Association between diuretic administration before diagnosis and incidence of acute kidney injury in patients with minimal change disease: A single-center observational study.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
07 May 2021
07 May 2021
Historique:
received:
01
12
2020
accepted:
18
04
2021
entrez:
5
5
2021
pubmed:
6
5
2021
medline:
21
5
2021
Statut:
ppublish
Résumé
We examined the association between diuretic administration before the diagnosis of minimal change disease and the incidence of acute kidney injury. Moreover, we examined whether the use of diuretics affected the time to complete remission in adults with such disease.The present study was a single-center, retrospective, observational cohort study. We included 107 patients with biopsy-proven minimal change disease who were treated at a tertiary referral center in Japan between January 1, 2000 and March 31, 2019. All biopsy specimens were examined by a board-certified renal pathologist. The patients were considered to have minimal change disease when the kidney biopsy specimen had no glomerular lesions or only mild focal mesangial prominence (not exceeding 3 or 4 cells per segment) by light microscopy and/or foot process effacement by electron microscopy. Logistic regression and Kaplan-Meier curve analyses were performed, comparing the data of patients who received diuretics or not.The median age was 47 (28-66) years, 52% of patients were women, and the median proteinuria dosage was 8.3 (5.3-11.2) g/d. When minimal change disease was diagnosed, 27% of patients were taking diuretics. Within 30 days after the diagnosis, acute kidney injury occurred in 27% of patients. On multivariable logistic regression analysis, the use of diuretics was significantly associated with a higher risk of acute kidney injury. The use of diuretics was also associated with a longer time to complete remission.Diuretic administration can be associated with an elevated acute kidney injury risk and longer remission time in adult patients with newly diagnosed minimal change disease.
Identifiants
pubmed: 33950999
doi: 10.1097/MD.0000000000025845
pii: 00005792-202105070-00087
pmc: PMC8104140
doi:
Substances chimiques
Diuretics
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25845Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Vivarelli M, Massella L, Ruggiero B, et al. Minimal change disease. Clin J Am Soc Nephrol 2017;12:332–45.
Waldman M, Crew RJ, Valeri A, et al. Adult minimal-change disease: clinical characteristics, treatment, and outcomes. Clin J Am Soc Nephrol 2007;2:445–53.
Crew RJ, Radhakrishnan J, Appel G. Complications of the nephrotic syndrome and their treatment. Clin Nephrol 2004;62:245–59.
Gupta S, Pepper RJ, Ashman N, et al. Nephrotic syndrome: oedema formation and its treatment with diuretics. Front Physiol 2019;9:1868.
Doucet A, Favre G, Deschênes G. Molecular mechanism of edema formation in nephrotic syndrome: therapeutic implications. Pediatr Nephrol 2007;22:1983–90.
Korbet SM, Whittier WL. Management of adult minimal change disease. Clin J Am Soc Nephrol 2019;14:911–3.
Ejaz AA, Mohandas R. Are diuretics harmful in the management of acute kidney injury? Curr Opin Nephrol Hypertens 2014;23:155–60.
Chen CL, Fang HC, Chou KJ, et al. Increased endothelin 1 expression in adult-onset minimal change nephropathy with acute renal failure. Am J Kidney Dis 2005;45:818–25.
Keskar V, Jamale TE, Kulkarni MJ, et al. Minimal-change disease in adolescents and adults: epidemiology and therapeutic response. Clin Kidney J 2013;6:469–72.
Von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 2014;12:1495–9.
Kdigo AK. Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012;2:01–38.
Matsuo S, Imai E, Horio M, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009;53:982–92.
Matuo S, Imai E, Saito T, et al. Guidelines for the treatment of nephrotic syndrome. Jpn J Nephrol 2011;53:79–122. (in Japanese).
American Diabetes Association. Executive summary: standards of medical care in diabetes -- 2014. Diabetes Care 2014;37:S5–13.
Colattur SN, Korbet SM. Long-term outcome of adult onset idiopathic minimal change disease. Saudi J Kidney Dis Transpl 2000;11:334–44.
Hogan J, Radhakrishnan J. The treatment of minimal change disease in adults. J Am Soc Nephrol 2013;24:702–11.
Testani JM, Chen J, McCauley BD, et al. Potential effects of aggressive decongestion during the treatment of decompensated heart failure on renal function and survival. Circulation 2010;122:265–72.
Felker GM, Lee KL, Bull DA, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 2011;364:797–805.
Christiansen CF, Johansen MB, Langeberg WJ, et al. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Eur J Intern Med 2011;22:399–406.
Park JT. Postoperative acute kidney injury. Korean J Anesthesiol 2017;70:258–66.
Oh SW, Han SY. Loop diuretics in clinical practice. Electrolyte Blood Press 2015;13:17–21.
Komukai D, Hasegawa T, Kaneshima N, et al. Influence of acute kidney injury on the time to complete remission in adult minimal change nephrotic syndrome: a single-centre study. Nephrology (Carlton) 2016;21:887–92.
McCarthy ET, Sharma M, Savin VJ. Circulating permeability factors in idiopathic nephrotic syndrome and focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 2010;5:2115–21.
Verma SK, Molitoris BA. Renal endothelial injury and microvascular dysfunction in acute kidney injury. Semin Nephrol 2015;35:96–107.