Abstract | AIMS: PATIENTS AND METHODS: 7 patients (mean age 69 years) diagnosed with CCE-related ARF were treated with oral PS at 15-20 mg/day for 2-4 weeks, which was then tapered at 5 mg/day over 2-4 weeks, followed by 5 mg/day maintenance dose. Recurrent ARF during PS tapering was treated with a larger dose of PS. RESULTS: Inciting factors were identified in four patients: coronary angiography (n=3) and cerebral angiography (n=1). On admission, serum creatinine (SCr) was 2.1 +/- 0.3 mg/dl (mean +/- SEM). SCr and eosinophil count before treatment were 4.2 +/- 0.4 mg/dl and 682 +/- 73/microl, respectively. PS therapy improved ARF in all cases at week 2 (SCr 3.8 +/- 0.5 mg/dl) parallel to a decrease in eosinophilia (116 +/- 30/microl), and at week 4 (3.1 +/- 0.4 mg/dl and 134 +/- 20/microl, respectively). At last follow-up, renal function was improved or maintained in 5 patients compared with that at week 4 post-treatment. One patient died of lung cancer. Another required LDL apheresis and hemodialysis but died due to CCE-related multi-organ failure. A third patient had recurrent ARF and was re-treated with a larger dose of PS, which resulted in an immediate decrease in SCr. However, the patient developed acute renal dysfunction due to congestive heart failure, and required hemodialysis. CONCLUSIONS: Low-dose PS improved CCE-related ARF, probably through amelioration of inflammatory reaction surrounding affected renal vessels.
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Authors | M Nakayama, M Nagata, T Hirano, K Sugai, R Katafuchi, S Imayama, N Uesugi, T Tsuchihashi, H Kumagai |
Journal | Clinical nephrology
(Clin Nephrol)
Vol. 66
Issue 4
Pg. 232-9
(Oct 2006)
ISSN: 0301-0430 [Print] Germany |
PMID | 17063989
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Acute Kidney Injury
(drug therapy, etiology)
- Aged
- Aged, 80 and over
- Dose-Response Relationship, Drug
- Embolism, Cholesterol
(complications, drug therapy, pathology)
- Female
- Humans
- Kidney
(blood supply, pathology)
- Male
- Middle Aged
- Prednisolone
(administration & dosage)
- Skin
(blood supply, pathology)
- Treatment Outcome
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