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Deniz R, Güner N, Ekmen ŞA, Mutlu IN, Özgür DS, Karaalioğlu B, Akkuzu G, Yıldırım F, Kalkan K, Güzelant-Özköse G, İnce B, Erdoğan M, Özlük Y, Kılıçaslan I, Bes C. Discrepancies between clinical and pathological findings seen at renal biopsy in rheumatological diseases. Reumatismo 2023; 75. [PMID: 37721346 DOI: 10.4081/reumatismo.2023.1586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE Renal biopsy contributes to the diagnosis, follow-up, and treatment of many rheumatic conditions. This study assessed the diagnostic role and safety of renal biopsies in a tertiary rheumatology clinic. METHODS Renal biopsies performed between June 2020 and December 2022 were screened, and demographic, clinical, histopathological, and safety data were collected from patient records. RESULTS In this study, 33 males and 38 females were included. Except for 1 patient who received acetylsalicylic acid, antiaggregant, and/or anticoagulant drugs were stopped before the biopsy. Complications included a decrease of hemoglobin in 8 patients (11.3%) and microscopic hematuria in 40 patients (56.3%). Control ultrasonography was performed in 16 patients (22.5%), and a self-limiting hematoma was found in 4 of them (5.6%) without additional complications. While less than 10 glomeruli were obtained in 9 patients (9.9%), diagnosis success was 94.4%. Histopathological data were consistent with one of the pre-biopsy diagnoses in 54 of 67 cases (80.6%) but showed discrepancies in 19.4% (n=13) of patients. A repeat biopsy was performed in 7 patients for re-staging or insufficient biopsy. CONCLUSIONS Renal biopsy significantly contributes to rheumatology practice, especially in patients with complex clinical and laboratory findings or in whom different treatments can be given according to the presence, severity, and type of renal involvement. Although the possibility of obtaining insufficient tissue and the need for re-staging and repeat biopsy in the follow-up might be expected, complication risk does not seem to be a big concern. Renal biopsy often evidenced discrepancies between pre-biopsy diagnosis and histopathological findings.
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Affiliation(s)
- R Deniz
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - N Güner
- Department of Internal Medicine, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - Ş A Ekmen
- Department of Internal Medicine, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - I N Mutlu
- Department of Radiology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - D S Özgür
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - B Karaalioğlu
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - G Akkuzu
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - F Yıldırım
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - K Kalkan
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - G Güzelant-Özköse
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - B İnce
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - M Erdoğan
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - Y Özlük
- Department of Pathology, Faculty of Medicine, University of İstanbul.
| | - I Kılıçaslan
- Department of Pathology, Faculty of Medicine, University of İstanbul.
| | - C Bes
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
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Hua R, Liu X, Yuan E. Red blood cell distribution width at admission predicts outcome in critically ill patients with kidney failure: a retrospective cohort study based on the MIMIC-IV database. Ren Fail 2022; 44:1182-1191. [PMID: 35834358 PMCID: PMC9291648 DOI: 10.1080/0886022x.2022.2098766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
PURPOSE We aimed to explore whether red blood cell distribution width (RDW) could serve as a biomarker to predict outcomes in critically ill patients with kidney failure in this study. MATERIALS AND METHODS This retrospective study was conducted with the Medical Information Mart for Intensive Care IV (MIMIC-IV).A total of 674 patients were divided into three groups based on tertiles of RDW. We used the generalized additive model, Kaplan-Meier curve, and Cox proportional hazards models to evaluate the association between RDW and clinical outcomes. We then performed subgroup analyses to investigate the stability of the associations between RDW and all-cause mortality. RESULTS Nonlinear and J-shaped curves were observed in the generalized additive model. Kaplan-Meier analysis showed that patients with elevated RDW had a lower survival rate. The Cox regression model indicated that high levels of RDW were most closely associated with ICU mortality and 30-day mortality (HR = 4.71, 95% CI: 1.69-11.64 and HR = 6.62, 95% CI: 2.84-15.41). Subgroup analyses indicated that the associations between RDW and all-cause mortality were stable. CONCLUSIONS Elevated levels of RDW were associated with an increased risk of all-cause mortality, and RDW could be an independent prognostic factor for kidney failure.
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Affiliation(s)
- Rongqian Hua
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuefang Liu
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Enwu Yuan
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Kojima K, Sakamoto T, Kasai T, Atagi S, Yoon H. A quantitative evaluation of the histological type dependence of the programmed death-ligand 1 expression in non-small cell lung cancer including various adenocarcinoma subtypes: a cross-sectional study. Jpn J Clin Oncol 2021; 52:281-285. [PMID: 34969085 PMCID: PMC8894954 DOI: 10.1093/jjco/hyab202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
The association between non-small cell lung cancer histology and programmed death-ligand 1 expression remains controversial. We retrospectively analyzed histological dependence of the programmed death-ligand 1 expression by a multiple regression analysis of 356 non-small cell lung cancer patients. The programmed death-ligand 1 expression patterns of adenocarcinoma were consistent with a pathological predominant growth pattern as a reference to papillary adenocarcinoma: minimally invasive adenocarcinoma[partial regression coefficient (B), 0.17; 95% confidence interval, 0.05–0.59], lepidic adenocarcinoma (B, 0.46; 95% confidence interval, 0.23–0.90), acinar adenocarcinoma (B, 1.98; 95% confidence interval, 1.05–3.76) and solid adenocarcinoma (B, 5.11; 95% confidence interval, 2.20–11.9). In histology other than adenocarcinoma, the programmed death-ligand 1 expression tended to be high with poor differentiation: adenosquamous carcinoma (B, 4.17; 95% confidence interval, 1.05–16.6), squamous cell carcinoma (B, 4.32; 95% confidence interval, 2.45–7.62) and pleomorphic carcinoma (B, 13.0; 95% confidence interval, 4.43–38.2). We showed quantitatively that the programmed death-ligand 1 expression in non-small cell lung cancer tended to be clearly histology-dependent, with more poorly differentiated histology showing a higher expression.
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Affiliation(s)
- Kensuke Kojima
- Department of General Thoracic Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Tetsuki Sakamoto
- Department of General Thoracic Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Takahiko Kasai
- Department of Laboratory Medicine and Pathology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Shinji Atagi
- Department of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hyungeun Yoon
- Department of General Thoracic Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
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Wu Q, Qin Y, Shi M, Yan L. Diagnostic significance of circulating miR-485-5p in patients with lupus nephritis and its predictive value evaluation for the clinical outcomes. J Chin Med Assoc 2021; 84:491-497. [PMID: 33742995 DOI: 10.1097/jcma.0000000000000522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Lupus nephritis (LN) is one of the main risk factors contributing to morbidity and mortality of systemic lupus erythematosus (SLE). This study aimed to investigate the potential role of miR-485-5p in human LN. METHODS Quantitative real-time polymerase chain reaction was used for the measurement of miR-485-5p levels. The levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in serum were determined by enzyme-linked immunosorbent assay. The diagnostic role of miR-485-5p in LN was evaluated by the receiver operating characteristic (ROC) curve. The impact of miR-485-5p on end-stage renal disease (ESRD) was compared by Kaplan-Meier analysis and Cox regression analysis. The target gene was determined by a dual-luciferase reporter assay system. RESULTS MiR-485-5p was highly expressed in SLE and LN patients compared with the healthy controls, and LN patients had the highest level of miR-485-5p. The expression level of miR-485-5p in active LN patients was significantly increased compared with that in nonactive cases. MiR-485-5p expression showed a positive correlation with the levels of estimated glomerular filtration rate, serum creatinine, proteinuria, SLE disease activity index score, and inflammatory cytokines. The ROC analysis results indicated that serum miR-485-5p was a promising biomarker for the early diagnosis of LN, and it can distinguish active LN patients from nonactive ones. Phosphatase and tensin homolog was a direct target of miR-485-5p, and negatively associated with serum miR-485-5p levels. More ESRD events were observed in cases with high miR-485-5p expression, miR-485-5p was an independent factor for the risk of ESRD in LN patients. CONCLUSION Serum miR-485-5p might be a novel promising diagnostic marker for LN and has potential predictive value for ESRD risk in LN patients.
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Affiliation(s)
- Qinghua Wu
- Department of Nephrology, Dongying People's Hospital, Dongying, Shandong, China
| | - Yanan Qin
- Department of Obstetrics, Dongying People's Hospital, Dongying, Shandong, China
| | - Mei Shi
- Department of Nephrology, Dongying People's Hospital, Dongying, Shandong, China
| | - Liping Yan
- Department of Outpatient, Dongying People's Hospital, Dongying, Shandong, China
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Mo X, Zhou M, Yan H, Chen X, Wang Y. Competing risk analysis of cardiovascular/cerebrovascular death in T1/2 kidney cancer: a SEER database analysis. BMC Cancer 2021; 21:13. [PMID: 33402111 PMCID: PMC7786899 DOI: 10.1186/s12885-020-07718-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/08/2020] [Indexed: 01/20/2023] Open
Abstract
Background Kidney cancer (KC) is associated with cardiovascular regulation disorder and easily leads to cardiovascular and cerebrovascular death (CCD), which is one of the major causes of death in patients with KC, especially those with T1/2 status. However, few studies have treated CCD as an independent outcome for analysis. We aimed to identify and evaluate the key factors associated with CCD in patients with T1/2 KC by competing risk analysis and compared these risk factors with those associated with kidney cancer-specific death (KCD) to offer some information for clinical management. Methods A total of 45,117 patients diagnosed with first primary KC in T1/2 status were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were divided into the CCD group (n = 3087), KCD group (n = 3212), other events group (n = 6312) or alive group (n = 32,506). Patients’ characteristics were estimated for their association with CCD or KCD by a competing risk model. Pearson’s correlation coefficient and variance inflation factor (VIF) were used to detect collinearity between variables. Factors significantly correlated with CCD or KCD were used to create forest plots to compare their differences. Results The competing risk analysis showed that age at diagnosis, race, AJCC T/N status, radiation therapy, chemotherapy and scope of lymph node represented different relationships to CCD than to KCD. In detail, age at diagnosis (over 74/1–50: HR = 9.525, 95% CI: 8.049–11.273), race (white/black: HR = 1.475, 95% CI: 1.334–1.632), AJCC T status (T2/T1: HR = 0.847, 95% CI: 0.758–0.946) and chemotherapy (received/unreceived: HR = 0.574, 95% CI: 0.347–0.949) were correlated significantly with CCD; age at diagnosis (over 74/1–50: HR = 3.205, 95% CI: 2.814–3.650), AJCC T/N status (T2/T1: HR = 2.259, 95% CI: 2.081–2.451 and N1/N0:HR = 3.347, 95% CI: 2.698–4.152), radiation therapy (received/unreceived: HR = 2.552, 95% CI: 1.946–3.346), chemotherapy (received/unreceived: HR = 2.896, 95% CI: 2.342–3.581) and scope of lymph nodes (1–3 regional lymph nodes removed/none: HR = 1.378, 95% CI: 1.206–1.575) were correlated significantly with KCD. Conclusions We found that age at diagnosis, race, AJCC T status and chemotherapy as the independent risk factors associated with CCD were different from those associated with KCD.
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Affiliation(s)
- Xiaofei Mo
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, 213003, Jiangsu, China
| | - Mingge Zhou
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, 213003, Jiangsu, China
| | - Hui Yan
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, 213003, Jiangsu, China
| | - Xueqin Chen
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, 213003, Jiangsu, China
| | - Yuetao Wang
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China. .,Changzhou Key Laboratory of Molecular Imaging, Changzhou, 213003, Jiangsu, China.
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