The Effect of Low-Dose Corticosteroids on Short- and Long-Term Renal Outcome in Patients with Cholesterol Crystal Embolism

被引:26
|
作者
Nakayama, Masaru [1 ,2 ]
Izumaru, Kensuke [2 ]
Nagata, Masaharu [3 ]
Ikeda, Hirofumi [2 ]
Nishida, Kanako [2 ]
Hasegawa, Eri [2 ,4 ]
Ohta, Yuko [2 ,4 ]
Tsuchihashi, Takuya [2 ,4 ]
Urabe, Kazunori
机构
[1] Natl Kyushu Med Ctr Hosp, Div Nephrol, Dept Internal Med, Chuo Ku, Fukuoka 8108563, Japan
[2] Natl Kyushu Med Ctr Hosp, Clin Res Inst, Dept Internal Med, Fukuoka 8108563, Japan
[3] Kyushu Univ, Dept Med & Clin Sci, Grad Sch Med Sci, Fukuoka 812, Japan
[4] Natl Kyushu Med Ctr Hosp, Div Hypertens, Dept Internal Med, Fukuoka 8108563, Japan
关键词
Cholesterol crystal embolism; renal failure; steroid therapy; renal outcome; eosinophilia; ATHEROMATOUS EMBOLISM; DISEASE; FAILURE; EMBOLIZATION;
D O I
10.3109/0886022X.2011.560403
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: The effect of corticosteroids on renal cholesterol crystal embolism (CCE) remains uncertain. The aim of the present study was to elucidate the effect of steroid therapy on short- and long-term renal outcome in CCE patients. Methods: Fifty-one patients diagnosed with renal CCE were included in this retrospective study. The patients were divided into two groups according to whether or not they had received steroid therapy (steroid therapy (+), n = 32; (-), n = 19). Corticosteroids were administered at an initial dose of 10-20 mg/day after CCE diagnosis. The values of the estimated glomerular filtration rate (eGFR) in the two groups were examined at CCE diagnosis, 4 weeks after diagnosis and the last follow-up. Additionally, the % change in eGFR at 4 weeks after diagnosis and % change per year in eGFR at the last follow-up were calculated for each patient. Results: The median values of eGFR at diagnosis in patients with and without steroid therapy were 16.4 and 17.9 mL/min/1.73 m(2), respectively. The median % change in eGFR between diagnosis and 4 weeks after diagnosis was 24% in patients with steroid therapy and 5% in those without, and this difference was statistically significant. On the other hand, there was no significant difference between the two groups in the % change in eGFR per year between diagnosis and the last follow-up. Conclusions: During the short period after CCE diagnosis, steroid therapy showed a good renal outcome in CCE patients. However, this treatment did not have a favorable effect on long-term renal outcome.
引用
收藏
页码:298 / 306
页数:9
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