Linked Life Data

15772921

Source:http://linkedlifedata.com/resource/pubmed/id/15772921

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2005-3-17
pubmed:abstractText
Small vessel vasculitides, usually associated with positive antineutrophil cytoplasmic antibodies (ANCA(+)) can cause pulmonary-renal syndrome (PRS). Data from 22 patients, (19 males), aged 28-76 yrs (mean 55), with PRS were analyzed retrospectively. Renal function was estimated at presentation, 1 month after treatment initiation and at the end of follow-up (mean 4.4 +/- 3.3 yrs). Thirteen out of 22 patients had PR3 (+) ANCA and 9/22 patients had MPO (+) ANCA. Mean serum creatinine (Cr) at diagnosis was 6.6 +/- 4.4 mg/dL (M +/- SD) and proteinuria 1.6 +/- 1.4 g/24 hr (M +/- SD). During the 1st month of treatment with corticosteroids and cyclophosphamide, renal function improved in 12 patients (54.5%) (serum Cr from 8.5 +/- 4.5 to 4.3 +/- 2.3 mg/dL, p=0.001) remaining stable thereafter, and renal function deteriorated in nine patients (41%) (serum Cr from 4.1 +/- 3 to 6.5 +/- 2.9 mg/dL, p=0.03); one patient (4.5%) died because of sepsis. At the end of the study, 11/22 patients (50%) had died, eight patients of these (73%) because of respiratory failure, three patients (13.6%) reached end-stage renal disease (ESRD), five patients (36.4%) remained stable, but with impaired renal function and finally three patients (13.6%) improved, achieving almost normal renal function. In multiple regression analysis, factors contributing to final serum Cr were: dialysis dependency at the time of diagnosis p=0.01, initial proteinuria p<0.0001, and percentage of cellular crescents p=0.003. Main differences between PR3 and MPO (+) patients were the chest CT findings (bilateral nodules in PR3 (+) and "ground glass" or fibrosis in MPO (+) patients) and the renal function improvement rate after treatment initiation (rapid decline in serum Cr in PR3 (+) patients). In conclusion, PRS with ANCA (+) is associated with increased mortality. If renal function improves during the 1st month of treatment, it usually remains stable thereafter. The presence of PR3-ANCA is associated with an early response to treatment, while MPO-ANCA vasculits seems to necessitate prolonged treatment.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1121-8428
pubmed:author
pubmed:issnType
Print
pubmed:volume
18
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
35-44
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:15772921-Adrenal Cortex Hormones, pubmed-meshheading:15772921-Adult, pubmed-meshheading:15772921-Aged, pubmed-meshheading:15772921-Antibodies, Antineutrophil Cytoplasmic, pubmed-meshheading:15772921-Cyclophosphamide, pubmed-meshheading:15772921-Female, pubmed-meshheading:15772921-Humans, pubmed-meshheading:15772921-Immunosuppressive Agents, pubmed-meshheading:15772921-Kidney, pubmed-meshheading:15772921-Kidney Diseases, pubmed-meshheading:15772921-Lung Diseases, pubmed-meshheading:15772921-Male, pubmed-meshheading:15772921-Middle Aged, pubmed-meshheading:15772921-Myeloblastin, pubmed-meshheading:15772921-Peroxidase, pubmed-meshheading:15772921-Radiography, Thoracic, pubmed-meshheading:15772921-Retrospective Studies, pubmed-meshheading:15772921-Serine Endopeptidases, pubmed-meshheading:15772921-Survival Analysis, pubmed-meshheading:15772921-Syndrome, pubmed-meshheading:15772921-Tomography, X-Ray Computed, pubmed-meshheading:15772921-Treatment Outcome, pubmed-meshheading:15772921-Vasculitis
pubmed:articleTitle
Factors influencing patient survival and renal function outcome in pulmonary-renal syndrome associated with ANCA (+) vasculitis: a single-center experience.
pubmed:affiliation
Nephrology Department, Aristotelion University of Thessaloniki, Thessaloniki-Greece. mstangou@math.com
pubmed:publicationType
Journal Article