Acute kidney injury in patients with primary nephrotic syndrome: influencing factors and coping strategies

Honghua, Lu; Xiao, Liping; Song, Mengqi; Liu, Xiaolan; Wang, Fang

doi:10.1186/s12882-022-02720-y

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…The concomitant use of two RAS inhibitors is a risk factor for AKI [ 13 ]. Furthermore, some reports have suggested that the use of RAS inhibitors in patients with nephrotic syndrome is associated with the risk of AKI [ 14 , 15 ], while another report did not suggest such a risk [ 16 ]. In this case, the nephrotic syndrome and diuretics may have further triggered the development of prerenal AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Torigoe¹,

Ikemi²,

Yoshida³

et al. 2022

Cureus

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A 76-year-old Japanese man with nephrotic syndrome was admitted to our department for treatment. After his admission, he was administered prednisolone (PSL) at 40 mg/day, and a percutaneous renal biopsy was performed. However, on the first day of admission, his urinary protein decreased from 5.05 g/gCr to 1.85 g/gCr. On the fourth day of admission, his urinary protein further decreased to 0.38 g/gCr and the patient developed acute kidney injury (AKI). Renin-angiotensin system (RAS) inhibitors were suspected to be the cause of AKI; therefore, they were discontinued. After the renal function improved, the urinary protein worsened again to 5.49 g/gCr. Renal pathology suggested minimal change disease (MCD); therefore, PSL was continued. The patient's urinary protein subsequently improved and he had no renal function impairment. Minimal change disease can be complicated by AKI through intravascular volume depletion caused by high urinary protein and hypoalbuminemia. However, when MCD is complicated by RAS inhibitor-associated AKI, the urinary protein may notably decrease, and the patient may present with an atypical course of MCDassociated AKI.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Torigoe¹,

Ikemi²,

Yoshida³

et al. 2022

Cureus

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“…We observed that LN patients with AKI exhibited more active renal involvement than those without AKI. A recent study demonstrated that AKI occurs in up to 44.9% of adult patients with primary nephrotic syndrome [14]. While the frequency of AKI in children hospitalized with nephrotic syndrome was more than doubled in the past decade [15].…”

Section: Dissusionmentioning

confidence: 99%

Clinicopathological Characteristics and Prognosis of Lupus Nephritis Patients with Acute Kidney Injury

Li,

Luo,

Fan

et al. 2023

Am J Nephrol

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Introduction: Acute kidney injury (AKI) is common in lupus nephritis (LN) and a risk factor for chronic kidney failure. Here, we aimed to assess the characteristics and prognosis of LN patients with AKI. Methods: AKI and AKI severity stages in LN patients were defined by the Kidney Disease Improving Global Outcomes (KDIGO) classification. Long-term renal outcomes and patient mortality between different stages of AKI were compared by Cox regression analysis. Results: Of 1272 LN patients, 225 (17.69%) had AKI and 72 (5.66%) were AKI stage 3. Compared with the non-AKI group, the proportion of male patients was significantly higher in the AKI group (p = 0.002). In addition, there were markedly higher proportions of hematologic system damage, more severe renal manifestations, and higher Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores in the AKI group than in the non-AKI group. The active and chronic lesions in renal biopsy were significantly higher in LN patients with AKI than those without AKI. During a median follow-up of 53 months, Kaplan-Meier curve showed that LN patients with AKI stage 3 had significantly poorer long-term renal outcomes (p = 0.002) and patient survival (p < 0.001) than those without AKI. Furthermore, AKI stage 3, but not stage 1 or 2 was significantly associated with adverse renal outcomes (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.01–6.28, p = 0.048) and all-cause mortality (HR = 2.80, 95% CI: 1.18–6.61, p = 0.019) in LN patients. In patients with AKI, increased baseline serum creatinine and severe glomerular sclerosis were independent risk factors for worse renal outcomes, while higher blood pressure, increased baseline serum creatinine, and anti-Sjogren’s syndrome A positivity could indicate poor survival. Discussion: LN patients with AKI stage 3, but not stages 1 and 2, have poorer long-term renal outcomes and patient survival. Our study demonstrates the importance of early identification and management of AKI in LN patients.

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Diagnostic Value of Metagenomics Next-Generation Sequencing in Nephrotic Syndrome Complicated with Pulmonary Infection

陈¹

2022

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Acute kidney injury in patients with primary nephrotic syndrome: influencing factors and coping strategies

Cited by 3 publications

References 30 publications

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Clinicopathological Characteristics and Prognosis of Lupus Nephritis Patients with Acute Kidney Injury

Diagnostic Value of Metagenomics Next-Generation Sequencing in Nephrotic Syndrome Complicated with Pulmonary Infection

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