A patient with persistent renal AL amyloid deposition after clinical remission by HDM/SCT therapy.
Abstract A 62-year-old female patient was admitted to our hospital for evaluation of nephrotic syndrome. Monoclonal gammopathy (IgG λ type) and urinary Bence Jones proteins were detected in the serum and urine by the immunofixation method. The initial renal biopsy revealed amyloid deposition in mesangial area, glomerular capillary walls and arterioles by Congo-red staining, and amyloid fibers were detected by electron microscopy. On the bone marrow test, plasma cells accounted for 8.6%. Based on these findings, we diagnosed as AL amyloidosis associated with multiple myeloma. We treated her by high-dose intr...
Source: Clinical Nephrology - March 1, 2013 Category: Urology & Nephrology Authors: Okuyama H, Yamaya H, Fukusima T, Yokoyama H Tags: Clin Nephrol Source Type: research

A purpose-built simulator for percutaneous ultrasound-guided renal biopsy.
Conclusions: We describe a purpose-built and affordable simulator for percutaneous ultrasound-guided renal biopsy. We suggest that others evaluate our simulator used as part of a structured approach to teach this important procedure. PMID: 23439245 [PubMed - in process] (Source: Clinical Nephrology)
Source: Clinical Nephrology - March 1, 2013 Category: Urology & Nephrology Authors: Woywodt A, How T, Schulz M Tags: Clin Nephrol Source Type: research

The renoprotective effect of cGMP phosphodiesterase inhibitor and nitroprusside in a rat model of cyclosporin A-induced nephrotoxicity.
Conclusion: The udenafil and nitroprusside ameliorated renal injury in rat model of CsA nephrotoxicity. The mechanism appears to be associated with decreasing tubular apoptosis by decreasing eNOS and increasing VEGF. PMID: 23442254 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 26, 2013 Category: Urology & Nephrology Authors: Yang JW, Kim JS, Kim MK, Lee JY, Han BG, Choi SO Tags: Clin Nephrol Source Type: research

Effect of rosuvastatin and sevelamer on the progression of coronary artery calcification in chronic kidney disease: a pilot study.
Abstract Introduction: Coronary artery calcification (CAC) is highly prevalent among chronic kidney disease (CKD) patients and its strong association with mortality has been recognized early in the course of CKD. The aim of the present study was to test the effect of rosuvastatin and sevelamer hydrochloride on the progression of CAC in nondialyzed CKD patients. Methods: An open-label, randomized and controlled pilot study was conducted including 117 CKD patients (62% men, 56.9 ± 11.2 years, eGFR 36 ± 16.5 ml/min). Patients were randomly assigned to rosuvastatin (n = 38; 10 mg/day), to sevelamer hydro...
Source: Clinical Nephrology - February 26, 2013 Category: Urology & Nephrology Authors: Lemos MM, Watanabe R, Carvalho AB, Jancikic AD, Sanches FM, Christofalo DM, Draibe SA, Canziani ME Tags: Clin Nephrol Source Type: research

Smoking as the potential link between Kimmelstiel-Wilson lesion and non-diabetic nodular glomerulosclerosis in male patients - a single center retrospective study.
Conclusions: We propose that chronic cigarette smoking could play a pivotal role in the development of KW lesions. PMID: 23442256 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 26, 2013 Category: Urology & Nephrology Authors: Halmai R, Degrell P, Szijártó IA, Mátyás V, Molnár GA, Kovács T, Wittmann I Tags: Clin Nephrol Source Type: research

Transition from endocapillary proliferative glomerulonephritis to membranoproliferative glomerulonephritis in a patient with a prolonged human parvovirus B19 infection.
We report a case in which renal biopsies were performed 4 years apart in a woman with a prolonged human parvovirus B19 (HPB19) infection. When she was 29 years old the first biopsy, performed because of microscopic hematuria and mild proteinuria, showed endocapillary and mesangial proliferative glomerulonephritis in light microscopy as well as deposits of immunoglobulins (Igs) and complement C3 on capillary walls. Mesangial, intramembranous, and subepithelial hump-like electron dense deposits were seen in electron microscopy. The principal differential diagnoses, acute poststreptococcal glomerulonephritis and lupus nephrit...
Source: Clinical Nephrology - February 26, 2013 Category: Urology & Nephrology Authors: Uchida T, Oda T, Watanabe A, Yamamoto K, Katsurada Y, Shimazaki H, Tamai S, Kumagai H Tags: Clin Nephrol Source Type: research

Malnutrition-inflammation score predicts long-term mortality in Chinese PD patients.
Abstract Background: Malnutrition-Inflammation Score (MIS) has proved to predict the prospective mortality in maintenance hemodialysis (MHD) patients. However, its value of long-term mortality predictability in peritoneal dialysis (PD) patients has not been adequately studied. Methods: A total of 155 chronic stable PD patients from November 2005 to December 2006 were enrolled. At baseline, the MIS, Subjective Global Assessment (SGA), as well as clinical, laboratory, and anthropometric parameters were recorded. All patients were followed until October 2009 to evaluate mortality as a primary outcome. Results: The MI...
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: He T, An X, Mao HP, Wei X, Chen JH, Guo N, Yang X, Li ZB, Yu XQ, Li ZJ Tags: Clin Nephrol Source Type: research

ESA therapy - the quest continues: anemia treatment following recent national and international recommendations 2011 and 2012.
Abstract The development of ESAs (Erythropoiesis Stimulating Agents) revolutionized the treatment of renal anemia. However, the initial euphoria has abated and, in the last few years, studies have shown that ESAs should not be administered without caution as the rate of cardiovascular events and possibly tumor related deaths may increase with over-augmented hemoglobin levels. Renal anemia therapy is discussed against the background of recent decisions to lower the recommended hemoglobin target ranges in chronic kidney disease (CKD) patients on ESAs, thus, necessitating a redefinition of treatment quality criteria ...
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Biggar P, Ketteler M Tags: Clin Nephrol Source Type: research

A 7-year-old boy with renal insufficiency and proteinuria after stem cell transplant for T-cell acute lymphoblastic leukemia.
Abstract Chronic kidney disease is common in pediatric patients following hematopoietic stem cell transplant. Its etiology is likely multifactorial and depends both on pre-conditioning regimens as well as immunosuppressive therapy and posttransplant prophylactic medications. Graft vs. host disease (GVHD) is a common sequela of hematopoietic stem cell transplant and has been associated with the nephrotic syndrome (NS). Here we report a case of a pediatric patient who developed proteinuria and renal insufficiency after stem cell transplant. A kidney biopsy showed chronic interstitial nephritis and extensive foot pro...
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Goodwin JE, Palmer M, Pashankar F, Tufro A, Moeckel G Tags: Clin Nephrol Source Type: research

The effect of phosphate binders, calcium and lanthanum carbonate on FGF23 levels in chronic kidney disease patients.
Conclusions: In conclusion, in CKD 4 - 5 patients lanthanum carbonate is effective in reducing phosphate load and FGF23 levels; this effect was not observed with calcium carbonate. PMID: 23391319 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Soriano S, Ojeda R, Rodríguez M, Almadén Y, Rodríguez M, Martín-Malo A, Aljama P Tags: Clin Nephrol Source Type: research

Clinical and prognostic implications of serum uric acid levels on IgA nephropathy: a cohort study of 348 cases with a mean 5-year follow-up.
Abstract Aim: To assess the prognostic implications of serum uric acid levels on patients with IgA nephropathy in a longitudinal 8-year follow-up study and to identify an association between serum uric acid levels and the clinical and pathological phenotypes of IgA nephropathy. Subjects and methods: We reviewed the files of all consecutive patients with IgA nephropathy treated at our hospital between 2001 and 2009. Analyses were performed to investigate the association between the level of serum uric acid and both clinical and pathological phenotypes of IgA nephropathy. Prognosis was assessed based on follow-up da...
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Cheng GY, Liu DW, Zhang N, Tang L, Zhao ZZ, Liu ZS Tags: Clin Nephrol Source Type: research

A simple screening test for the detection of erythropoietin antibodies.
Abstract Antibody-mediated pure red cell aplasia (PRCA) is a rare complication of erythropoietin (EPO) therapy. Identification and demonstration of functional activity of EPO antibodies required to diagnose this condition is difficult and only performed in selected laboratories worldwide. In this article we report a recent cluster of three cases of antibody-mediated PRCA over a 16-month period in a single center associated with EPREX use. We also describe the use of a simple low-cost inhibitor assay that can be used to screen for PRCA in local laboratories. PMID: 23391321 [PubMed - as supplied by publisher] (...
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Meran S, Wonnacott A, Davies M, Ellis R, Phillips A Tags: Clin Nephrol Source Type: research

Familial LCAT deficiency in a child with nephrotic syndrome.
Conclusion: Although rare, LCAT deficiency should be in the differential diagnosis of nephrotic syndrome in the setting of abnormally low HDL cholesterol levels. PMID: 23391322 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 8, 2013 Category: Urology & Nephrology Authors: Rajpal JS, Mapellentz J, Mancera AD, Reed RC, Kim Y, Chavers BM Tags: Clin Nephrol Source Type: research

The clinical course and long-term outcome of primary focal segmental glomerulosclerosis in Chinese adults.
Conclusion: TW is a new potential treatment for steroid-resistant nephrotic FSGS. The 5-year renal outcome in adults with primary FSGS in China is better in comparison to the west. Severe proteinuria, CKD with AKI, chronic tubulointerstitial injury, and no response were independent risk factors of prognosis. PMID: 23380386 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Tang X, Xu F, Chen DM, Zeng CH, Liu ZH Tags: Clin Nephrol Source Type: research

Treatment of childhood nephrotic syndrome with long-term, low-dose tacrolimus.
Abstract Aim: Children with steroidresistant (SR) and steroid-dependent (SD) nephrotic syndrome (NS) pose a treatment challenge. Literature on the use of tacrolimus (TAC), a calcineurin inhibitor, for maintenance treatment of NS is sparse. We aimed to evaluate the efficacy and safety of low-dose, long-term TAC for inducing and sustaining remission in children with SD/SR NS. Methods: Data from patients treated at our center from 1999 to 2009 were analyzed. Results: 40 patients with NS were treated with TAC for 3 - 80-month periods (median 25.2 months). Diagnoses included focal segmental glomerulosclerosis (FSGS) (6...
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Bock ME, Cohn RA, Ali FN Tags: Clin Nephrol Source Type: research

Unexplained severe acute kidney injury with rapid recovery of kidney function 11 months later after the start of high-dose steroid therapy.
Abstract Our patient appears to represent a previously unrecognized variant of steroid-responsive minimal change disease (MCD)/focal and segmental glomerulosclerosis (FSGS) in which severe AKI developed even though the serum albumin was essentially normal and proteinuria was minimal. This would be a paradox because the AKI of MCD/FSGS is a manifestation of severe nephrotic syndrome. To explain this paradox, it is suggested that our patient is a rare variant of a phenomenon that is well documented in steroid-responsive MCD/FSGS, specifically, glomerular permeability to large molecules is increased (accounting for t...
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Roncone D, Rovin B, Falk R, Nicely C, Nadasdy T, Parikh S, Hebert LA Tags: Clin Nephrol Source Type: research

Idiopathic membranous nephropathy and IgG4: an interesting relationship.
Abstract Idiopathic membranous nephropathy (iMN) is a single-organ autoimmune disease characterized by subepithelial deposition of immune complexes containing IgG4 resulting in proteinuria, nephrotic syndrome, and, in some, end-stage renal disease. The pathogenesis involves a chronic IgG4 response against specific podocyte antigens which have now been at least partially defined in the neonatal, early childhood, and adult varieties. More has recently been learned about the genetic predisposition as well. This review discusses the pathophysiology of iMN in light of these discoveries and what is known about the genes...
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Filippone EJ Tags: Clin Nephrol Source Type: research

Interferon-α for IgM nephropathy?
We describe a patient with IgM nephropathy represented by recurrence of nephrotic syndrome who achieved longterm remission with interferon-α sustained treatment. PMID: 23380390 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Liu S, Zhang D, Zhang Q, Liu W Tags: Clin Nephrol Source Type: research

Adult hemolytic uremic syndrome associated with Streptococcus pneumoniae.
We report a case of an adult presenting with pneumococcal pneumonia complicated by HUS and required renal replacement therapy.Immunoglobulin M (IgM) nephropathy is an idiopathic glomerulonephritis characterized by mesangial deposits of IgM. IgM nephropathy presenting with proteinuria, especially nephrotic syndrome, frequently is steroid-dependent or steroidresistant and associated with reaching endstage renal disease after a 15-year follow-up. Because no long-term effective treatment is known for patients with IgM nephropathy, there is a clear need for therapeutic alternatives. We describe a patient with IgM nephropathy re...
Source: Clinical Nephrology - February 5, 2013 Category: Urology & Nephrology Authors: Allen JC, McCulloch T, Kolhe NV Tags: Clin Nephrol Source Type: research

Advanced native kidney renal cell carcinoma in renal transplant recipients: role of sirolimus as dual anti-cancer and anti-rejection agent.
We describe 2 cases of advanced renal cellcarcinoma of native kidneys in renal transplantrecipients and present our experiencewith sirolimus as a dual immunosuppressiveand anti-tumor agent. PMID: 23364206 [PubMed - in process] (Source: Clinical Nephrology)
Source: Clinical Nephrology - February 1, 2013 Category: Urology & Nephrology Authors: Javaid MM, Chowdhury S, Henderson A, Olsburgh J Tags: Clin Nephrol Source Type: research

A case of IgA nephropathy associated with mycosis fungoides that developed into rapidly progressive glomerulonephritis.
Abstract A 53-year-old Japanese malewas diagnosed with atopic dermatitis and initiatedtreatment with a local dermatologist inFebruary 2001. A routine medical check-uprevealed proteinuria, microscopic hematuriaand slight elevation of serum creatinine levelin spring 2006. He was referred to our hospitalfor nephrology consultation and followup.In December 2009, he developed a suddenhigh fever of greater than 39 °C with sorethroat. In addition, his serum creatinine levelgreatly increased to 4.6 mg/dl. His prevalentrenal illness was thought to be rapidly progressiveglomerulonephritis (RPGN). Soonafter admission, ki...
Source: Clinical Nephrology - February 1, 2013 Category: Urology & Nephrology Authors: Hara M, Nemoto T, Hijima T, Tsuchiya K, Nitta K, Ando M Tags: Clin Nephrol Source Type: research

Factitious proteinuria - the most dominant feature in a young female patient with Munchausen syndrome.
We report the case of a young femalepatient with factitious proteinuria in thenephrotic range and a fairly eventful medicalhistory. After performing many expensive andunnecessary investigations and procedures,the real origin of the proteinuria was determined;it was found to be caused by the patientcarefully adding calibrated egg albuminto her urine samples. This discovery rousedsuspicions about multiple, non-corroboratedconditions from her history (e.g., multiplemiscarriages, breast cancer, and thyroid disorders).The diversity of diseases presented by asingle Munchausen patient tends to be bizarre,and thus is a challenge f...
Source: Clinical Nephrology - February 1, 2013 Category: Urology & Nephrology Authors: Lela IV, Karanovic S, Matišic D, Kuzmanic D, C Oric M, Simic M, Jelakovic B Tags: Clin Nephrol Source Type: research

Goodpasture's syndrome with concomitant immune complex mixed membranous and proliferative glomerulonephritis.
In this report, for the first time we describe in a 21-year-old woman GP syndrome with 50% crescentic sclerosing glomerulonephritis with linear immunofluorescence characteristic of anti-GBM pathogenesis, combined with mixed membranous and membranoproliferative glomerulonephritis with granular immunofluorescence and subepithelial, mesangial and subendothelial deposits characterizing immune complex pathogenesis. The clinical picture was also unusual for GP syndrome, manifesting a recurrent but non-progressive course, nephrotic syndrome, normal renal function and low values of anti-GBM antibodies, identified only by novel mor...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Jurcic V, Vizjak A, Rigler AA, Jeruc J, Wieslander J, Ferluga D Tags: Clin Nephrol Source Type: research

Elevated serum Cystatin C at continuous renal replacement therapy initiation predicts lack of renal recovery.
Abstract Background and objective: Serum Cystatin C (sCyC) has been associated with renal function, and it rises earlier than creatinine after renal injury. However, its role in predicting renal recovery in critically ill patients after continuous renal eplacement therapy (CRRT) remains untested. The study aimed to investigate the association of CyC with renal recovery in critically ill patients requiring CRRT. Methods: Medical charts of AKI patients that had been admitted to a tertiary 15-bed intensive care unit from January 2006 to January 2008 were reviewed. Renal recovery was defined as the return to pre-morbi...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Zhang Z, Ni H, Lu B, Jin N Tags: Clin Nephrol Source Type: research

High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury.
Conclusion: We concluded that intravenous high dose epoetin does not acutely increase blood pressure, suggesting no acute vasoconstrictor effect in this setting. PMID: 23320967 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Ralib AM, Pickering JW, Major T, Palmer SC, Shaw GM, Goodkin DA, Endre ZH Tags: Clin Nephrol Source Type: research

What can we learn from a patient on dialysis for 42 years?
Abstract We performed autopsy on a 60-year-old Japanese man who had received dialysis for 42 years. He started on intermittent peritoneal dialysis in 1968, which was combined with hemodialysis in 1969. His serum calcium-phosphate balance and his blood pressure had been controlled well. Carpal tunnel syndrome occurred in 1984. Then lumbar spinal canal stenosis (SCS) occurred in 1997, followed by cervical SCS in 2000, destructive lumbar spondyloarthropathy (DSA) in 2002, and pathological fracture of the right femoral neck due to an enlarging bone cyst in 2006. All of his surgical specimens showed dialysis-related de...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Suwabe T, Ubara Y, Inoue M, Kitajima I, Oohashi K, Nakano I, Takaichi K Tags: Clin Nephrol Source Type: research

Hemolytic uremic syndrome associated with Clostridium difficile infection.
We report 3 cases of Clostridium difficile-associated hemolytic uremic syndrome (HUS) with biopsy proven renal thrombotic microangiopathy. Two patients with acute renal failure were kidney transplants recipients whereas the third patient developed renal failure in the native kidneys. The presentation was preceded by acute diarrhea and stool. Clostridium difficile toxin was detected in all the 3 patients. Stool studies were negative for Escherichia coli, Shigella dysenteriae and other enteric pathogens. The diagnosis of Clostridium difficile-associated hemolytic uremic syndrome was suspected due to presence of thrombocytope...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Alvarado AS, Brodsky SV, Nadasdy T, Singh N Tags: Clin Nephrol Source Type: research

New onset hypertension following abrupt discontinuation of citalopram.
We present a 48-year-old woman who developed sustained hypertension closely associated with abrupt cessation of citalopram (40 mg twice daily), in addition to the known withdraw symptoms. Re-initiation of the medication completely abolished the symptoms and normalized her blood pressure. Pre-clinical studies show that chronic citalopram use inhibits the activity of noradrenergic neurons, and abrupt removal of such inhibition could cause adrenergic hyperactivation. We postulate this mechanism might account for or contribute to the hypertension observed in our patient. As illustrated in this case, the degree of hypertension ...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Astorne Figari WJ, Herrmann S, Akogyeram C, Qian Q Tags: Clin Nephrol Source Type: research

Henoch-Schönlein purpura-like presentation in IgA-dominant Staphylococcus infectionassociated glomerulonephritis - a diagnostic pitfall.
Conclusion: In adult patients with an HSPlike presentation, a high index of suspicion for underlying Staphylococcal infection is warranted. Blood cultures are frequently negative. Cultures from the site of infection should be performed. Steroid treatment did not improve outcomes. Renal outcomes were frequently poor. PMID: 23320971 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Satoskar AA, Molenda M, Shim R, Zirwas M, Variath RS, Brodsky SV, Nadasdy GM, Hebert L, Rovin B, Nadasdy T Tags: Clin Nephrol Source Type: research

Electronic health records: a new tool to combat chronic kidney disease?
Abstract Electronic health records (EHRs) were first developed in the 1960s as clinical information systems for document storage and retrieval. Adoption of EHRs has increased in the developed world and is increasing in developing countries. Studies have shown that quality of patient care is improved among health centers with EHRs. In this article, we review the structure and function of EHRs along with an examination of its potential application in CKD care and research. Well-designed patient registries using EHRs data allow for improved aggregation of patient data for quality improvement and to facilitate clinica...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Navaneethan SD, Jolly SE, Sharp J, Jain A, Schold JD, Schreiber Jr MJ, Nally Jr JV Tags: Clin Nephrol Source Type: research

Effectiveness of treatment with oral paricalcitol in patients on peritoneal dialysis: a Spanish multicenter study.
;s M, González T Abstract Aims: Recently, oral form of paricalcitol has allowed extension of treatment to ambulatory patients on peritoneal dialysis but few data have been published about the benefits of paricalcitol in this subgroup. A multicenter, retrospective study was carried out to increase current knowledge on the effectiveness and safety of paricalcitol in 162 peritoneal dialyzed patients with secondary hyperparathyroidism. Methods: Case histories of patients treated with paricalcitol for at least 6 months were reviewed to extract data on 12 biochemical parameters related to bone disease and health ...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Ramos R, Fontán MP, Sánchez E, Bajo A, Barbosa F, Borràs M, González T Tags: Clin Nephrol Source Type: research

The changing pattern of glomerular disease in HIV and Hepatitis C co-infected patients in the era of HAART.
We describe the renal biopsy findings and renal outcome in 29 co-infected patients in the HAART era and compare them to findings in 14 historical controls reported from our institution in the pre-HAART era. Our present cohort was predominantly male and Black with the majority reporting a history of intravenous (i.v.) drug use. Renal biopsy findings included 16 patients with immune complex mediated glomerular disease and 14 patients with FSGS, of which only 3 had collapsing features and/or tubular microcysts typical of HIVAN. Five patients had other biopsy diagnoses not directly related to viral infection. Median renal surv...
Source: Clinical Nephrology - January 15, 2013 Category: Urology & Nephrology Authors: Mohan S, Herlitz LC, Tan J, Cheng JT, Anderson HL, Stokes MB, Markowitz GS, D'Agati VD, Radhakrishnan J Tags: Clin Nephrol Source Type: research

Resolution of epoetin-induced pure red cell aplasia 2 years later, successful re-challenge with continuous erythropoiesis receptor stimulator.
We report a young hemodialysis patient who developed PRCA 2 years after receiving intravenous epoetin-β. Epoetin- induced PRCA was confirmed by bone marrow aspiration, associated with markedly elevated anti-erythropoietin antibody. He was treated with prednisolone and cyclophosphamide for 3 months but continued to be transfusion-dependent. 17 months after the development of PRCA, he was started on intravenous continuous erythropoiesis receptor stimulator (CERA) in view of frequent transfusions. He tolerated the CERA injection well and the hemoglobin level stabilized 7 months later. Repeat bone marrow aspiration confir...
Source: Clinical Nephrology - January 8, 2013 Category: Urology & Nephrology Authors: Lim SK, Bee PC, Keng TC, Chong YB Tags: Clin Nephrol Source Type: research