Conclusions: In patients with MGN with long-term CNI dependence, rituximab can be an effective tool to overcome dependence on CNI, thus avoiding the risk of nephrotoxicity related to the chronic exposure to these drugs.
Renal artery embolism (RAE) is an underdiagnosed condition leading to acute renal failure in patients with a single functioning kidney. We prospectively studied 41 patients according to a previously validated algorithm based on Lactate Dehydrogenase (LDH) determination, which enables us to identify RAE patients and allocate them to a different protocolled treatment. The most frequent symptom was atypical low back pain. Atrial fibrillation was present in 65.8% of patients. The most frequent site of the embolism was the main renal artery of a single kidney. Surgery was performed in 13 patients, fibrinolytic treatment in 17 and anticoagulation in 11. Mean LDH levels were 1690 ± 1108 U/L. Oliguria was present in 15 patients. Hemodialysis requirements were not different between patients with main RAE or intrarenal embolism, or according to treatment group. Conclusions: Our results indicate that the use of a diagnostic algorithm based on LDH values is useful for identifying RAE patients. Further randomized trials are needed to compare results on treatment.
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