This ASN, there was a series of talks regarding complement glomerulopathy and the use of certain newer agents for treatment. Dr Licht discussed this in detail in one of the talks.
Bottom line
1. MPGN pattern of injury is seen in complement related glomerular diseases.
2. DDD is now part of C3 glomerulopathies
3. Complement factor H antibodies, complement factor B antibodies have been associated with C3 glomerular disease since they will enhance c3 conversion and eventually affect the alternate pathway.
4. Genetic forms such as mutations in Factor H, CFHR5, C3 polymorphisms were also noted in that case.
5. It is possible that what we used to call perhaps C3 only post infectious GN or resolving post infectious GN was really C3 glomerulopathy.
6. Treatment is plasma exchange as there might be antibody that exists ( if you think there is)
7. Complement inhibition is the key- and the only drug we have is eculizumab ( 4 doses 900mg IV per week and 1200mg per week following that for 4 doses):- but expensive
8. Overall, there is a paradigm shift happening in introduction of these disorders.
Showing posts with label extracorporeal treatments. Show all posts
Showing posts with label extracorporeal treatments. Show all posts
Tuesday, November 15, 2011
Wednesday, June 1, 2011
IN THE NEWS: EXRTIP
What is EXTRIP? It is a workforce in extracorporeal treatments in poisoning that is comprised of nephrologists and toxicologists to come up with evidence based data to treat common poisonings. There are no randomized trials in poisonings to define the role of dialysis properly. Most of the data out there is based on opinions and hence there is always disagreements.
Randomized trials in poisonings are hard to design. Few reasons are consenting, rare disease category, heterogeneous patients, mortality is low. The workforce will address how to even conduct proper trials in poisonings. Hemodialysis is a valuable tool used in it but indications are very often based on perhaps erroneous toxicokinetics or clinical assumptions. An entire journal of ACKD was recently dedicated to this topic
A must read for all for a topic that has lost it's flavour amongsts nephrologists
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/21531321
Randomized trials in poisonings are hard to design. Few reasons are consenting, rare disease category, heterogeneous patients, mortality is low. The workforce will address how to even conduct proper trials in poisonings. Hemodialysis is a valuable tool used in it but indications are very often based on perhaps erroneous toxicokinetics or clinical assumptions. An entire journal of ACKD was recently dedicated to this topic
A must read for all for a topic that has lost it's flavour amongsts nephrologists
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/21531321
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