increase of serum creatinine occurred in 54 patients (16.6%) and renal survival was much better in groups having lower TAp. The median follow up was 66.6 months (range 12 to 144). The primary endpoint of the 100% increase of serum creatinine occurred in 54 patients (16,6%) and renal survival was much better in groups having lower TA proteinuria. At univariate analysis plasma creatinine and 24h proteinuria, systolic (SBP) and diastolic (DBP) blood pressure during follow-up and treatment with either steroid (CS) or steroid plus azathioprine (CS+A) were the main factors associated with lower TAp and renal survival. At multivariate analysis, female gender, treatment with S or S+A, lower baseline proteinuria and SBP during follow-up remained as the only variables independently influencing TAp. In conclusion, TA-proteinuria is confirmed as one of the best outcome indicators, also in patients with a severe renal insufficiency. A 6-month course of corticosteroids seems the most effective therapy to reduce TAp.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945016 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158584 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
MELANOMAS, SARCOMAS, AND RENAL METASTASES IN THE LIVER: HOW TO TREAT?
Arq Bras Cir Dig
January 2025
D'Or Institute for Research and Education, Digestive Surgery Residency Program - Rio de Janeiro (RJ), Brazil.
Liver metastases from melanomas, sarcomas, and renal tumors are less frequent. Treatment and prognosis will depend on whether they are isolated or multiple, size and location, the presence or absence of extrahepatic neoplastic disease, age, stage of the initial disease, initial treatments instituted, time of evolution, and clinical condition of the patient. Recently, a high number of oncological therapies including monotherapy or in combination, neoadjuvants or adjuvants, and immuno-oncological treatments have been developed and tested, increasing disease-free time and survival.
View Article and Find Full Text PDF[Analysis of the performance of dialysis centers in referring and enrolling patients into the pre-kidney transplant waiting list in Minas Gerais State, Brazil, 2015 to 2019].
Cad Saude Publica
January 2025
Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brasil.
Despite the relevance of kidney transplantation, the supply of organs and the process for inclusion in its waiting list still represent obstacles. This study aimed to analyze the performance of dialysis centers in referring patients for pre-kidney transplant evaluation and inclusion in the waiting list of incident dialysis patients from 2015 to 2019 in the state of Minas Gerais, Brazil. This retrospective cohort study sampled 23,297 records of patients who underwent dialysis therapy in public or philanthropic institutions or who had their treatment funded by the Brazilian Unified National Health System in private clinics.
View Article and Find Full Text PDFPhase I Clinical Trial of High Doses of Seleno-L-methionine in Combination with Axitinib in Patients with Previously Treated Metastatic Clear Cell Renal Cell Carcinoma.
Clin Cancer Res
January 2025
Roswell Park Cancer Institute, Buffalo, NY, United States.
Background: Data in clear cell renal cell carcinoma (ccRCC) xenografts defined the seleno-L-methionine (SLM) dose and the plasma selenium concentrations associated with the enhancement of HIF1α/2α degradation, stabilization of tumor vasculature, enhanced drug delivery, and efficacy of axitinib. The data provided the rationale for the development of this phase I clinical trial of SLM and axitinib in advanced or metastatic relapsed ccRCC.
Patients And Methods: Patients were ≥18 years with histologically and radiologically confirmed advanced or metastatic ccRCC who had received at least one prior systemic therapy, which could include axitinib (last dose ≥6 months prior to enrollment).
Favourable Living Donor Kidney Transplantation Outcomes within a National Kidney Exchange Program: A Propensity Score Matching Analysis.
Clin J Am Soc Nephrol
January 2025
Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Background: KEPs (kidney exchange programs) facilitate living donor kidney transplantations (LDKT) for patients with incompatible donors, who are typically higher risk than non-KEP patients because of higher sensitization and longer dialysis vintage. We conducted a comparative analysis of graft outcomes and risk factors for both KEP and non-KEP living donor kidney transplants.
Methods: All LDKTs performed in the Netherlands between 2004-2021 were included.
Impact of impaired renal function on kinetics of high-sensitive cardiac troponin following cardiac surgery.
Clin Res Cardiol
January 2025
Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany.
Background: Impaired renal function can increase cardiac troponin levels due to reduced elimination, potentially affecting its diagnostic utility. Limited data exist on high-sensitivity cardiac troponin I (hs-cTnI) kinetics after cardiac surgery relative to renal function. This study evaluates how impaired renal function influences hs-cTnI kinetics following cardiac surgery, distinguishing between patients with and without postoperative myocardial infarction (PMI).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!