Therapy with 20 mg/day esomeprazole appears to be efficacious for improving disease-specific QOL and GERD symptoms in Japanese patients on maintenance hemodialysis.
A 62-year-old female dialysis patient with chronic glomerulonephritis had been receiving hemodialysis therapy for 32 years. In 1985 she underwent a parathyroidectomy for secondary hyperparathyroidism (HPT); however, her parathyroid hormone (PTH) levels gradually increased. Her serum calcium level ranged from 9.0 to 10.0 mg/dL, which caused difficulties in performing vitamin D injection therapy. No parathyroid glands were seen by echography or scintigraphy. On 31 March 2008 her intact PTH (iPTH) level was 895 pg/mL so treatment with cinacalcet 25 mg/day was started. After 3 months her iPTH level decreased to 269 pg/mL and her hemoglobin level increased from 9.3 to 12.9 g/dL. In some cases of severe HPT, anemia improves after parathyroidectomy; however, in this case, cinacalcet improved not only secondary HPT but also anemia.
We herein report a 75-year-old man with non-small-cell lung cancer who developed tubulointerstitial nephritis due to pembrolizumab administration. He was successfully treated with atezolizumab following steroid administration. He was initially diagnosed with lung adenocarcinoma (T1bN3M1b, stage IV), with a programmed cell death-ligand 1 tumor proportion score of 25-49%. Although the tumor responded well to pembrolizumab, the drug was discontinued because of the diagnosis of tubulointerstitial nephritis on a renal biopsy. Tubulointerstitial nephritis was treated with 30 mg prednisolone, the dose of which was tapered to and maintained at 5 mg. Following lung cancer progression, atezolizumab was administered, and the tumor responded again. Its efficacy has been sustained for >15 months without recurrence of tubulointerstitial nephritis.
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