Etiologies and outcome of acute renal insufficiency in older adults: A renal biopsy study of 259 cases

Haas, Mark; Spargo, Benjamin H.; Wit, Ernst; Meehan, Shane M.

doi:10.1016/s0272-6386(00)70196-x

Cited by 229 publications

(168 citation statements)

References 33 publications

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“…However, the histopathological diagnosis was considered to contribute to a better therapeutic guidance and definition of prognosis. We agree with the current tendency identified in several publications 4,[8][9][10]14 that renal biopsy can be indicated in nephropathies in the elderly as long as safety criteria are met.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Doenças renais em pacientes idosos submetidos à biópsia percutânea de rins nativos

Oliveira

Costa²,

Neto³

et al. 2010

J. Bras. Nefrol.

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Section: Discussionsupporting

confidence: 92%

“…Another study has reported that association in nine patients. 14 The reasons for the high frequency in that population have not been discussed, but the greater susceptibility of the kidneys of elderly patients to that additional complication may exist.…”

Section: Discussionmentioning

confidence: 99%

Doenças renais em pacientes idosos submetidos à biópsia percutânea de rins nativos

Oliveira

Costa²,

Neto³

et al. 2010

J. Bras. Nefrol.

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“…A cute tubulointerstitial nephritis (ATIN) is a common pattern of acute kidney injury (AKI) and accounts for 15-27% of intrinsic renal AKI biopsy specimens (1). The cause varies between cases, with drug hypersensitivity being the most common, followed by systemic autoimmune diseases, tubulointerstitial nephritis and uveitis (TINU) syndrome, infections, and malignancies (2).…”

mentioning

confidence: 99%

HLA-DQA1, -DQB1, and -DRB1 Alleles Associated with Acute Tubulointerstitial Nephritis in a Chinese Population: A Single-Center Cohort Study

Jia

et al. 2018

The Journal of Immunology

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Acute tubulointerstitial nephritis (ATIN) is a common cause of acute kidney injury with various origins. HLA-DQA1, -DQB1, and -DRB1 have been associated with development of tubulointerstitial nephritis and uveitis (TINU) syndrome in case reports and small case series, but information about HLA genetic susceptibility to drug hypersensitivity–related ATIN (D-ATIN) or other types of ATIN is limited. In this article, we genotyped 154 patients with ATIN of different causes and 200 healthy controls at HLA-DQA1, -DQB1, and -DRB1 loci. We found that there was no difference between patients with D-ATIN and TINU in the carrier’s frequency of HLA-DQA1, -DQB1, or -DRB1. Patients with Sjogren’s syndrome–ATIN and IgG4-related ATIN presented a different pattern of tested HLA alleles. HLA-DQA1*0104 (p value corrected by false discovery rate method [Pc] = 4.72 × 10−22, odds ratio [OR] = 13.81), -DQB1*0503 (Pc = 1.95 × 10−14, OR = 9.51), and -DRB1*1405 (Pc = 8.06 × 10−19, OR = 12.80) were significant risk alleles for the occurrence of D-ATIN and TINU. There were no significant associations between tested HLA alleles and ATIN induced by other causes. Patients with D-ATIN/TINU carrying HLA-DQA1*0104/DQB1*0503/DRB1*1405 had higher peak serum creatinine and more severe renal tubulointerstitial inflammatory impairment. They also had significantly higher levels of tubular HLA-DR and HLA-DQ expression, which were correlated with the numbers of interstitial CD4+ T lymphocytes (r = 0.975, p < 0.001 and r = 0.832, p = 0.005, respectively) and monocytes/macrophages (r = 0.721, p = 0.004 and r = 0.615, p = 0.02, respectively). In conclusion, patients with D-ATIN or TINU have genetic susceptibility in HLA-DQA1, -DQB1, and -DRB1 alleles. HLA-DQA1*0104/DQB1*0503/DRB1*1405 serves as a significant risk haplotype for development of D-ATIN and TINU, which might facilitate renal tubulointerstitial inflammation by enhancing Ag-presenting capacity of renal tubular cells.

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“…Renal involvement is seen in more than 50% of the cases, with progression to dialysis in 28-61%, and 1 year mortality rate up to 83% [12]. AERD was noted in 7.1% of 259 patients, who are above 60 years and underwent renal biopsy for acute renal failure [13]. This shows that AERD is not an uncommon cause of acute kidney injury in elderly patients.…”

Section: Discussionmentioning

confidence: 82%

Atheroembolic Renal Disease and Anticoagulants use: A Case Report and Literature Review

Pasupala

2012

World J Nephrol Urol

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Warfarin therapy is associated with improved clinical outcomes in several conditions including atrial fibrillation and thromboembolic disease. However, it can cause peripheral embolization by destabilizing the atherosclerotic plaque. This usually manifests as purple or blue toe syndrome, but isolated cases of renal manifestations are also reported. We report the case of a 77-year-old man who has been hemodialysis dependent due to warfarin induced atheroembolic renal disease. This is the most common cause of death in patients with cholesterol crystal embolization. Better understanding of the clinicopathological manifestations and high index of suspicion for the condition in predisposed patients can facilitate early diagnosis and potentially decrease the mortality risk.

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Etiologies and outcome of acute renal insufficiency in older adults: A renal biopsy study of 259 cases

Cited by 229 publications

References 33 publications

Doenças renais em pacientes idosos submetidos à biópsia percutânea de rins nativos

Doenças renais em pacientes idosos submetidos à biópsia percutânea de rins nativos

HLA-DQA1, -DQB1, and -DRB1 Alleles Associated with Acute Tubulointerstitial Nephritis in a Chinese Population: A Single-Center Cohort Study

Atheroembolic Renal Disease and Anticoagulants use: A Case Report and Literature Review

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