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César Augusto Restrepo Valencia, Consuelo Vélez Álvarez Abstract Objective. To evaluate the effectiveness of calcineurin ciclosporin and tacrolimus inhibitors to induce remission in patients with refractory lupus nephritis. Patients, materials and methods. Patients with lupus nephritis class IV-G who despite receiving therapy with high doses of steroid and with a cytostatic (cyclophosphamide or mycophenolate) for 3 months had not been able to induce some kind of remission.The exclusion criteria were creatinine levels greater than 3 mg / dl, pregnancy, previous history of exposure to calcineurin inhibitors, cancer, active infections, uncontrolled hypertension, and negligence with medication intake. The recommended dose of cyclosporine was 3 mg / kg / day and tacrolimus 0.1 mg / kg / day, in joint with prednisone 0.3 mg / kg / day, cyclophosphamide 1 mg / kg / day or mycophenolate mofetil 1 gram every 12 hours. The cyclophosphamide was administered only during 6 months, after which it was changed to azathioprine at doses of 1 mg / kg / day. Still, mycophenolate was continued at the same dose. All patients completed a minimum period of 12 months follow-up, it was considered that patients achieved partial remission when proteinuria decreased by 50% of the baseline value or its value decreased to less than 1 gram in 24 hours, decrease of leukocytes count and red blood cells in urine of 50%, and creatinine values were stable. A complete remission was considered when there was a reduction in proteinuria in a value less than 300 mg per 24 hours, urinary sediment with less than 3 red blood cells, less than 5 leukocyte for each high power microscopic field, and a creatinine value reduction by 50% or reaching a normal value. Results. Twelve patients met the inclusion criteria and initiated the calcineurin inhibitor protocol. Two presented accelerated deterioration in their function and required chronic dialysis therapy. Ten patients with active treatment completed 12 months of follow-up, of which 4 (40%) had partial remission (PR), 5 (50%) complete remission (RC). One patient had no significant modification to his baseline values. The following findings were made for all the patients with any significant degree of remission: their creatinine levels were reduced significantly from an average value of 1,34 +/-0,7 mg/dl to an average of 0,96 +/- 0,3 mg/dl and 0,97 +/- 0,24 mg/dl for measurements taken 6 and 12 months respectively after the start of the treatment (p<0,05). The protein levels in the urine in a timeframe of 24 hours changed from a baseline value of 2865 +/- 2586.7 milligrams to 824 +/- 981.9 milligrams at 6 months, and 488 +/- 697.7 milligrams at 12 months (p <0.05). On average, in both PR and CR patients, the C3 levels raised unlike the values for antinuclear antibodies that were diminished. No patients died, nor were there significant side effects triggered by medications. No patient presented relapses during the follow-up time. Conclusion. The calcineurin inhibitors at low doses are an important alternative to induce partial or complete remission in patients with refractory lupus nephritis compared to classic steroid and cytostatic treatment. It is required to do a long-term follow-up to establish its safety profile at low doses and relapse rate after suspension. Keywords Lupus nephritis, cyclosporine, tacrolimus. References Cameron J S. Lupus Nephritis. J Am Soc Nephrol 10:413-424. Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR; European Working Party on Systemic Lupus Erythematosus. 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Tacrolimus- (FK 506) based immunosuppression in severe systemic lupus erythematosus. Clinical Nephrology 2004;62:49-53. Duddridge M, Powell RJ. Treatment of severe and difficult cases f systemic lupus erythematosus with tacrolimus. Areport of three cases. Ann Rheum Dis 1997;56:690-692. Uchino A, Tsukamoto H, Nakashima H, Yoshizawa S, Furugo I, Mitoma H, Oryoji K, Shimoda T, Niiro H, Tada Y, Yano T, Nonaka T, Oishi R, Akashi K, Horiuchi T. Safety and potential efficacy of tacrolimus for treatment of lupus nephritis with persistent proteinuria. Clinical Experimental Rheumatology 2010;28:6-12. Fei Y, Wu Q, Zhang W, Chen H, Hou Y, Xu D, Li M, Zhang X, Zhao Y, Zeng X, Zhang F. Low dose tacrolimus in treating lupus nephritis refractory to cyclophosphamide: a prospective cohort study. Clin Exp Rheumatol 2013;31:62-68. Gordon S, Denunzio T, Uy A. Success using tacrolimus in patients with proliferative and membranous lupus nephritis and refractory proteinuria. Hawaii J Med Public Health 2013;72:18-23. Wang S, Li X, Qu L, Wang R, Chen Y, Li Q, He X, Zhang X, Wang H, Wu J, Xu Y, Chen J. Tacrolimus versus cyclophosphamide as treatment for diffuse proliferative or membranous lupus nephritis: a non-randomized prospective cohort study. Lupus 2012;21:1025-1035. Deng J, Huo D, Wu Q, Yang Z, Liao Y. A meta-analysis of randomized controlled trials comparing tacrolimus with intravenous cyclophosphamide in the induction treatment for lupus nephritis. Tohoku J Exp Med 2012;227:281-288. Chen W, Liu Q, Chen W, Tang X, Fu P, Liu F, Liao Y, Yang Z, Zhang J, Chen J, Lou T, Fu J, Kong Y, Liu Z, Li Z, Yu X. Outcomes of maintenance therapy with tacrolimus versus azathioprine for active lupus nephritis: a multicenter randomized clinical trial. Lupus 2012;21:944-952. Full Text: PDF (Español (España)) PDF DOI: 10.22265/acnef.1.2.179 Refbacks There are currently no refbacks. Copyright (c) User Username Password Remember me This journal follows the principles and procedures given by the Committee on Publication Ethics (COPE) www.publicationethics.org Instructions for authors How to submit an article How to upload a modified version Instructions for reviewers How to review an article Instructions for associate editors How to send it to reviewers How to send corrections to authors Language Select Language Journal Content Search Search Scope Browse By Issue By Author By Title About The Authors César Augusto Restrepo Valencia Facultad de Ciencias para la Salud, Departamento de Medicina Interna, Universidad de Caldas, Manizales, Colombia Colombia Consuelo Vélez Álvarez Grupo de Investigación Promoción de la Salud y revención de la enfermedad, Facultad de Ciencias para la Salud, Departamento de Salud Pública Colombia Font Size Make font size smaller Make font size default Make font size larger Information For Readers For Authors For Librarians Indexaciones JournalTOCs Notifications View Subscribe Keywords Adolescence Biocompatible peritoneal dialysis solutions Chronic renal disease Glucose degradation products (GDP) Rejection chronic renal insufficiency education. fatty acids folic acid graft biopsy inflammation, Polivinil chloride (PVC), phthalates kidney Transplant peritoneal dialysis proteins. renal protection residual renal function. scintigraphy survival transition transplant. zinc
Autor: César Augusto Restrepo Valencia, Consuelo Vélez Álvarez
Publikováno v: Revista Colombiana de Nefrología, Vol 2, Iss 1, Pp 77-88 (2014)
Objective: To evaluate the effectiveness of calcineurin ciclosporin and tacrolimus inhibitors to induce remission in patients with refractory lupus nephritis. Patients, materials and methods: Patients with lupus nephritis class IV-G who despite recei
Externí odkaz: https://explore.openaire.eu/search/publication?articleId=doajarticles::0e5ed7fbac141766c09d3a26f76917b3
http://www.revistanefrologia.org/index.php/rcn/article/view/179/pdf
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Association of metabolic syndrome and chronic kidney disease.
Autor: Scurt FG; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany., Ganz MJ; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany., Herzog C; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany., Bose K; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany., Mertens PR; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany., Chatzikyrkou C; Department of Nephrology, Hannover Medical School, Hanover, Germany.
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DNA-Binding Protein A Is Actively Secreted in a Calcium-and Inflammasome-Dependent Manner and Negatively Influences Tubular Cell Survival.
Autor: Hoppstock G; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Lindquist JA; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Willems A; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Becker A; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Reichardt C; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Morgenroth R; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Stolze S; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Zhu C; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Brandt S; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany., Mertens PR; Clinic of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany.
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Game-Based Assessment of Peripheral Neuropathy Combining Sensor-Equipped Insoles, Video Games, and AI: Proof-of-Concept Study.
Autor: Ming A; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Clemens V; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Lorek E; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Wall J; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Alhajjar A; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Galazky I; University Clinic for Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Baum AK; University Clinic for Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Li Y; Pure-systems, Magdeburg, Germany., Li M; Affective Neuroscience Lab, Friedrich Schiller University Jena, Jena, Germany., Stober S; Artificial Intelligence Lab, Otto von Guericke University Magdeburg, Magdeburg, Germany., Mertens ND; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany., Mertens PR; University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Otto von Guericke University Magdeburg, Magdeburg, Germany.
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Interdisciplinary Management of Traumatic Injuries to the Kidneys and Urinary Tract Caused by Blunt Abdominopelvic Trauma.
Autor: Wendler JJ; University Clinic for Urology, Urooncology, Robot-Assisted and Focal Therapy, University Hospital Magdeburg A.ö.R., Medical Faculty of the Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.; Urology Practice, 39104 Magdeburg, Germany., Albert C; University Clinic for Cardiology and Angiology, University Hospital Magdeburg A.ö.R., Medical Faculty of the Otto-von-Guericke University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany.; Department of Nephrology, Central Clinic Bad Berka, Robert-Koch-Allee 9, 99438 Bad Berka, Germany., Cash H; University Clinic for Urology, Urooncology, Robot-Assisted and Focal Therapy, University Hospital Magdeburg A.ö.R., Medical Faculty of the Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.; Urology Practice, 10117 Berlin, Germany., Meyer F; University Clinic for General, Visceral, Vascular and Transplantation Surgery, University Hospital A.ö.R., Medical Faculty of Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany., Pech M; University Clinic for Radiology and Nuclear Medicine, University Hospital A.ö.R., Medical Faculty of Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany., Schostak M; University Clinic for Urology, Urooncology, Robot-Assisted and Focal Therapy, University Hospital Magdeburg A.ö.R., Medical Faculty of the Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany., Mertens PR; University Clinic for Nephrology and Hypertension, Diabetes and Endocrinology, University Hospital A.ö.R., Medical Faculty of Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany., Porsch M; University Clinic for Urology, Urooncology, Robot-Assisted and Focal Therapy, University Hospital Magdeburg A.ö.R., Medical Faculty of the Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.; Urology Practice, 39104 Magdeburg, Germany.
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8
Akademický článek
DNA-binding protein-A promotes kidney ischemia/reperfusion injury and participates in mitochondrial function.
Autor: Reichardt C; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Brandt S; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Bernhardt A; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Krause A; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Lindquist JA; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Weinert S; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Clinic of Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Geffers R; Genome Analytics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany., Franz T; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Molecular and Clinical Immunology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Kahlfuss S; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Molecular and Clinical Immunology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Dudeck A; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Molecular and Clinical Immunology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Mathew A; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Leipzig, Germany., Rana R; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Leipzig, Germany., Isermann B; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Leipzig, Germany., Mertens PR; Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Health Campus Immunology, Infectiology and Inflammation (GCI3), Otto-von-Guericke University Magdeburg, Magdeburg, Germany. Electronic address: peter.mertens@med.ovgu.de.
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Akademický článek
Predicting outcomes after transplantation of deceased donor kidneys of marginal quality within the Eurotransplant service area.
Autor: Scurt FG, Fischer-Fröhlich CL, Ernst A, Mertens PR, Becker JU, Chatzikyrkou C
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10
Akademický článek
Sex hormone binding globulin (SHBG) serum levels and insulin resistance in men on chronic hemodialysis.
Autor: Nikolaou E; Department of Nephrology, University of Thessaly School of Medicine, Mezourlo Hill, Larissa, 41110, Greece., Tziastoudi M; Department of Nephrology, University of Thessaly School of Medicine, Mezourlo Hill, Larissa, 41110, Greece., Gougoura SG; Department of Endocrinology, University of Thessaly School of Medicine, Larissa, Greece., Filippidis G; Department of Nephrology, University of Thessaly School of Medicine, Mezourlo Hill, Larissa, 41110, Greece., Dousdampanis P; Department of Nephrology, Saint Andrews State General Hospital, Patras, 26221, Greece., Bargiota A; Department of Endocrinology, University of Thessaly School of Medicine, Larissa, Greece., Mertens PR; Department of Nephrology, Hypertension, Diabetes and Endocrinology, School of Medicine, University of Magdeburg, Magdeburg, Germany., Eleftheriadis T; Department of Nephrology, University of Thessaly School of Medicine, Mezourlo Hill, Larissa, 41110, Greece., Hadjigeorgiou GM; Department of Neurology, Medical School, University of Cyprus, Nicosia, 2408, Cyprus., Koukoulis GN; Department of Endocrinology, University of Thessaly School of Medicine, Larissa, Greece., Stefanidis I; Department of Nephrology, University of Thessaly School of Medicine, Mezourlo Hill, Larissa, 41110, Greece. stefanid@med.uth.gr.
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