Curso clínico de la nefropatía membranosa lúpica pura

Background: The long-term outcome of the pure form of WHO type V lupus membranous glomerulonephritis is apparently more benign than that of other forms of lupus glomerulonephritis. However 12% of such patients progress to terminal renal failure. The presence of proteinuria may be an indication of cy...

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Autores principales:	Pastén V,Rolando, Massardo V,Loreto, Rosenberg G,Helmar, Radrigán A,Francisco, Roessler B,Emilio, Valdivieso D,Andrés, Jacobelli G,Sergio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Glomerulonephritis membranous Kidney failure chronic Lupus nephritis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100004
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spelling	oai:scielo:S0034-988720050001000042014-08-12Curso clínico de la nefropatía membranosa lúpica puraPastén V,RolandoMassardo V,LoretoRosenberg G,HelmarRadrigán A,FranciscoRoessler B,EmilioValdivieso D,AndrésJacobelli G,Sergio Glomerulonephritis membranous Kidney failure chronic Lupus nephritis Background: The long-term outcome of the pure form of WHO type V lupus membranous glomerulonephritis is apparently more benign than that of other forms of lupus glomerulonephritis. However 12% of such patients progress to terminal renal failure. The presence of proteinuria may be an indication of cytotoxic agents. Aim: To study the clinical long-term outcome of WHO type V lupus membranous glomerulonephritis. Material and methods: A retrospective analysis of all kidney biopsies of a University Pathology Department, with the diagnosis of WHO type V lupus membranous glomerulonephritis. Review of medical records of patients with the disease and one clinical assessment of all living patients. Results: Between 1973 and 2000, 703 kidney biopsies were done to patients with systemic lupus erythematosus. Of these, 40 were membranous glomerulonephritis and in 33 patients (28 women, age range 6-71 years), data on the evolution and survival was obtained. Nineteen had type Va and the rest type Vb nephritis. Two presented with renal failure and 11 with proteinuria over 3.5 g/24h. The median follow-up since the renal biopsy was 63 months (range 1-316). At the end of follow-up, four had a creatinine clearance of less then 15 ml/h and four a clearance between 15 and 29 ml/h (one of these received a renal allograft). Eleven (33%) patients had died, mostly due to infections. Life expectancy at five years with a creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine and high blood pressure at the moment of the biopsy. Conclusions: The clinical outcome of these patients was bad. Twelve percent reached a stage of terminal renal failure. This is in contrast with the 3% progression to a similar stage of proliferative glomerulonephritis treated with i.v. cyclophosphamide. New therapies for this condition must be sought (Rev Méd Chile 2005; 133: 23-32)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.1 20052005-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100004es10.4067/S0034-98872005000100004
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Glomerulonephritis membranous Kidney failure chronic Lupus nephritis
spellingShingle	Glomerulonephritis membranous Kidney failure chronic Lupus nephritis Pastén V,Rolando Massardo V,Loreto Rosenberg G,Helmar Radrigán A,Francisco Roessler B,Emilio Valdivieso D,Andrés Jacobelli G,Sergio Curso clínico de la nefropatía membranosa lúpica pura
description	Background: The long-term outcome of the pure form of WHO type V lupus membranous glomerulonephritis is apparently more benign than that of other forms of lupus glomerulonephritis. However 12% of such patients progress to terminal renal failure. The presence of proteinuria may be an indication of cytotoxic agents. Aim: To study the clinical long-term outcome of WHO type V lupus membranous glomerulonephritis. Material and methods: A retrospective analysis of all kidney biopsies of a University Pathology Department, with the diagnosis of WHO type V lupus membranous glomerulonephritis. Review of medical records of patients with the disease and one clinical assessment of all living patients. Results: Between 1973 and 2000, 703 kidney biopsies were done to patients with systemic lupus erythematosus. Of these, 40 were membranous glomerulonephritis and in 33 patients (28 women, age range 6-71 years), data on the evolution and survival was obtained. Nineteen had type Va and the rest type Vb nephritis. Two presented with renal failure and 11 with proteinuria over 3.5 g/24h. The median follow-up since the renal biopsy was 63 months (range 1-316). At the end of follow-up, four had a creatinine clearance of less then 15 ml/h and four a clearance between 15 and 29 ml/h (one of these received a renal allograft). Eleven (33%) patients had died, mostly due to infections. Life expectancy at five years with a creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine and high blood pressure at the moment of the biopsy. Conclusions: The clinical outcome of these patients was bad. Twelve percent reached a stage of terminal renal failure. This is in contrast with the 3% progression to a similar stage of proliferative glomerulonephritis treated with i.v. cyclophosphamide. New therapies for this condition must be sought (Rev Méd Chile 2005; 133: 23-32)
author	Pastén V,Rolando Massardo V,Loreto Rosenberg G,Helmar Radrigán A,Francisco Roessler B,Emilio Valdivieso D,Andrés Jacobelli G,Sergio
author_facet	Pastén V,Rolando Massardo V,Loreto Rosenberg G,Helmar Radrigán A,Francisco Roessler B,Emilio Valdivieso D,Andrés Jacobelli G,Sergio
author_sort	Pastén V,Rolando
title	Curso clínico de la nefropatía membranosa lúpica pura
title_short	Curso clínico de la nefropatía membranosa lúpica pura
title_full	Curso clínico de la nefropatía membranosa lúpica pura
title_fullStr	Curso clínico de la nefropatía membranosa lúpica pura
title_full_unstemmed	Curso clínico de la nefropatía membranosa lúpica pura
title_sort	curso clínico de la nefropatía membranosa lúpica pura
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100004
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Curso clínico de la nefropatía membranosa lúpica pura

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