Clinical and experimental nephrology
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Clin. Exp. Nephrol. · Feb 2009
Case ReportsFocal segmental glomerulosclerosis complicating solitary kidney.
A 78-year old woman with complicating solitary kidney had nephrotic syndrome. Renal biopsy specimens showed focal segmental glomerulosclerosis (FSGS). ⋯ Additional treatment with prednisolone and cyclosporine reduced proteinuria to less than 1.0 g/day. We report that combination therapy with ARB, ACEI, prednisolone, and cyclosporine was successful for FSGS complicating solitary kidney.
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Clin. Exp. Nephrol. · Feb 2009
Validation of Liano score in acute renal failure: a prospective study in Indian patients.
To validate Liano score as a prognostic scoring system in acute renal failure (ARF): a prospective study in Indian patients. ⋯ In this study there were 68 males and 32 females. Peak incidence by age was in the fifth decade. There was no increased mortality in any age group (p = 0.278). A total of 19 patients had pre-renal ARF, 74 patients had intrinsic ARF, of which 46 were acute tubular necrosis (ATN); 7 patients had obstructive ARF. A total of 21 patients had Liano score greater than 0.9, of which 18 patients died and 3 were discharged against medical advice in a critical condition (and died later at home). Calculated sensitivity was 62.1%, specificity was 100% and positive predictive value was 100%. Sensitivity and specificity when calculated separately for intrinsic renal ARF (after excluding post renal ARF) were 60.7% and 100%, respectively. There was statistically significant correlation between Liano score and mortality (p < 0.001).
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Clin. Exp. Nephrol. · Jun 2008
Case ReportsSuccessful treatment of mucormycosis in a renal allograft recipient.
Mucormycosis is a rare but potentially lethal fungal infection in renal allograft recipients with rhinocerebral mucormycosis is the most common presentation. The usual infection route is inhalation of the spores, but certain procedures such as intravenous cannulation and bladder catheterization are often the cause of infection. ⋯ Mucormycosis in a renal allograft recipient is an extremely rare and potentially lethal complication. Aggressive anti-rejection therapy is a risk factor for the development of this unfavourable outcome. Early diagnosis, aggressive treatment with amphoteracin B and careful monitoring can be helpful in treating these patients and achieve favourable prognosis.
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Clin. Exp. Nephrol. · Sep 2007
Case ReportsEmphysematous cystitis complication in a patient undergoing hemodialysis.
Emphysematous cystitis is a rare condition characterized by air formation in and around the bladder wall by gas-forming organisms. Although diabetes mellitus and chronic urinary infection, which are frequently encountered in patients with endstage renal disease (ESRD), are predisposing factors for this entity, emphysematous cystitis is actually not common in ESRD patients. ⋯ The possible reason that this case is of a less common type that is more refractory than the other cases, and the method by which patients with ESRD are commonly treated, are discussed. Not anuric but rather oliguric diabetic patients, even after long-term hemodialysis, are the patients at risk for emphysematous cystitis.
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Clin. Exp. Nephrol. · Jun 2007
Randomized Controlled TrialProspective randomized study of azathioprine vs cyclosporine based therapy in primary haplo-identical living-donor kidney transplantation: 20-year experience.
The achievements in short-term graft survival since the introduction of cyclosporine (CsA) have not been matched by improvements in long-term graft function. Chronic allograft nephropathy (CAN) remains the second most common cause of graft attrition over time, after patient mortality. We aimed to evaluate the long-term results of azathioprine vs CsA in live-donor kidney transplantation in a prospective randomized study. ⋯ From this study we can conclude that the long-term result of historical conventional therapy (steroid/Aza) without induction therapy is effective for living-donor kidney transplants. In spite of the comparable graft function for the two groups, the steroid/CsA group experienced more hypertension, as well as many adverse reactions to CsA. Nowadays, since the introduction of induction therapy and the utilization of newer maintenance immunosuppressive agents - such as mycophenolate mofetil (MMF) and rapamycin - it is possible to achieve an excellent calcineurin inhibitors (CNI)-free regimen.