Acute Kidney Injury in Adult Idiopathic Nephrotic Syndrome

Chen, Tianxin; Lv, Yingqiu; Lin, Fan; Zhu, Jun

doi:10.3109/0886022x.2011.553301

Cited by 27 publications

(28 citation statements)

References 27 publications

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“…14 , 15 Risk factors for ARF include severe hypoalbuminemia, older age (in adults), and infection (in children). 16 The incidence of ARF in this study was 1.22%, which is consonant with the rates of 0.8% to 5% noted in previous reports. 17 Another very rare complication, acute hypertensive encephalopathy, is a transient neurologic dysfunction induced by marked increases in blood pressure during a moderate to severe nephrotic state.…”

Section: Discussionsupporting

confidence: 92%

Epidemiology and Predictors of End-stage Renal Disease in Taiwanese Children With Idiopathic Nephrotic Syndrome

Chang

Tsai

Yang

et al. 2012

Journal of Epidemiology

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BackgroundThe incidence of idiopathic nephrotic syndrome (INS) varies among countries, with Asia reporting a higher incidence in comparison with Western countries. We investigated the epidemiologic features of INS and attempted to identify factors that predispose individuals to develop end-stage renal disease (ESRD).MethodsClaims data from the Taiwanese National Health Insurance program from 1996 to 2008 were used to investigate the epidemiologic features and clinical variables of INS (International Classification of Diseases, Ninth Revision, Clinical Modification code, 581) in children younger than 18 years.ResultsWe enrolled 4083 children (male-female ratio, 1.91:1). During the 13 years of observation, annual incidence decreased from 9.91 to 3.36 per 100 000 children. Annual number of hospital admissions progressively decreased during the first 3 years after diagnosis. At 3.14 ± 2.77 years after INS onset, ESRD had developed in 145 (3.6%) children. Independent predictors of ESRD included older age at onset, acute renal failure (ARF), hypertensive encephalopathy, and a histologic subtype with focal segmental glomerulosclerosis (FSGS).ConclusionsPediatric INS in Taiwan was more frequent in boys. Unlike India, the current incidence of pediatric INS in Taiwan is very similar to that reported in Western studies. Older age at disease onset, ARF, hypertensive encephalopathy, and FSGS on biopsy are important predictors of poor renal outcome.

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Section: Discussionsupporting

confidence: 92%

Epidemiology and Predictors of End-stage Renal Disease in Taiwanese Children With Idiopathic Nephrotic Syndrome

Chang

Tsai

Yang

et al. 2012

Journal of Epidemiology

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“…A recent retrospective study (1) showed that AKI, defined according to the newly developed RIFLE international consensus classification criteria (4), was observed in 95 of 277 adult idiopathic NS cases, consistent with the observations of previous studies. Immunotherapy takes some weeks to reduce proteinuria and increase the glomerular filtration rate (GFR), thereby alleviating fluid excess and hypoxia.…”

Section: Discussionsupporting

confidence: 85%

Successful Treatment of Acute Kidney Injury in Patients with Idiopathic Nephrotic Syndrome Using Human Atrial Natriuretic Peptide

et al. 2014

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The acute onset of idiopathic nephrotic syndrome (NS) is often accompanied by acute kidney injury, which can lead to congestive heart failure and lung edema. In this report, we present two cases of NS-induced acute kidney injury successfully treated with a low dose of carperitide, a human atrial natriuretic peptide. In combination with standard diuretic therapy and immunotherapy, carperitide retained the renal function and spared the need for renal replacement therapy, including hemodialysis. Although further investigation in clinical trials is required to validate these findings, carperitide may be useful for maintaining the renal function in cases of NS-induced acute kidney injury.

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“…In previous studies, Waldman et al [5] and Chen et al [6] showed that MCD patients with AKI were more likely to be older and have a lower serum albumin level. Age and the albumin level were the confounding factors that affect coagulation and thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

Impact of acute kidney injury on coagulation in adult minimal change nephropathy

Huang

Wei²,

Su³

et al. 2016

Medicine

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A hypercoagulable state exists in patients with nephrotic syndrome (NS), which more easily leads to venous thromboembolism (VTE). However, whether acute kidney injury (AKI), a common complication of NS, affects the hypercoagulable state and VTE has rarely been elucidated. In this study, we aimed to explore coagulation changes and analyze relevant influencing factors in NS-AKI patients.A total of 269 consecutive NS patients with minimal change disease (MCD) between 2011 and 2016 were included in this observational study. Ninety-one cases were in the AKI group and 178 cases in the non-AKI group. The 1:1 propensity score matching (PSM) method was applied to match the baseline information. The coagulation biomarkers were compared, and the thrombosis events were recorded. Linear correlation was performed to detect any relation between D-dimer and clinical data.The PSM method gave matched pairs of 88 MCD patients with AKI and non-AKI patients, resulting in no differences in baseline information. The D-dimer, fibrinogen, and thromboelastography parameters maximum amplitude (MA), G values of the MCD-AKI patients were significantly higher than the levels of the MCD patients without AKI (D-dimer: 1.8 [1.0, 3.3] vs 1.1 [0.6, 1.7] mg/L, P < 0.001; fibrinogen: 7.0±2.0 vs 6.5 ± 1.4 g/L, P = 0.036; MA: 74.6 ± 5.0 vs 70.5 ± 5.3 mm, P = 0.020; G: 15.7 ± 5.3 vs 12.5 ± 3.3, P = 0.034). For the MCD patients, the serum creatinine, white blood cell count, and interleukin-6 levels in the patients with D-dimers >1 mg/L were significantly higher than those of patients with D-dimers ≤1 mg/L. The correlation analysis showed that the D-dimer level was correlated with serum creatinine, white blood cell count, and interleukin-6 (r = 0.410, P = < 0.001; r = 0.248, P = < 0.001; r = 0.306, P = < 0.001, respectively). Five deep vein thrombosis events occurred in the AKI group and 1 pulmonary embolism event occurred in the non-AKI group after adjusting the propensity score value. AKI appeared to have an association with higher incidence of VTE, but the difference was not statistically significant (RR: 4.9, 95% CI: 0.6–42.7, P = 0.154).The MCD-NS patients complicated with AKI had a more severe hypercoagulable state, which might be associated with the active inflammation of AKI that mediated activation of the coagulation system.

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Acute Kidney Injury in Adult Idiopathic Nephrotic Syndrome

Cited by 27 publications

References 27 publications

Epidemiology and Predictors of End-stage Renal Disease in Taiwanese Children With Idiopathic Nephrotic Syndrome

Epidemiology and Predictors of End-stage Renal Disease in Taiwanese Children With Idiopathic Nephrotic Syndrome

Successful Treatment of Acute Kidney Injury in Patients with Idiopathic Nephrotic Syndrome Using Human Atrial Natriuretic Peptide

Impact of acute kidney injury on coagulation in adult minimal change nephropathy

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