Abstract:
BACKGROUND:Henoch-Schönlein Purpura (HSP) is a common childhood vasculitis with manifestations in numerous organ systems, including glomerulonephritis. Patients with more severe HSP-associated glomerulonephritis may develop chronic renal failure. Currently, no widely accepted treatment protocols exist for patients with significant renal involvement. METHODS:We retrospectively reviewed the clinical courses of 12 children (mean age 9 years) with HSP glomerulonephritis treated with high-dose corticosteroids plus oral cyclophosphamide. All patients had nephrotic-range proteinuria, and all had significant histopathologic changes on biopsy, including crescentic nephritis in 10 patients. Treatment consisted of either intravenous pulse methylprednisolone or oral prednisone followed by oral cyclophosphamide (2 mg/kg/day) for 12 weeks, along with either daily or alternate-day oral prednisone. Prednisone was tapered following completion of cyclophsophamide. RESULTS:Serum albumin rose significantly after treatment from 2.8 +/- (SD) 0.5 to 3.7 +/- 0.4 g/dl (p < 0.001), and there was a concurrent reduction in proteinuria, as reflected by decreasing serial protein-to-creatinine ratios: from 6.3 +/- 4.4 to 0.8 +/- 0.8 (p = 0.002). Renal function remained normal in all patients. Hypertension developed during treatment in 10 patients, all but 1 of whom were normotensive at last follow-up, 35 +/- 17 months following biopsy. CONCLUSIONS:We conclude that treatment of children with HSP nephritis with high-dose corticosteroids plus oral cyclophosphamide is safe and, as in nephrotic syndrome, appears to significantly reduce proteinuria which is a known risk factor for the development of renal insufficiency in HSP. Further studies with larger numbers of patients should be conducted to confirm this finding.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Flynn JT,Smoyer WE,Bunchman TE,Kershaw DB,Sedman ABdoi
10.1159/000046235subject
Has Abstractpub_date
2001-03-01 00:00:00pages
128-33issue
2eissn
0250-8095issn
1421-9670pii
46235journal_volume
21pub_type
临床试验,杂志文章abstract::A quantitative scoring method was designed to assess the extent of muscle damage. Technetium-99m pyrophosphate (99mTc-PYP) scintigraphy was performed for 9 patients experiencing crush injury in the Chichi (Taiwan) earthquake. The magnitude of muscle uptake of 99mTc-PYP was graded as follows: grade 0, less than bone ra...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046249
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Serum phosphorus concentrations reflect a dynamic balance between generation, exchanges, and removal. Time-averaged phosphorus concentrations (TAC(phos)) reflect the overall exposure better than single time-point concentrations, especially in dialysis patients treated with an intermittent modality. The prese...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000336308
更新日期:2012-01-01 00:00:00
abstract::Pasteurella multocida has been reported only once previously as a cause of peritonitis in a patient undergoing chronic peritoneal dialysis. The present report describes findings associated with a case of P. multocida peritonitis in a human immunodeficiency virus (HIV)-positive patient in which renal replacement therap...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168274
更新日期:1991-01-01 00:00:00
abstract::Two patients are reported who presented within the first 3 months posttransplantation with acute bone pain where serial magnetic resonance imaging (MRI) allowed differentiation between bone edema, which resolved spontaneously, and avascular necrosis (AVN) requiring core decompression. Case 1 had ill-defined images con...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013305
更新日期:1998-01-01 00:00:00
abstract::Bicarbonate dialysate is claimed to be superior to acetate for both chronic and acute hemodialysis. We compared acetate and bicarbonate dialysates in 30 acute renal failure patients during 120 dialyses. 4 patients were diabetic and 2 had liver failure. Patients were dialyzed alternating acetate and bicarbonate dialysa...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000166484
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND/AIMS:HFE protein controls iron absorption and cycling, and HFE mutations influence iron status. The aim was to evaluate the effect of the HFE genotype on the need for iron and erythropoietin in Italian hemodialysis patients. METHODS:Ninety-six prevalent patients were evaluated at the time of enrolment and p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111387
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000358496
更新日期:2014-01-01 00:00:00
abstract::The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the co...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168491
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND/AIMS:Intradialytic hypotension is the most common complication of modern day haemodialysis (HD). Convective modalities, including haemodiafiltration (HDF) are reported to result in greater cardiovascular stability compared to standard HD, which has been suggested to be due to improved solute transport betwee...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349925
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Patients with diabetic nephropathy are at high risk for further progressive renal function loss. Treatments that decrease albuminuria have been linked with renal and cardiovascular protection. However, even when taking optimal treatment, residual renal and cardiovascular risk remains high which correlates wi...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000225903
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The proinflammatory cytokine S100A12 (also known as EN-RAGE) is associated with cardiovascular morbidity and mortality in hemodialysis patients. In the current study, we tested the hypothesis that S100A12 expressed in vascular smooth muscle in nonatherosclerosis-prone C57BL/6J mice on normal rodent chow diet...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000324693
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Persons with chronic kidney disease (CKD) represent a population prone to cardiovascular disease (CVD) but vulnerable to adverse medication effects. We assessed the impact of intensive antihypertensive therapy on the cerebrovascular and other CVD outcomes in high-risk patients with type 2 diabetes and baseli...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000446122
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND AIM:Robust evidence about dialyzer reuse effects on mortality is not available. Our aim was to summarize the evidence for the effectiveness of dialyzer reuse compared to single use in patients with end-stage renal disease. METHODS:We searched MEDLINE, Embase, CINAHL, SciELO, LILACS, USRDS ADR, universit...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000336532
更新日期:2012-01-01 00:00:00
abstract::The influence of fluvastatin, a liver-selective, competitive inhibitor of the 3-hydroxymethyl-glutaryl-coenzyme A reductase, on the lipoprotein metabolism was investigated in 9 patients with nephrotic syndrome. All patients had biopsy-proven renal disease as cause of their nephrotic syndrome and exhibited severe hyper...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013504
更新日期:1999-01-01 00:00:00
abstract:AIMS:This study was conducted prospectively to ascertain the prevalence of anticardiolipin antibodies (ACAs) in patients with lupus nephritis and to determine whether this subgroup of patients differed clinically and histologically from patients without the antibody. PATIENTS AND METHODS:40 SLE patients (26 Blacks, 14...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013615
更新日期:2000-09-01 00:00:00
abstract::Recent studies have focused attention on the possible role of zinc depletion in the pathogenesis of uremic symptoms such as dysgeusia and impotence. The present studies were undertaken to evaluate the prevalence of zinc deficiency and abnormalities of zinc metabolism in patients with end-stage renal disease. A total o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167247
更新日期:1986-01-01 00:00:00
abstract::Five patients with the clinical patterns of Bartter's syndrome underwent a series of clearance studies in order to characterize the underlying tubule defect. Free water generation during maximal water diuresis (CH2O), expressed as percentage of the distal delivery (CH2O + CCl), was lower in the patients (72.5 +/- 3.2%...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168451
更新日期:1992-01-01 00:00:00
abstract::We have compared the renal effects of ioxitalamate, ioxaglate, and iopamidol in patients with chronic renal failure. Sixty consecutive patients with an estimated creatinine clearance (ECRCl) less than 60 ml/min were randomly assigned to receive either ioxitalamate, iopamidol, or ioxaglate. All patients received 500 cm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168328
更新日期:1991-01-01 00:00:00
abstract::In order to evaluate the changes in causes and outcome of acute renal failure (ARF) during the years 1975-1989, 710 patients treated in our dialysis center were analyzed. We compared the etiology, the severity and catabolic state of ARF, the techniques of renal replacement therapy, which were employed and the ages and...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168466
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Oxidative stress (OS) and asymmetric dimethylarginine (ADMA) are accepted as nonclassical cardiovascular risk factors in end-stage renal disease patients. To clarify the role of these factors in the atherosclerotic process, we investigated if OS and ADMA are associated with common carotid artery intima media...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000109397
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:It is uncertain whether kidneys from marginal donors are suitable for live kidney transplantation. In deceased donor kidneys, tubular cell senescence affects allograft function. However, the degree of cell senescence in a living donor kidney with marginal factors has not been reported. In this study, we asse...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000485845
更新日期:2018-01-01 00:00:00
abstract::We analyzed routine serum potassium concentration measurements and conditions temporally associated with abnormalities in potassium concentration in outpatients on chronic hemodialysis (136 nondiabetics, 36 diabetics) and continuous ambulatory peritoneal dialysis (16 nondiabetics, 10 diabetics). The following potassiu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167443
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Fatigue is an important symptom to patients with advanced chronic kidney disease (CKD). The aim of this study is to examine the prevalence and severity of fatigue among non-dialysis-dependent CKD and end-stage renal disease (ESRD) patients, to examine the association of fatigue with subjective and objective ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000356939
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) impairs intestinal barrier function which by allowing influx of noxious products causes systemic inflammation. We have recently shown that intestinal barrier dysfunction in CKD is due to degradation of epithelial tight junction (TJ) which is, in part, mediated by influx of urea a...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000351171
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Published reports examining the efficacy and safety of glucocorticoids for preserving renal function in immunoglobulin A nephropathy (IgAN) have yielded conflicting results. To systematically evaluate the efficacy and safety of glucocorticoids agents for IgAN, we conducted a meta-analysis of the published ra...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000226129
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The prognostic value of the anti-neutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis (GN) classification has been demonstrated in several cohorts with sclerotic class having the worst renal outcome. Relevant published data on factors predicting outcomes in sclerotic ANCA GN is limited. METH...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.1159/000494840
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Previous studies on end-of-life (EOL) care among patients with chronic kidney disease (CKD) have been largely limited to White hemodialysis patients. In this study, we sought to explore racial variability in EOL communication, care preferences and advance care planning (ACP) among patients with advanced CKD ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000447097
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Kidney failure is believed to have a negative impact on cognitive function, and cognitive impairment is common among maintenance hemodialysis (HD) patients. Previous studies have shown a beneficial effect of kidney transplantation in certain cognitive tests but not across all cognitive domains assessed. But,...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330849
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski's histological score o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000346257
更新日期:2013-01-01 00:00:00
abstract:UNLABELLED:Although it is anticipated that most patients with renal insufficiency will progress towards end-stage renal disease (ESRD) there have been few population-based studies to validate this assumption. We examined serial creatinines from 3,874 anonymous patients at an urban VA medical center who had a baseline c...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046280
更新日期:2001-09-01 00:00:00