Abstract:
INTRODUCTION:The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis with renal involvement are associated with high morbi-mortality. In this study we analyse if the prognosis of these diseases have improved in recent years, and which factors influence the outcomes. MATERIAL AND METHODS:Retrospective single-centre observational study, which included all patients diagnosed with microscopic polyangiitis and granulomatosis with polyangiitis with renal involvement in the last 25 years. Demographic, clinical and biochemical parameters of prognostic interest were recorded. The differences between four chronological periods were analysed, along with the determinants of a poor outcome (death or end-stage renal disease). RESULTS:Eighty-nine patients were included (mean age 64±15 years). Sixty-four patients (72%) had microscopic polyangiitis and 25 (28%) granulomatosis with polyangiitis. During the study period, 37 (42%) patients died. Through Cox regression analysis, the best determinants of mortality were the initial glomerular filtration rate (HR 0.911; P=.003), Charlson comorbidity index (HR 1.513; P<.0001) and tobacco smoking (HR 1.816; P=.003). 35% developed end-stage renal disease, and the best determinants (by competing-risk regression) were: initial glomerular filtration rate (sub-hazard ratio [SHR]: 0.791; P<.0001), proteinuria (SHR: 1.313; P<.0001), and smoking status (SHR: 1.848; P=.023). No differences were found in patients' mortality or renal survival between the different study periods. CONCLUSIONS:Prognosis of anti-neutrophil cytoplasm antibodies vasculitis with renal involvement treated with conventional immunosuppressive therapy remains unsatisfactory, and continues to have increased long-term complications and mortality.
journal_name
Med Clin (Barc)journal_title
Medicina clinicaauthors
Caravaca-Fontán F,Yerovi E,Delgado-Yagu E M,Galeano C,Pampa-Saico S,Tenorio MT,Liaño Fdoi
10.1016/j.medcli.2016.09.015subject
Has Abstractpub_date
2017-01-06 00:00:00pages
1-7issue
1eissn
0025-7753issn
1578-8989pii
S0025-7753(16)30424-9journal_volume
148pub_type
杂志文章相关文献
MEDICINA CLINICA文献大全abstract:BACKGROUND AND OBJECTIVE:Our objective was to assess the activity of thiopurine methyltransferase (TPMT) in a very large number of Spanish patients with inflammatory bowel disease (IBD), to evaluate the influence of several variables (including azathioprine or 6-mercaptopurine) on that activity, and to know the proport...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1157/13078420
更新日期:2005-09-10 00:00:00
abstract:BACKGROUND:Delirium is an organic mental disorder frequently seen in elderly patients admitted to hospital for medical or surgical diseases. The prevalence, triggering factors, the relationship with prior existence of dementia and the evolution of delirium were studied. METHODS:One hundred eight elderly patients admit...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1995-03-11 00:00:00
abstract::Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised c...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2017.11.042
更新日期:2018-09-14 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Dengue is the most common imported arbovirus infection in Europe. International travel and an increasing incidence of dengue fever in tropical areas have defined the disease as an emerging infection in returning travellers. We describe the clinical and microbiological features of imported dengu...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1157/13123037
更新日期:2008-06-07 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Pulmonary arterial hypertension associated with systemic lupus erythematosus (PAH-SLE) is a rare disease with a low incidence rate. In this study, PAH related genes and genetic modifiers were characterised molecularly in patients with PAH-SLE. PATIENTS AND METHODS:Three patients diagnosed with...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/j.medcli.2018.01.023
更新日期:2018-08-10 00:00:00
abstract:OBJECTIVE:Fibromyalgia (FM) is a chronic pain syndrome of unknown etiology, which affects predominantly women. Among the alterations that have been implicated in the pathophysiology of FM, there have been postulated disturbances in serotonin levels and metabolism, and their implication in symptoms. The aim of the prese...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/j.medcli.2010.05.009
更新日期:2010-11-13 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Several models for the prediction of liver fibrosis have been developed which consist of the measurement of routine laboratory data: a) a model combining platelets, gamma-glutamil-transpeptidase, cholesterol and age (Forns model), and b) a model using an aspartate-aminotransferase to platelet r...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1157/13075845
更新日期:2005-05-28 00:00:00
abstract::The REACH registry allows the degree of control of risk factors associated with atherothrombosis to be evaluated. Although 90% were taking at least one antihypertensive agent, hypertension was controlled in only 42.9% of the patients with vascular disease. This inadequate control may have multiple causes but the main ...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/S0025-7753(09)71754-3
更新日期:2009-09-01 00:00:00
abstract::Hemolytic disease by cold-reacting antibodies is a rare form of hemolytic anemia. In most cases a subjacent cause is found. This disease is generally related with reactive lymphoproliferative processes (infections by the Epstein-Barr virus and cytomegalovirus) or uncontrolled lymphoproliferative disorders (lymphomas, ...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1992-04-04 00:00:00
abstract:BACKGROUND:The most appropriate methods for surveillance of nosocomial infection (NI) in hospitals with less than 250 beds remain to be elucidated. The aims of this study were to investigate the differences between the results found in a study in incidence (IS) and in another concerning prevalence (PS) carried out in a...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1993-01-16 00:00:00
abstract:BACKGROUND:Primary pulmonary hypertension is a poorly understood disease with a difficult treatment. PATIENTS AND METHOD:Retrospective study of a series of 44 patients suffering from pulmonary hypertension who were studied in our center between 1992 and 2000. RESULTS:At diagnosis, 6 (13%) patients were classified as ...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/s0025-7753(02)72524-4
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To establish the seroprevalence of infection by Borrelia burgdorferi in Navarre (Spain). PATIENTS AND METHOD:Serum samples of 1,429 individuals considered representative of the population of Navarre were analyzed. The individuals were recruited from a list issued by the government of Navarre. ...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/j.medcli.2010.06.008
更新日期:2011-03-26 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To analyze the serum levels of immunoglobulin G (IgG) subclasses in a broad range of elderly patients with bronchiectasis. PATIENTS AND METHOD:Data were collected from all patients who had a high-resolution chest computerized axial tomography diagnosis of bronchiectasis in our center. We gathe...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1157/13111419
更新日期:2007-10-20 00:00:00
abstract::Negative-pressure wound therapy (NPWT) is used to promote wound healing by using suction to drain excess fluid from wounds. A systematic literature review was undertaken to assess the effectiveness, safety and cost-effectiveness of NPWT for the treatment of chronic wounds. Medline, Embase, CENTRAL, CINAHL and the Coch...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2010.06.010
更新日期:2011-09-17 00:00:00
abstract::The case of a 74-year-old woman with a carotid-cavernous fistula is reported. She was admitted to hospital with oliguria and generalized edema. After improvement of the edematous condition she suddenly presented intense, pulsatile, frontal cephalea. It was more intense on the right side and was accompanied by nausea a...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1979-03-25 00:00:00
abstract::Pulmonary thromboembolism (PE) is a common cause of morbidity and mortality in patients with cancer. Having cancer is an independent risk factor for death in the general series of patients with PE and is included as a variable in the prognostic scales of acute symptomatic PE. This fact limits the discriminatory power ...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/S0025-7753(15)30016-6
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:The albumin-cytologic dissociation in cerebrospinal fluid (CSF) supports the diagnosis of Guillain-Barre syndrome (GBS) but does not support the prognosis, so the aim of this study is to determine the usefulness of protein numbers in the CSF to predict progression in paediatric patients. PAT...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/j.medcli.2017.06.063
更新日期:2018-05-11 00:00:00
abstract::Most patients with type 2 diabetes have excess adiposity. There is wide consensus that adequate treatment of type 2 diabetes requires a simultaneous approach to overweight/obesity and the remaining cardiovascular risk factors. Non-pharmacological interventions (diet, exercise) represent the cornerstone of the treatmen...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/S0025-7753(17)30620-6
更新日期:2016-11-01 00:00:00
abstract::A case of rapidly progressive glomerular disease with 100% of epithelial crescents completely enveloping each glomerulus, prolonged anuria and renal failure requiring dialysis. There were no indications of either streptococcal etiology or systemic disease. Improvement in renal function in response to plasmapheresis an...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1981-06-10 00:00:00
abstract::The term cryptogenic stroke refers to a stroke for which there is no specific attributable cause after a comprehensive evaluation. However, there are differences between the diagnostic criteria of etiological classifications used in clinical practice. An improvement in diagnostic tools such advances in monitoring for ...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2018.01.024
更新日期:2018-08-10 00:00:00
abstract::The follow-up of the Mediterranean Diet (MD) has been associated with lower mortality and morbidity from cardiovascular diseases. However, it is important to evaluate the scientific evidence provided by published articles. Therefore, in order to analyze the literature on the overall effects of MD on intermediate and f...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2009.01.033
更新日期:2010-01-23 00:00:00
abstract:BACKGROUND AND OBJECTIVE:More information is needed on hypertension control in clinical practice, which includes taking at least two blood pressure (BP) readings and taking into account surgery times and previous antihypertensive drug intake. Our study aimed to assess the optimum degree of BP control in a broad sample ...
journal_title:Medicina clinica
pub_type: 杂志文章,多中心研究
doi:10.1016/s0025-7753(04)74183-4
更新日期:2004-02-14 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the familial aggregation of lipid levels in schoolchildren of Cuenca city, Spain. SUBJECTS AND METHODS:A cross sectional study was made including 307 both sexes schoolchildren 9-12 years old recruited in three schools of Cuenca city, and 346 of their parents. Sociodemogra...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1997-10-04 00:00:00
abstract::The most widespread types of oxygen delivery at home in our area are bottles where the gas is stored under pressure and concentrators. Both devices can only be used at rest. We have assessed a new system for the delivery of liquid oxygen to be used at home, provided with a portable unit which permits that the patients...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1990-11-10 00:00:00
abstract::Atherosclerotic renovascular disease is a common entity, particularly in persons older than 50 years of age and especially in those patients with other evidence of atherosclerotic vascular disease. The illness clearly progresses in some patients, and progression rate appears to be highly variable. Taken into account t...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1997-04-12 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Alcohol and its metabolites play an important role in carcinogenesis. This effect could be modulated by polymorphisms in genes encoding enzymes involved in the metabolism of alcohol and folate. Therefore, we analyzed the effect of alcohol consumption and ADH1B Arg48His, ADH1B Arg370Cys, ADH1C I...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:10.1016/j.medcli.2016.12.033
更新日期:2017-06-21 00:00:00
abstract::Non-alcoholic fatty liver disease (NAFLD) consists of an excessive depositing of fat in the liver, which can end up by causing inflammation, fibrosis and also cirrhosis with the corresponding complications including liver cancer. NAFLD has become the most common liver disease worldwide. The incidence has increased in ...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2017.06.026
更新日期:2017-12-20 00:00:00
abstract::Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a prevalent disease in the general population, associated with an increase in the cardiovascular morbimortality. A basic and/or standardized otolaryngologic exploration could help us to detect the structural abnormalities that alter the upper airway collapsibility a...
journal_title:Medicina clinica
pub_type: 杂志文章,评审
doi:10.1016/j.medcli.2013.04.035
更新日期:2014-04-07 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the value of the Toxoplasma gondii culture in blood and in other organic fluids in HIV positive and negative patients. METHODS:Retrospective analysis (October 1990-May 1992) was carried out including all patients with positive cultures for T. gondii admitted to the Hos...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the risk of active tuberculosis in intravenous drug addict (IVDA) patients seropositive and seronegative for the HIV. METHODS:A retrospective study of a cohort of IVDA males in 2 drug addict detoxication communities was carried out. Patients with tuberculosis, under tr...
journal_title:Medicina clinica
pub_type: 杂志文章
doi:
更新日期:1993-05-15 00:00:00