The 4G/4G-PAI-1 genotype might be a protective factor against ACI, whereas the factor V point mutation (1691G-A) and the factor VII Arg/Gln353 gene polymorphism have not proved to be risk factors for ACI.
A family history of cardiovascular disease predicts cardiovascular risk in the next generation, which is either the result of inherited traits or certain living habits in some families. The aim of our study was to evaluate both variables and particularly the role of one of the possible genetic risk factors--angiotensin-converting enzyme (ACE) gene polymorphism. History and anthropometric and biochemical parameters, ACE gene polymorphism and carotid wall thickness--intima media thickness (IMT) were studied in two groups of children: in children whose parents had a stroke before the age of 45 years and in children without a positive family history. The preliminary results of the present study failed to confirm our hypothesis that ACE gene polymorphism is a cardiovascular risk factor in children of parents with premature stroke.
The angiotensin-converting enzyme (ACE) is a rate-limiting enzyme in the renin angiotensin system, the enzyme is involved in the vascular remodelling and atherosclerosis. Its significance in pathogenesis of ischemic cerebrovascular insults (CVI) is not known. We analysed 124 Slovenian patients with CVI and compared them with 161 healthy controls for I/D polymorphism. Under a recessive model (chi2 = 1.76, p = 0.1, OR = 1.40, 95% CI: 0.85-2.34) we found no significant difference in I/D genotypes between patients with CVI and controls. This study shows that in a group of Slovenian CVI patients the DD genotype is not an important risk factor for the development of stroke.
Background and Aims
PRB is relatively contraindicated in patients with solitary kidney (SK) due to the perception that PRB is a risky procedure in this patient population. There are however situations in which a renal biopsy is essential to assess renal toxicity of systemic therapy and/or to identify the underlying kidney disease in the remaining kidney. Data on pathological findings of the kidney disease in mRCC patients receiving systemic anticancer therapy is scarce and it may influence the cancer treatment plan. The main aim of this study was to characterize the pathological findings of PRB in patients with SK undergoing systemic therapy.
Method
We retrospectively analyzed the pathological findings of mRCC patients with AKI who underwent PRB during systemic treatment with antiangiogenic tyrosine kinase inhibitors (TKIs) and/or immune check point inhibitors (ICIs) at the Institute of Oncology Ljubljana between 2018 and 2022. All biopsies were performed under ultrasound guidance by the treating nephrologist in patients with clinical evidence of AKI and no other formal contraindications for PRB.
Results
A total of 11 PRBs were performed in 10 patients, eight of whom had SK (Table 1). Six patients were treated with TKIs and ICIs, three with ICIs and one with a TKI alone. None of the patients had major bleeding or required any additional intervention as a consequence of the PRB. Histology revealed thrombotic microangiopathy (TMA) in three, diabetic nephropathy in three, acute interstitial nephritis in two and focal segmental glomerulosclerosis in three patients. Based on pathological findings, the therapy was discontinued after seven PRBs. One patient with TMA showed progressive loss of renal function (RF) after discontinuation of antiangiogenic therapy while the other two had either stable or improved RF.
Conclusion
Our results indicate that PRB is a safe procedure in patients with SK undergoing systemic treatment for mRCC. The pathological findings in our patients guided the decision either to continue or to discontinue the treatment, which resulted in improvement or stabilization of RF in the vast majority of patients. This study suggests that in patients with SK, PRB can provide important information, which may have a significant impact on the oncological and the nephrological therapeutic approaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.