Prospective trial of warfarin and dipyridamole in patients with membranoproliferative glomerulonephritis

Zimmerman, Stephen W.; Moorthy, A. Vishnu; Dreher, W.H.; Friedman, Aaron L.; Varanasi, Umamaheswara R.

doi:10.1016/0002-9343(83)90864-1

Cited by 96 publications

(21 citation statements)

References 10 publications

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“…Thus, the antiproteinuric ef fect o f any drug per se might be beneficial to the nephrotic patient. In this respect the recent observations o f Z im merman et al [23] are worth mentioning. In a prospective trial of warfarin and dipyramidole in patients with membranoproliferative glomerulonephritis the anticoagulant therapy resulted not only in a significant decrease in uri nary protein but also in stabilization o f the kidney func tion.…”

Section: Discussionmentioning

confidence: 82%

Antiproteinuric Effect of Naproxen and Indomethacin

Vriesendorp¹,

Donker²,

Zeeuw

et al. 1985

Am J Nephrol

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In a double-blind crossover study in 10 salt-depleted nephrotic patients the reduction of proteinuria was significantly larger during indomethacin 50 mg three times daily than during naproxen 250 or 500 mg three times daily (72 vs. 44%, p < 0.05; 77 vs. 46%, p < 0.05, respectively). Both drugs induced similar reversible intrarenal hemodynamic changes, but indomethacin had more pronounced effects than naproxen. A common pathway, such as the reduction of the glomerular filtration rate and a reduction of the glomerular transcapillary hydraulic pressure, is likely to explain the observed phenomena and is most probably mediated by inhibition of intrarenal prostaglandin synthesis. If treatment with a nonsteroidal anti-inflammatory drug is considered in patients with the idiopathic nephrotic syndrome, indomethacin appears up to now the most effective agent in reducing urinary protein loss.

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Section: Discussionmentioning

confidence: 82%

Antiproteinuric Effect of Naproxen and Indomethacin

Vriesendorp¹,

Donker²,

Zeeuw

et al. 1985

Am J Nephrol

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“…Thus Cattran et al [27] were not able to find any influence on the natural course of the disease in a recently published controlled study exactly using the treatment regimen recommended by Kincaid-Smith [10]. On the other hand, Zimmerman et al [28] and Donadio et al [29] observed an improvement of the prognosis merely by simultaneous administration of warfarin/dipyridamole or dipyridamole/acetylsalicylic acid, without cyclophosphamide. Good results were also achieved with indomethacin [30,31] or an alternateday steroid treatment [32].…”

Section: Discussionmentioning

confidence: 97%

Long-Term Prognosis of Membranoproliferative Glomerulonephritis Type I

Schmitt

Böhle

Reineke³

et al. 1990

Nephron

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A b stra c t. We carried out a retrospective investigation in 220 patients to assess the influence of various parameters on the long-term course of membranoproliferative glomerulonephritis (MPGN) type 1.50 patients (23%) died during the follow-up period of 59 months on average, in another 57 (26%) end-stage renal failure developed. 54 patients (24%) suffered from chronic renal failure, stable renal function (creatinine below 1.3 mg/dl) was preserved in 59 patients (27%).5 years after biopsy 49% of the patients had already died or needed regular dialysis treatment; after 10 years this proportion increased to 64%. Morphological findings: The outcome was with the exception of focal crescent formations -not determined by the severity of glomerular changes ; the survival rate, however, decreased significantly, if tubulointerstitial lesions were present as defined by acute renal failure, interstitial fibrosis ora combination of both. Clinical parameters; A progressive deterioration of renal function and an increasing number of renal deaths was noticed, when elevated serum creatinine levels at the time of biopsy and high blood pressure values during the follow-up period were observed. 26 patients died from hypertension, 18 of whom before reaching end-stage renal failure. Nephrotic syndrome and the degree of proteinuria as well as antiphlogistic and immunosuppressive treatment did not influence the prognosis of MPGN type 1.Studies on the long-term course of membranoprolifer ative glomerulonephritis (MPGN) have previously been carried out only on small numbers of cases, due to the rarity of the disease [1 13]. The prognosis is generally considered unfavorable [1-16], but there is still uncer tainty about the factors causing the progression to endstage renal failure or even death of the patient. In earlier investigations [14,[17][18][19] we noticed certain correlations between the severity of tubulointerstitial changes at the time of biopsy and renal function in MPGN. Therefore we were interested in determining whether, and to what extent, these changes as well as the clinical parameters blood pressure (BP), creatinine, proteinuria and hematu ria are of prognostic significance.1 Supported by the Deutsche Forschungsgemeinschaft (DFG). Material and MethodsAmong 36000 patients in our renal biopsy registry we found 346 in whom idiopathic MPGN was diagnosed between 1965 and 1984. By further investigations (immunohistology, electron microscopy) 108 patients had to be excluded from our study because primary diagnosis was not correct. They either suffered from other renal disorders (endocapillary/mesangioproliferative/membranous glo merulonephritis) or renal involvement due to underlying diseases such as lupus erythematodes, cryoglobulinemia and monoclonal gammopathy/multiple myeloma: 18 patients with MPGN type II (dense deposits) were also excluded. In the remaining 220 cases (male:female ratio = 1.75:l: mean age 36.4± 15.5 years) the lightmicroscopic diagnosis of MPGN was confirmed and type I (subendothelial deposits) could be ...

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“…In experimental mouse models and patients with different types of glomerulonephritis platelets accumulate in the kidneys and/or platelet-derived factors are systemically elevated (21,22,105–108). Accordingly, some clinical studies (using only a small patient cohort, however) show beneficial effects of anti-platelet therapy in glomerulonephritis patients by reducing circulating platelet aggregates, albuminuria and/or glomerular filtration rate (109–113) and anti-platelet drugs are indeed commonly prescribed in Japanese hospitals to patients with IgA nephropathy (114). The contribution of platelets in the induction of renal inflammation via direct interactions with leukocytes is further supported by the requirement of platelet P-selectin for neutrophil recruitment and/or neutrophil-mediated injury in experimental acute postischemic renal failure (115) and glomerulonephritis (21,22).…”

Section: Platelet-leukocyte Interactions In Pathologic Conditionsmentioning

confidence: 99%

Measuring and interpreting platelet-leukocyte aggregates

et al. 2018

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Platelets, besides their specialised role in haemostasis and atherothrombosis, actively modulate innate and adaptive immune responses with crucial roles in immune surveillance, inflammation and host defence during infection. An important prerequisite for platelet-mediated changes of immune functions involves direct engagement with different types of leukocytes. Indeed, increased platelet-leukocyte aggregates (PLAs) within the circulation and/or locally at the site of inflammation represent markers of many thrombo-inflammatory diseases, such as cardiovascular diseases, acute lung injury, renal and cerebral inflammation. Therefore, measurement of PLAs could provide an attractive and easily accessible prognostic and/or diagnostic tool for many diseases. To measure PLAs in different (patho-)physiological settings in human and animal models flow cytometric and microscopic approaches have been applied. These techniques represent complementary tools to study different aspects relating to the involvement of leukocyte subtypes and molecules, as well as location of PLAs within tissues, dynamics of their interactions and/or dynamic changes in leukocyte and platelet behaviour. This review summarises various approaches to measure and interpret PLAs and discusses potential experimental factors influencing platelet binding to leukocytes. Furthermore, we summarise insights gained from studies regarding the underlying mechanism of platelet-leukocyte interactions and discuss implications of these interactions in health and disease.

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Prospective trial of warfarin and dipyridamole in patients with membranoproliferative glomerulonephritis

Cited by 96 publications

References 10 publications

Antiproteinuric Effect of Naproxen and Indomethacin

Antiproteinuric Effect of Naproxen and Indomethacin

Long-Term Prognosis of Membranoproliferative Glomerulonephritis Type I

Measuring and interpreting platelet-leukocyte aggregates

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