Idiopathic membranous nephropathy preceding membranous lupus nephritis: a case report.

Membranous nephropathy is one of the most common causes of nephrotic syndrome in the adult population. According to the underlying etiology, membranous nephropathy is classified as either primary or secondary. Systemic lupus erythematosus is an autoimmune disease that can affect the kidneys in 50% of patients in the course of the disease. Renal disease may be the first manifestation of systemic lupus erythematosus and the development of systemic findings may be delayed for about 1-5 years following the diagnosis of lupus nephritis. We present a 59-year-old male patient who had a diagnosis of idiopathic membranous nephropathy since 2007 and developed membranous lupus nephritis during the 12-year follow-up without any extrarenal systemic lupus erythematosus findings.

A comparative study of the effect of icodextrin based peritoneal dialysis and hemodialysis on lipid metabolism.

Dyslipidemia is frequent in patients with end stage renal disease. Excessive peritoneal glucose absorption from high glucose-containing peritoneal dialysis solutions may enhance disturbances on the lipid metabolism of patients on peritoneal dialysis. We compared the effect of icodextrin-based peritoneal dialysis therapy with hemodialysis (HD) therapy on lipid metabolism. A total of 157 non-diabetic patients on dialysis at least for 3 months; 78 patients on Icodextrin-based continuous ambulatory peritoneal dialysis (CAPD) (44 M, 34 F) and 79 patients in HD group (47M, 32F) were included into the study. After 12 h of fasting and before the dialysis session, serum urea, creatinin, glucose, Sodium, potasium, and albumin, total cholesterol (TC), triglycerides (TG), very low density lipoprotein (VLDL), low density lipoprotein (LDL)-C, high-density lipoprotein (HDL)-C, apolipoprotein A (Apo A), apolipoprotein B, and lipoprotein a were measured. TG (P = 0018) and VLDL (P = 0.022) were lower in CAPD group than HD group, HDL-C (P < 0.001) and Apo A (P = 0.001) were higher in CAPD group than in HD group. A total of 24.4% in CAPD group and 11.4% in HD group (P < 0.034) had normal serum levels of TG, LDL-C, and HDL-C. More patients in CAPD group (47.4%) had high serum Apo A levels than in HD group (21.5%) (P = 0.001). We suggest that patients receiving icodextrin-based CAPD may have better TG, HDL-C, and Apo A levels than patients on HD.

In vitro effect of silicone oil and liquid perfluorocarbons on platelet aggregation.

PURPOSE: To study the in vitro effect of silicone oil of different viscosities and liquid perfluorocarbons on platelet aggregation. METHODS: Silicone oil with a viscosity of 5700 cs and 1000 cs and liquid perfluorocarbons of perfluoroperhydrophenantren and perfluorodecaline were studied to investigate the effect of these agents on platelet aggregation under in vitro conditions. The experiments were performed by using platelet rich plasma with an aggregometer. Aggregation was induced with three different agonists, including 5"-adenosine diphosphate (ADP), epinephrine (EPI), and collagen (Col). The results were obtained as a percentage of maximal aggregation and compared with controls using Kruskal-Wallis one way analysis of variance test. RESULTS: The tests with ADP as aggregating agent revealed that the percentage of maximal aggregation was a mean of 72.66+/-3.51% for ADP only, 58.66+/-3.05% for silicone oil of 1000 cs, 62.66+/-2.08% for silicone oil of 5700 cs, 56.00+/-7.00% for perfluoroperhydrophenantren, and 52.3+/-3.1 % for perfluorodecaline. With EPI, aggregation was induced in all control samples with a mean of 76+/-9.54%. The mean percentage of maximal aggregation was 66.7+/-3.06 for silicone oil of 1000 cs, 72.33+/-5.5% for silicone oil of 5700 cs, 71.67+/-3.79% for perfluoroperhydrophenantren, and 70.33+/-2.52% for perfluorodecaline. With collagen, it was 86.67+/-1.53% for controls, 83.67+/-3.51% for silicone oil of 1000 cs, 85.33+/-4.51% for silicone oil of 5700 cs, 83.33+/-4.93% for perfluoroperhydrophenantren, and 81.33+/-4.16% for perfluorodecaline. Statistical analysis revealed no significant change in the percentage of maximal aggregation for all tested substances in the experiments. CONCLUSIONS: Silicone oil of different viscosities and perfluoroperhydrophenantren and perfluorodecaline have minimal antiaggregating effect on platelets. The level of effect is not statistically significant.