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1.
Clin Exp Immunol ; 159(1): 73-81, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19891659

RESUMO

We investigated Toll-like receptors (TLR-3, -4 and -7) expression in circulating mononuclear cells of patients with immunoglobulin A nephropathy (IgAN), a disease with debated relationships with mucosal immunity. TLR-4 expression (detected by fluorescence activated cell sorter) and mRNA transcriptional levels (Taqman) were significantly higher in patients with IgAN than in healthy controls (P = 0.00200 and P = 0.0200). TLR-3 and TLR-7 were not modified significantly. In IgAN patients proteinuria was correlated significantly with TLR-4 expression (P = 0.0312). In a group of nephrotic syndromes, TLR-3, -4 and -7 expression was similar to healthy controls. A significant difference in TLR-4 expression and mRNA levels was found between very active IgAN patients (proteinuria > 1 g/1.73 m(2)/day in association with severe microscopic haematuria) and inactive patients (proteinuria < 0.5 g/1.73 m(2)/day, with absent or minimal haematuria). No correlation with levels of aberrantly glycosylated IgA1, age, renal biopsy features or therapy was found. This study shows for the first time an up-regulation of TLR-4 in circulating mononuclear cells of patients with IgAN, particularly in association with proteinuria and heavy microscopic haematuria.


Assuntos
Glomerulonefrite por IGA/metabolismo , Leucócitos Mononucleares/metabolismo , Receptor 4 Toll-Like/metabolismo , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Expressão Gênica/genética , Glomerulonefrite por IGA/sangue , Glomerulonefrite por IGA/urina , Hematúria/metabolismo , Humanos , Imunoglobulina A/sangue , Masculino , Pessoa de Meia-Idade , Monócitos/metabolismo , Proteinúria/metabolismo , Receptor 3 Toll-Like/genética , Receptor 3 Toll-Like/metabolismo , Receptor 4 Toll-Like/genética , Receptor 7 Toll-Like/genética , Receptor 7 Toll-Like/metabolismo , Adulto Jovem
3.
G Ital Nefrol ; 25 Suppl 44: 53-63, 2008.
Artigo em Italiano | MEDLINE | ID: mdl-19048587

RESUMO

With its aging population, the Western world is experiencing a significant increase in the prevalence of chronic kidney disease, which has actually been defined as ''pandemic''. The high mortality and comorbidity, especially in terms of cardiovascular disease, have led to a significant increase in hospitalizations and rising public health expenditure, setting a trend that will become unsustainable in the next decades, even in the most developed countries. These epidemiological data have underlined the need for prevention campaigns and urged researchers and clinicians to develop new and more specific treatments able to slow down the progression of chronic kidney disease towards dialysis. To obtain such results, a deeper understanding of the pathogenetic mechanisms of nephropathy progression is mandatory. Once sclerosis is established and the initial pathogenetic noxa, whether or not involving the glomeruli, has been extinguished, the sclerotic progression of different nephropathies follows a standard pathway, irrespective of the initial cause. The achievement of an effective therapy for this condition, in native kidneys as well as transplanted organs, is the third-millennium challenge for nephrologists. In this review we will first describe the main risk factors and pathogenetic mechanisms involved in nephropathy progression and then discuss the results obtained with drugs that basic research has identified as potentially useful in experimental animal models as well as rigorous clinical trials.


Assuntos
Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Transplante de Rim , Diálise Renal , Doença Crônica , Ensaios Clínicos como Assunto , Progressão da Doença , Medicina Baseada em Evidências , Saúde Global , Hospitalização/estatística & dados numéricos , Humanos , Imunoterapia , Itália/epidemiologia , Nefropatias/fisiopatologia , Nefropatias/terapia , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/etiologia , Falência Renal Crônica/prevenção & controle , Testes de Função Renal , Glomérulos Renais/patologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença
5.
G Ital Nefrol ; 24(2): 121-31, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-17458827

RESUMO

Acute pyelonephritis (APN) is a frequent and possibly severe pathological condition responsible for more than 100,000 hospitalizations per year in the United States. Etiology is prevalently Escherichia coli, and risk factors include sexual activity, genetic predisposition, old age and infection via urological instrumentation. The exact correlation between APN and vesicoureteral reflux has not yet been defined. Diagnosis of APN may be clinical, but examination using computed tomography (CT) or nuclear magnetic resonance (NMR) spectroscopy allows a more precise definition and may provide evidence of abscesses. Severe cases should be treated with a fluoroquinolone or extended-spectrum cephalosporin associated or not with aminoglycoside. Treatment should be continued for at least 10 days. Long-term evolution of APN is still unknown, even if formation of cortical scars and possible development of macroalbuminuria or renal failure are described. Pregnancy, diabetes and renal transplantation represent situations in which APN may be particularly severe. Formation of renal abscesses is underestimated and must be evaluated by CT or NMR spectroscopy evaluation. Abscesses must be drained only if they are of great size.


Assuntos
Pielonefrite , Doença Aguda , Adulto , Aminoglicosídeos/uso terapêutico , Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Quimioterapia Combinada , Escherichia coli/isolamento & purificação , Fluoroquinolonas/uso terapêutico , Humanos , Incidência , Itália/epidemiologia , Pielonefrite/diagnóstico , Pielonefrite/tratamento farmacológico , Pielonefrite/epidemiologia , Pielonefrite/microbiologia , Fatores de Risco , Resultado do Tratamento , Estados Unidos/epidemiologia
6.
G Ital Nefrol ; 23(3): 366-9, 2006.
Artigo em Italiano | MEDLINE | ID: mdl-16868916

RESUMO

An 84 year-old woman was admitted because of sepsis, thrombocytopenia, anaemia and acute renal failure that required hemodialysis. The diagnostic tests performed during hospitalization showed a severe urinary tract infection due to Enterococcus faecalis, resulting in mild sepsis. This infection was responsible for acute tubular necrosis and thrombotic microangiopathy, in a clinical context of difficult differential diagnosis and hemolytic-uremic syndrome.


Assuntos
Trombose/diagnóstico , Trombose/etiologia , Infecções Urinárias/complicações , Idoso de 80 Anos ou mais , Feminino , Humanos
7.
Lupus ; 13(10): 769-72, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15540508

RESUMO

Hypertension is a common manifestation of antiphospholipid syndrome (APS). Antiphospholipid antibodies (aPL) have been described in patients with hypertension secondary to renal artery stenosis (RAS). Twenty-six patients with RAS and 25 patients with severe essential hypertension (diastolic blood pressure > 110 mmHg or > or = 3 hypertensive drugs) were studied and compared to 61 age- and sex-matched healthy subjects. Serum samples were tested for lupus anticoagulant (LA), anticardiolipin (aCL) IgG and IgM, antiprothrombin (aPT) IgG and IgM, anti-beta2glycoprotein 1 (abeta2GP1) IgG and IgM. aPL were negative in all patients with RAS. Two patients with essential hypertension had positive aPL (8%) (LA in one patient confirmed in a second assay and abeta2GP1-IgG in the other patient confirmed one year later together with aCL IgG positivity). Among healthy subjects, one case (1.6%) was found to be positive for LA, aCL IgM, abeta2GP1 IgM, aPT IgG, aPT IgM. In conclusion, the association between RAS and aPL seems to be casual rather than an expression of an elective thrombotic localization ofAPS. The positive finding of aPL in 8% of patients with essential hypertension, a frequency higher than that of the control population, deserves further studies in larger series to better explore the relationship between aPL and hypertension.


Assuntos
Anticorpos Antifosfolipídeos/análise , Hipertensão/etiologia , Hipertensão/imunologia , Obstrução da Artéria Renal/complicações , Idoso , Anticorpos Anticardiolipina/sangue , Autoanticorpos/sangue , Estudos de Casos e Controles , Feminino , Glicoproteínas/imunologia , Humanos , Inibidor de Coagulação do Lúpus/sangue , Masculino , Pessoa de Meia-Idade , beta 2-Glicoproteína I
8.
Minerva Urol Nefrol ; 53(2): 81-6, 2001 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-11455316

RESUMO

BACKGROUND: Aim of this study was a retrospective analysis of the renal biopsies performed in our Division. METHODS: Since January 1, 1996 to September 30, 1999 289 biopsies were performed on native kidneys, 90 patients were older than 65. RESULTS: The most frequent nephropathy was IgA glomerulonephritis (IgAGN) (28%), followed by membranous glomerulonephritis (MGN) (11%). In patients older than 65, the most frequent was MGN (20%), followed by IgAGN (12.2%). The total complications were 84 (29.1%) (hematomas >3 cm 1%; blood transfusion: 1.4%). Complications were not related to age, blood pressure, renal function, clinical presentation, number of shots. In 217 patients, the results obtained with two different modalities were compared: manual system (needle size=15 gauge) and automatic system (18 gauge). No statistically significant differences were found as regards the number of shots for single biopsy, number of glomeruli and major complications (1.6% vs 1.3%), while minor complications were more frequent in the second group. CONCLUSIONS: In conclusion, the number of renal biopsies performed in our Division has been increasing year after year. This trend can be partially explained by our wider indications to renal biopsy in elderly population (the data related to resident population showed the greatest prevalence of biopsies in patients 70 to 79 years old). Renal biopsy actually represents a safe examination even in elderly patients. From a technical point of view, on the basis of personal experience, 18 gauge acecut automatic needles seem to be preferred to other kind of devices.


Assuntos
Biópsia por Agulha , Nefropatias/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Hospitais , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
J Nephrol ; 14(1): 15-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11281338

RESUMO

Angiotensin converting enzyme inhibitors (ACEI) are the most effective antiproteinuric agents and should be used as first-line drugs in both diabetic and non-diabetic proteinuric nephropathies. The role of calcium channel blockers (CCB) is much more controversial. In diabetic patients verapamil and diltiazem seem more effective than dihydropyridines in reducing urinary protein excretion, and have additive effects with ACEI, but little is available on chronic treatment of non-diabetic nephropathies for non-dihydropyridine CCBs. To test whether the combination of verapamil 180 mg or amlodipine 5 mg with trandolapril 2 mg reduces urinary protein excretion more than trandolapril 2 mg alone, we planned a prospective, randomized, double-blind, multicenter trial. The secondary aims are to evaluate the effects of both treatments on the selectivity of proteinuria and check their safety. Consecutive patients aged between 18 and 70 years with non-diabetic proteinuria > or =2 g/24 h and plasma creatinine < 3 mg/dl or creatinine clearance > or = 20 ml/min are asked to participate. After a four-week run-in during which previous antihypertensive therapy is withdrawn, a single dose of trandolapril 2 mg is given once a day in open conditions for four weeks. At the end of this period patients are randomly assigned to receive once a day, in a double blind fashion, either trandolapril 2 mg and verapamil 180 mg [plus a placebo], or trandolapril 2 mg plus amlodipine 5 mg. They are monitored after one, two, five and eight months.


Assuntos
Anlodipino/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Indóis/uso terapêutico , Nefropatias/tratamento farmacológico , Proteinúria/tratamento farmacológico , Verapamil/uso terapêutico , Adulto , Idoso , Método Duplo-Cego , Quimioterapia Combinada , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Projetos de Pesquisa
10.
Clin Exp Immunol ; 122(3): 471-6, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11122257

RESUMO

IL-10 displays modulatory properties on the synthesis of platelet-activating factor (PAF), a potent inflammatory mediator of vascular injury. Despite the fact that IL-10 is considered to be an anti-inflammatory cytokine, IL-10 levels correlate with disease activity in SLE. Moreover, in SLE IL-10 is unable to exert its immunosuppressive and anti-inflammatory effects. We have investigated the ability of IL-10 to stimulate PAF production from monocytes of SLE patients. Spontaneous and IL-10-stimulated PAF production by peripheral blood monocytes was measured in active (n = 13) and inactive (n = 14) SLE patients and in 15 normal control subjects. We observed that monocytes derived from patients with active SLE, but not from controls or inactive SLE, spontaneously produced significant amounts of PAF. Moreover, IL-10 enhanced the synthesis of PAF from monocytes of active SLE patients only. IL-10-induced PAF production correlated with the severity of the disease and with the extent of proteinuria. These results indicate that IL-10 only stimulates the synthesis of PAF from monocytes of SLE patients when immunologically active, suggesting that IL-10 may possess a paradoxical proinflammatory effect in SLE by promoting the production of PAF, a secondary mediator of inflammation.


Assuntos
Interleucina-10/metabolismo , Lúpus Eritematoso Sistêmico/metabolismo , Monócitos/metabolismo , Fator de Ativação de Plaquetas/biossíntese , Adulto , Biomarcadores , Feminino , Humanos , Interleucina-10/farmacologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Lúpus Eritematoso Sistêmico/urina , Masculino , Monócitos/efeitos dos fármacos , Proteinúria
11.
Ren Fail ; 22(5): 605-11, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11041292

RESUMO

Cardiovascular disease accounts for almost half of the total mortality in patients with end stage renal disease (ESRD). It has recently been debated whether coronary revascularization has the same rate of risks and successes in this cohort of patients compared to patients without renal disease. Since 1991, 17 dialysis patients were submitted to coronary revascularization in our center. Seven patients were following peritoneal, 10 hemodialytic treatment. Four patients were submitted to percutaneous transluminal coronary angioplasty (PTCA) and 13 to surgical revascularization (CABG). In 2 patients the coronary lesion was unique, in the others stenosis of multiple vessels were found. Six patients were diabetic. The mean age at the onset of the coronary artery disease (CAD) was 57.17 +/- 11.6 years. The mean time elapsed from the onset of the CAD and the performance of the PTCA or CABG was 30.1 +/- 35.4 months. The mean time from beginning of dialysis treatment to revascularization was 48.2 +/- 39.6 months. Mean hemoglobin values were 9.7 +/- 1 g/dL, mean phosphorus values were 5.2 +/- 8.7 mg/dL, mean cholesterol values were 211 +/- 49.5 mg/dL. The procedure was technically successful in all patients. Mean survival was 25.09 +/- 28.12 months. Twelve patients died, 5 of whom within one month. Survival at one month was 70.5%, at 6 months 58.8%, at one year 52.9%, at 2 years 47%. There was neither significant difference patients submitted to PTCA and those submitted to CABG, nor between diabetic and non-diabetic patients. In conclusion, coronary revascularization in our experience is a high risk procedure in dialysis patients. The reasons for this could be the severe general conditions of these patients affected with diffuse vasculopathy and the long time elapsed since the onset of the ischemic cardiopathy. Thus, our results could suggest the opportunity of performing earlier screening of coronary situation and revascularization treatment in CAD dialysis patients.


Assuntos
Ponte de Artéria Coronária , Falência Renal Crônica/complicações , Diálise Renal , Idade de Início , Angioplastia Coronária com Balão , Colesterol/sangue , Doença das Coronárias/complicações , Doença das Coronárias/cirurgia , Hemoglobinas/análise , Humanos , Falência Renal Crônica/mortalidade , Pessoa de Meia-Idade , Diálise Peritoneal , Fósforo/sangue , Taxa de Sobrevida , Resultado do Tratamento
12.
Artif Organs ; 24(5): 386-7, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10848680

RESUMO

Vecuronium is a curaric agent, largely used in anesthesia. Indications as to its employ in uremic patients appear to be debated because of partial renal elimination of the drug. A 52-year-old hemodialyzed woman required transplantectomy for rejection. At awakeness after general anesthesia (induced with fentanyl, propofol, and 6 mg of vecuronium, repeated with a single 2 mg dose 30 min later), she presented diafragmatic and muscular limb weakeness that lasted 180 min in spite of prostigmine administration. A 2 h 30 min predilutional hemofiltration was then performed, which induced rapid disappearance of neuromuscular blockade. Even if vecuronium can be used in dialysis patients, one should remember its possible side effects, especially with repeated doses, in determining prolonged neuromuscular blockade. Cautious use of this drug in renal failure is mandatory. Low dosage must be employed and repeated administration avoided. Neuromuscular blockade seems to be rapidly reversible with dialytic treatment.


Assuntos
Debilidade Muscular/terapia , Fármacos Neuromusculares não Despolarizantes/efeitos adversos , Diálise Renal , Brometo de Vecurônio/efeitos adversos , Inibidores da Colinesterase/uso terapêutico , Feminino , Rejeição de Enxerto/cirurgia , Humanos , Transplante de Rim , Pessoa de Meia-Idade , Debilidade Muscular/induzido quimicamente , Neostigmina/uso terapêutico , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Respiração Artificial , Paralisia Respiratória/induzido quimicamente , Paralisia Respiratória/terapia , Brometo de Vecurônio/administração & dosagem
13.
Proc Soc Exp Biol Med ; 223(4): 367-71, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10721006

RESUMO

The prolactin (PRL) receptor (R), a member of the cytokine hemopoietin receptor superfamily, has been shown to activate early differentiation steps along the erythroid pathway. In particular PRL, a product of bone marrow stroma, induces functional erythropoietin (EPO)-R on CD34+ hemopoietic progenitors. In this study, expression of EPO-R mRNA and responsiveness to EPO were assessed on enriched hemopoietic progenitor cells (HPC) from seven hyperprolactinemic and three normoprolactinemic patients and two normal subjects. Expression of EPO-R mRNA by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was found in HPC of four out of seven hyperprolactinemic patients but not in normoprolactinemic patients or normal donors. Development of EPO-dependent Colony Forming Unit-Erythroid (CFU-E) colonies in semi-solid medium was observed only in hyperprolactinemic patients (six out of seven). A much higher number of CFU-E colonies was observed in the four patients with a positive EPO-R message. We conclude from these data that abnormally high levels of PRL may increase the number of EPO-responsive hemopoietic precursors in vivo as they do in vitro. Since hyperprolactinemia associates in these patients with depressed EPO production, it may be regarded as a compensatory mechanism for the reduced availability of the hemopoietic factor.


Assuntos
Células Precursoras Eritroides/citologia , Hiperprolactinemia/sangue , Diálise Renal , Ensaio de Unidades Formadoras de Colônias , Células Precursoras Eritroides/química , Eritropoetina/farmacologia , Feminino , Humanos , Hiperprolactinemia/etiologia , Masculino , Prolactina/sangue , RNA Mensageiro/sangue , Receptores da Eritropoetina/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa
15.
Minerva Urol Nefrol ; 52(3): 119-22, 2000 Sep.
Artigo em Italiano | MEDLINE | ID: mdl-11227360

RESUMO

BACKGROUND: To describe the clinical aspects of renal failure due to cholesterol atheroembolism. METHODS: An hospital based observational study on renal failure due to cholesterol atheroembolism was carried out. Twenty-two cases (19 males, mean age 68 yrs, range 53-83 yrs) were identified from January 1992 to September 1998. RESULTS: Clinical symptoms were acute or rapidly progressive renal failure with blue toe and/or skin livedo reticularis in 13/22 cases (59%) and indolent progressive renal failure in 7/22 cases (32%). In 6/22 cases (27%) an abdominal organ involvement was evident; two (9%) had retinal cholesterol emboli, two (9%) peripheral and two (9%) central nervous system impairment. In 7 patients (32%) the cholesterol atheroembolism occurred spontaneously, while in 15 (68%) it followed invasive or interventional radiology (8 cases, 36%); cardiac or vascular surgery (4 cases, 18%); thrombolytic or anticoagulant therapy (3 cases, 14%). The time interval between the procedure at risk and the onset of symptoms or signs of cholesterol atheroembolism ranged between few hours to 60 days. Eleven patients (50%) required dialysis, which was then withheld in 4 cases (36%), owing to partial functional recovery after a median time of 30 days, ranging from 10 to 690 days. Median follow-up was 2.5 months (ranging from 2 days to 68 months), and eleven patients (50%) deceased. CONCLUSIONS: Cholesterol atheroembolism is a cause of renal failure associated with high mortality rates; its prevention needs the skill of all physicians involved in the care of patients with severe atherosclerosis.


Assuntos
Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Arteriosclerose/complicações , Embolia de Colesterol/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Nephrol Dial Transplant ; 12(11): 2269-76, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9394310

RESUMO

BACKGROUND: The presence and the pathogenetic role of circulating IgA reacting with neutrophil cytoplasmic antigens (IgA-ANCA) in patients with Henoch-Schönlein purpura (HSP) is still debated. This study was aimed to investigate some characteristics of serum IgA and macromolecular IgA in HSP patients, focusing on IgA-ANCA. METHODS: Eighty-seven HSP patients with biopsy proved renal involvement (51 adults and 36 children) enrolled in a multicentre study of the Italian Group of Immunopathology were investigated. RESULTS: Significantly high levels of IgA immune complexes were found in both adults (P < 0.05) and children (P < 0.01), while the binding of IgA to jacalin, was significantly low in children with HSP (P < 0.01) only. Two series of ELISA were done for IgA-ANCA, in two different laboratories. Increased binding to PMN crude extracts (P < 0.01) without any modification in IgA binding to proteinase 3 was found by either specific ELISA. Conversely, the binding of IgA to myeloperoxidase (MPO) was found to be significantly (P < 0.05) increased with positive values in 25% of patients by one assay only. Three of four sera with positive IgA-MPO ANCA exhibited binding in Western-blot studies with the MPO preparation used in ELISA to a 28-kDa species. D-galactose and N-acetyl-glucosamine decreased the binding of serum IgA to MPO more in HSP than in controls (P < 0.05). CONCLUSIONS: The conflicting reports on IgA-ANCA may reflect some atypical characteristics of the reaction which can be detected only by some ELISAs. We suggest that not an antigen-antibody reaction but a lectinic interaction due to abnormal composition of IgA carbohydrate side chains may account for the IgA-ANCA reaction in patients with HSP nephritis.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/metabolismo , Vasculite por IgA/imunologia , Imunoglobulina A/metabolismo , Nefrite/imunologia , Adulto , Western Blotting , Criança , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina A/sangue , Peroxidase/metabolismo
19.
Minerva Urol Nefrol ; 48(1): 7-12, 1996 Mar.
Artigo em Italiano | MEDLINE | ID: mdl-8848774

RESUMO

The authors present a clinical analysis of the literature data regarding aged patients affected with glomerulonephritis (GN) and of 115 GN patients aged more than 65 years, biopsied in their own Center. Complications of renal biopsy, including the subclinical ones, were found in 19.1% of old patients compared to 19.2% of younger patients (p = NS), major complications in 5 and 1.4% respectively (p = NS). The most frequent GN was membranous GN (MGN) (27.8%), followed by IgA-GN (12%) and rapidly progressive GN (RPGN), idiopathic (8.6%) or secondary to vasculitis (8.6%). Eighteen out of 32 old MGN patients treated with alternated courses of steroids and immunosuppressive drugs for 6 months were compared to 32 MGN patients aged < 65 years identically treated. Complete remission was observed in 27.7% of cases and partial remission in 38.8% (p = NS). Complications of treatment were similar in the two groups of patients (p = NS). Patients with RPGN were treated with steroids (17 patients) plus immunosuppressive drugs (15 patients) and plasma exchange (13 patients). Systemic symptoms disappeared in 13/14 patients; ANCA became negative in all the 5 patients in whom they were detected; a 50% reduction of serum creatinine was obtained in 12 patients. These patients were compared to a control group of 26 patients aged < 65 years. Amelioration of renal function was evidenced more frequently among old patients with vasculitis (p < 0.05). Complications of treatment were more frequent among old patients with idiopathic RPGN (p < 0.05), but severe in only 1 case. Our data and data from the literature support the opportunity to perform renal biopsy in aged people, because it is as safe as in the younger population and allows a rational basis for treatment of GN. Clinical responses are similar to those of younger patients. Complications of treatment seem to be more frequent in old patients, but can be limited by some technical precautions and careful clinical monitorization.


Assuntos
Glomerulonefrite/epidemiologia , Distribuição por Idade , Idoso , Biópsia/efeitos adversos , Glomerulonefrite/patologia , Humanos , Pessoa de Meia-Idade
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