The most common glomerular disease in the >80 age group is ANCA associated vasculitis and usually anti MPO in nature. This is now well established. A Recent paper in Kidney International retrospectively looks at treatment of this entity in this age group. Many of us would not treat given the heavy immunosuppresive burden and anticipating increase risk. The investigators in this study, looked at 78 cases that were biopsy proven ANCA vasculitis and showed that the patients with treatment with the agents had a significant lower incidence of ESRD 1 year biopsy with significant p value. No difference in terms of mortality between the two groups in one year. When followed for 2 years, the immunosuppresive group had a better advantage.
Only 35% had extra renal involvement, so most were pure renal involved vasculitis
70% were anti MPO
Majority of them were caucasian
15% had cancer(at the time diagnosed)
58% of the treated group got Steroids + PO cytoxan
24% got IV cytoxan + steroids, few got MMF
Majority, 34% had no maintenance, Followed by steroids alone and steroids + cytoxan.
Infection was higher in treatment arm.
No particular regimen is suggested from this article, just that immunosuppresion will help in the long run.
Check it out
- ► 2017 (48)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Fascinating Wordle in AJT 2011
- NKF 2011 Live Blogging from Nephrology on Demand
- TOPIC DISCUSSION: Vascular Amyloidosis and the Kid...
- NKF 2011 Live Blogging: Integrating the treatment ...
- TOPIC DISCUSSION: TMA ( AJKD tells the tale of 2 d...
- Nephron Animation website
- CONSULT ROUNDS: Renal Involvement in Bardet-Biedl ...
- USA-Nephronpower Wordle( Nephrology Rules)
- Dichotomous Effects of Rapamycin
- TOPIC DISCUSSION: The impact of stopping inhibitor...
- Health News - Research brings new hope of renal re...
- AJP Podcasts
- IN THE NEWS--> Salt sensitive HTN and temperature?...
- TOPIC DISCUSSION: Renal Denervation for Treatment ...
- CONSULT ROUNDS: Pre Eclampsia
- Online CME resource( Nephrology)
- Pediatrics Grand rounds continue
- TOPIC DISCUSSION: Hypophosphatemia in Nocturnal he...
- Journal CLUB: Pediatric Nephrology
- IN THE NEWS--> Statins and the Kidney after surger...
- Arteries and Kidney Transplant
- Pancreas Transplantation in the Treatment of Diabe...
- IN THE NEWS -MDR-1 polymorphisms in steroid resist...
- TOPIC DISCUSSIONS: Glomerular Disease following co...
- May 2011 Hofstra University Kidney Walk
- IN THE NEWS:- RENALASE and CKD
- Transplant Tourism and Malignancy
- IN THE NEWS --->Innovative tools in nephrology su...
- TOPIC DISCUSSION: Rheumatoid Arthritis and the Kid...
- Cystic Diseases of the Kidney: A primer
- CLINICAL CASE 35, ANSWERS AND SUMMARY
- Submit Kidney Week 2011 Abstracts
- IVIG - how does it work from the Immunology blog?
- JOURNAL CLUB: CHOICE STUDY
- IN THE NEWS- ANCA in the Elderly
- Medicine for residents: Calcium gluconate in a dig...
- IN THE NEWS--> Detective Nephron's next venture
- Neutropenia from Tacrolimus
- IN THE NEWS-- Serum Bilirubin and chronic dialysis...
- ▼ April (39)
- ► 2010 (461)