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Petrakis I, Sfakiotaki M, Bitsori M, Drosataki E, Dermitzaki K, Pleros C, Androvitsanea A, Samonakis D, Sertedaki A, Xekouki P, Galanakis E, Stylianou K. The Phenotypic Variability Associated with Hepatocyte Nuclear Factor 1B Genetic Defects Poses Challenges in Both Diagnosis and Therapy. Int J Mol Sci 2024; 25:4552. [PMID: 38674137 PMCID: PMC11050681 DOI: 10.3390/ijms25084552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
The evolving landscape of clinical genetics is becoming increasingly relevant in the field of nephrology. HNF1B-associated renal disease presents with a diverse array of renal and extrarenal manifestations, prominently featuring cystic kidney disease and diabetes mellitus. For the genetic analyses, whole exome sequencing (WES) and multiplex ligation-dependent probe amplification (MLPA) were performed. Bioinformatics analysis was performed with Ingenuity Clinical Insights software (Qiagen). The patient's electronic record was utilized after receiving informed consent. In this report, we present seven cases of HNF1B-associated kidney disease, each featuring distinct genetic abnormalities and displaying diverse extrarenal manifestations. Over 12 years, the mean decline in eGFR averaged -2.22 ± 0.7 mL/min/1.73 m2. Diabetes mellitus was present in five patients, kidney dysplastic lesions in six patients, pancreatic dysplasia, hypomagnesemia and abnormal liver function tests in three patients each. This case series emphasizes the phenotypic variability and the fast decline in kidney function associated with HNF-1B-related disease. Additionally, it underscores that complex clinical presentations may have a retrospectively straightforward explanation through the use of diverse genetic analytical tools.
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Affiliation(s)
- Ioannis Petrakis
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
| | - Maria Sfakiotaki
- Department of Endocrinology, University of Crete, 71500 Heraklion, Greece; (M.S.); (P.X.)
| | - Maria Bitsori
- Department of Pediatrics, University of Crete, 71500 Heraklion, Greece; (M.B.); (E.G.)
| | - Eleni Drosataki
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
| | - Kleio Dermitzaki
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
| | - Christos Pleros
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
| | - Ariadni Androvitsanea
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
| | - Dimitrios Samonakis
- Department of Gastroenterology, University of Crete, 71500 Heraklion, Greece;
| | - Amalia Sertedaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Paraskevi Xekouki
- Department of Endocrinology, University of Crete, 71500 Heraklion, Greece; (M.S.); (P.X.)
| | - Emmanouil Galanakis
- Department of Pediatrics, University of Crete, 71500 Heraklion, Greece; (M.B.); (E.G.)
| | - Kostas Stylianou
- Department of Nephrology, University of Crete, 71500 Heraklion, Greece; (I.P.); (E.D.); (K.D.); (C.P.); (A.A.)
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Pleros C, Adamidis K, Kantartzi K, Griveas I, Baltsavia I, Moustakas A, Kalliaropoulos A, Fraggedaki E, Petra C, Damianakis N, Mentis A, Drosataki E, Petrakis I, Passadakis P, Panagopoulos P, Stylianou K, Panagoutsos S. Dialysis Patients Respond Adequately to Influenza Vaccination Irrespective of Dialysis Modality and Chronic Inflammation. J Clin Med 2023; 12:6205. [PMID: 37834849 PMCID: PMC10573409 DOI: 10.3390/jcm12196205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Chronic inflammation and suboptimal immune responses to vaccinations are considered to be aspects of immune dysregulation in patients that are undergoing dialysis. The present study aimed to evaluate immune responses in hemodialysis (HD) and online hemodiafiltration (OL-HDF) patients to a seasonal inactivated quadrivalent influenza vaccine (IQIV). (2) Methods: We enrolled 172 chronic dialysis patients (87 on HD and 85 on OL-HDF) and 18 control subjects without chronic kidney disease in a prospective, cross-sectional cohort study. Participants were vaccinated with a seasonal IQIV, and antibody titers using the hemagglutination inhibition (HI) assay were determined before vaccination (month 0) and 1, 3, and 6 months thereafter. Demographics and inflammatory markers (CRP, IL-6, IL-1β) were recorded at month 0. The primary endpoints were the rates of seroresponse (SR), defined as a four-fold increase in the HI titer, and seroprotection (SP), defined as HI titer ≥ 1/40 throughout the study period. Statistical analyses were conducted in R (version 3.6.3) statistical software. The differences between groups were analyzed using chi-square and t-test analyses for dichotomous and continuous variables, respectively. To identify independent determinants of SR and SP, generalized linear models were built with response or protection per virus strain as the dependent variable and group, age, sex, time (month 0, 1, 3, 6), diabetes, IL-6, dialysis vintage, HD access, and HDF volume as independent explanatory variables. (3) Results: SR and SP rates were similar between control subjects, and dialysis patients were not affected by dialysis modality. SP rates were high (> 70%) at the beginning of the study and practically reached 100% after vaccination in all study groups. These results applied to all four virus strains that were included in the IQIV. IL-6 levels significantly differed between study groups, with HD patients displaying the highest values, but this did not affect SP rates. (4) Conclusions: Dialysis patients respond to influenza immunization adequately and similarly to the general population. Thus, annual vaccination policies should be encouraged in dialysis units. OL-HDF reduces chronic inflammation; however, this has no impact on SR rates.
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Affiliation(s)
- Christos Pleros
- Nephrology Department, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.P.); (E.D.); (I.P.)
| | | | - Konstantia Kantartzi
- Nephrology Department, University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.K.); (P.P.); (S.P.)
| | - Ioannis Griveas
- Nephrology Department, 417 Army Share Fund Hospital of Athens, 11521 Athens, Greece;
| | - Ismini Baltsavia
- Laboratory of Computational Biology, Division of Basic Sciences, Medical School, University of Crete, 71500 Heraklion, Greece;
| | | | - Antonios Kalliaropoulos
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.K.); (A.M.)
| | | | - Christina Petra
- Venizeleio-Pananeio General Hospital of Heraklion, 71409 Heraklion, Greece;
| | | | - Andreas Mentis
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.K.); (A.M.)
| | - Eleni Drosataki
- Nephrology Department, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.P.); (E.D.); (I.P.)
| | - Ioannis Petrakis
- Nephrology Department, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.P.); (E.D.); (I.P.)
| | - Ploumis Passadakis
- Nephrology Department, University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.K.); (P.P.); (S.P.)
| | - Periklis Panagopoulos
- Department of Infectious Diseases, Second University Department of Internal Medicine, University Hospital of Alexandroupoli, Democritus University of Thrace, 68100 Alexandroupoli, Greece;
| | - Kostas Stylianou
- Nephrology Department, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.P.); (E.D.); (I.P.)
| | - Stylianos Panagoutsos
- Nephrology Department, University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.K.); (P.P.); (S.P.)
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Georgopoulou T, Petrakis I, Dermitzaki K, Pleros C, Drosataki E, Aletras G, Foukarakis E, Lioudaki E, Androulakis E, Stylianou K. Cardiorenal Syndrome: Challenges in Everyday Clinical Practice and Key Points towards a Better Management. J Clin Med 2023; 12:4121. [PMID: 37373813 DOI: 10.3390/jcm12124121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/14/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Under the term cardiorenal syndrome (CRS) falls an increasing number of patients who present with combined heart and kidney dysfunction. Despite the increasing knowledge concerning CRS pathophysiology, diagnosis, and treatment, many of the aforementioned aspects remain obscure in everyday clinical practice. Some of the challenges that clinicians face when they treat CRS nowadays is the need for a patient-centered management with early diagnosis, early intervention, the distinction of true kidney injury from permissive renal function deterioration during decongestion therapy, and the development of therapeutic algorithms to guide therapy.
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Affiliation(s)
| | - Ioannis Petrakis
- Department of Nephrology, University General Hospital of Heraklion, 71500 Heraklion, Greece
| | - Kleio Dermitzaki
- Department of Nephrology, University General Hospital of Heraklion, 71500 Heraklion, Greece
| | - Christos Pleros
- Department of Nephrology, University General Hospital of Heraklion, 71500 Heraklion, Greece
| | - Eleni Drosataki
- Department of Nephrology, University General Hospital of Heraklion, 71500 Heraklion, Greece
| | - Georgios Aletras
- Department of Cardiology, Venizeleio General Hospital, 71409 Heraklion, Greece
| | | | - Eirini Lioudaki
- Renal Unit, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | | | - Kostas Stylianou
- Department of Nephrology, University General Hospital of Heraklion, 71500 Heraklion, Greece
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Dermitzaki K, Petrakis I, Drosataki E, Papapanagiotou M, Pleros C, Lygerou D, Stavrakaki I, Mitrakos M, Papadakis N, Konidaki M, Maragou S, Kroustalakis N, Varvouti D, Androvitsanea A, Stylianou K. WCN23-0585 THE FIRST CASE DNAJB11 ASSOCIATED NEPHROPATHY IN GREECE (AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE-6/ ADPKD-6). Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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PETRAKIS I, Dermitzaki K, Pleros C, Mitrakos M, Kroustalakis N, Androvitsanea A, Lygerou D, Drosataki E, Stavrakaki I, Konidaki M, Papadakis N, Maragou S, Xylouri E, Zaganas I, Stylianou K. WCN23-0577 TWO MUTATIONS IN COMPLEMENT FACTOR H GENE CAUSE ATYPICAL HEMOLYTIC UREMIC SYNDROME (AHUS). Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Petrakis I, Dermitzaki K, Drosataki E, Pleros C, Lygerou D, Korsavas K, Katsipi I, Kroustalakis N, Stavrakaki I, Mitrakos M, Konidaki M, Papadakis N, Stylianou K. WCN23-0427 COENZYME Q10 SUPPLEMENTATION IN AN ADULT PATIENT WITH COQ8 MUTATION AND NEPHROTIC SYNDROME ALLEVIATES RENAL FUNCTION DETERIORATION AND REMITS PROTEINURIA. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Pleros C, PETRAKIS I, Stavrakaki I, Drosataki E, Mitrakos M, Dermitzaki K, Kroustalakis N, Androvitsanea A, Lygerou D, Konidaki M, Papadakis N, Passam A, Katsipi I, Zaganas I, Stylianou K. WCN23-0434 THE FURTHER EVALUATION OF A PATIENT WITH ALLEGED PSYCHOGENIC POLYDIPSIA REVEALED A KINDRED WITH NEPHROGENIC DIABETES INSIPIDUS WITH A NOVEL MUTATION IN AVPR2. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Bacharaki D, Petrakis I, Kyriazis P, Markaki A, Pleros C, Tsirpanlis G, Theodoridis M, Balafa O, Georgoulidou A, Drosataki E, Stylianou K. Adherence to the Mediterranean Diet Is Associated with a More Favorable Left Ventricular Geometry in Patients with End-Stage Kidney Disease. J Clin Med 2022; 11:jcm11195746. [PMID: 36233612 PMCID: PMC9571193 DOI: 10.3390/jcm11195746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction. The aim of the study was to examine the impact of adherence to a Mediterranean-style diet (MD) on left ventricular hypertrophy (LVH) and cardiac geometry in chronic kidney disease patients on dialysis (CKD-5D), given the high prevalence of cardiovascular morbidity in this population. Methods. n = 127 (77 men and 50 women) CKD-5D patients (69 on hemodialysis and 58 on peritoneal dialysis) with a mean age of 62 ± 15 years were studied. An MD adherence score (MDS) (range 0−55, 55 representing maximal adherence) was estimated with a validated method. Echocardiographic LVH was defined by LV mass index (LVMI) > 95 g/m2 in women and >115 g/m2 in men. Based on LVMI and relative wall thickness (RWT), four LV geometric patterns were defined: normal (normal LVMI and RWT), concentric remodeling (normal LVMI and increased RWT > 0.42), eccentric LVH (increased LVMI and normal RWT), and concentric LVH (increased LVMI and RWT). Results. Patients with LVH (n = 81) as compared to patients with no LVH (n = 46) were older in age (66 ± 13 vs. 55 ± 16 years; p < 0.001) had lower MDS (24 ± 2.7 vs. 25 ± 4.3; p < 0.05) and higher malnutrition-inflammation score (5.0 ± 2.7 vs. 3.9 ± 1.9; p < 0.05), body mass index (27.5 ± 4.9 vs. 24.1 ± 3.5 kg/m2; p < 0.001), prevalence of diabetes (79% vs. 20%; p < 0.05), coronary artery disease (78% vs. 20%; p < 0.05) and peripheral vascular disease (78% vs. 20%; p < 0.01). In a multivariate logistic regression analysis adjusted for all factors mentioned above, each 1-point greater MDS was associated with 18% lower odds of having LVH (OR = 0.82, 95% CI: 0.69−0.98; p < 0.05). MDS was inversely related to LVMI (r = −0.273; p = 0.02), and in a multiple linear regression model (where LVMI was analyzed as a continuous variable), MDS emerged as a significant (Β = −2.217; p < 0.01) independent predictor of LVH. Considering LV geometry, there was a progressive decrease in MDS from the normal group (25.0 ± 3.7) to concentric remodeling (25.8 ± 3.0), eccentric (24.0 ± 2.8), and then concentric (23.6 ± 2.7) group (p < 0.05 for the trend). Conclusions. The greater adherence to an MD is associated with lesser LVH, an important cardiovascular disease risk factor; MD preserves normal cardiac geometry and may confer protection against future cardiac dysfunction in dialysis patients.
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Affiliation(s)
- Dimitra Bacharaki
- Nephrology Department, Attikon University Hospital, 12462 Athens, Greece
| | - Ioannis Petrakis
- Nephrology Department, University General Hospital of Heraklion, 71500 Iraklio, Greece
| | - Periklis Kyriazis
- Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Anastasia Markaki
- Department of Nutrition and Dietetics, Sciences School of Health Science, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Christos Pleros
- Nephrology Department, University General Hospital of Heraklion, 71500 Iraklio, Greece
| | | | - Marios Theodoridis
- Department of Nephrology, Democritus University of Thrace, 68150 Alexandroupolis, Greece
| | - Olga Balafa
- Nephrology Department, University Hospital of Ioannina, 45500 Ioannina, Greece
| | | | - Eleni Drosataki
- Nephrology Department, University General Hospital of Heraklion, 71500 Iraklio, Greece
| | - Kostas Stylianou
- Nephrology Department, University General Hospital of Heraklion, 71500 Iraklio, Greece
- Correspondence:
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Drosataki E, Maragkou S, Dermitzaki K, Stavrakaki I, Lygerou D, Latsoudis H, Pleros C, Petrakis I, Zaganas I, Stylianou K. Dent-2 disease with a Bartter-like phenotype caused by the Asp631Glu mutation in the OCRL gene. BMC Nephrol 2022; 23:182. [PMID: 35549682 PMCID: PMC9097321 DOI: 10.1186/s12882-022-02812-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dent disease is an X-linked disorder characterized by low molecular weight proteinuria (LMWP), hypercalciuria, nephrolithiasis and chronic kidney disease (CKD). It is caused by mutations in the chloride voltage-gated channel 5 (CLCN5) gene (Dent disease-1), or in the OCRL gene (Dent disease-2). It is associated with chronic metabolic acidosis; however metabolic alkalosis has rarely been reported. CASE PRESENTATION We present a family with Dent-2 disease and a Bartter-like phenotype. The main clinical problems observed in the proband included a) primary phosphaturia leading to osteomalacia and stunted growth; b) elevated serum calcitriol levels, leading to hypercalcemia, hypercalciuria, nephrolithiasis and nephrocalcinosis; c) severe salt wasting causing hypotension, hyperaldosteronism, hypokalemia and metabolic alkalosis; d) partial nephrogenic diabetes insipidus attributed to hypercalcemia, hypokalemia and nephrocalcinosis; e) albuminuria, LMWP. Phosphorous repletion resulted in abrupt cessation of hypercalciuria and significant improvement of hypophosphatemia, physical stamina and bone histology. Years later, he presented progressive CKD with nephrotic range proteinuria attributed to focal segmental glomerulosclerosis (FSGS). Targeted genetic analysis for several phosphaturic diseases was unsuccessful. Whole Exome Sequencing (WES) revealed a c.1893C > A variant (Asp631Glu) in the OCRL gene which was co-segregated with the disease in male family members. CONCLUSIONS We present the clinical characteristics of the Asp631Glu mutation in the OCRL gene, presenting as Dent-2 disease with Bartter-like features. Phosphorous repletion resulted in significant improvement of all clinical features except for progressive CKD. Angiotensin blockade improved proteinuria and stabilized kidney function for several years.
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Affiliation(s)
- Eleni Drosataki
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Sevasti Maragkou
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Kleio Dermitzaki
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Ioanna Stavrakaki
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Dimitra Lygerou
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Helen Latsoudis
- Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Christos Pleros
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece
| | - Ioannis Petrakis
- Department of Nephrology, Saarland University Medical Center, Homburg, Germany
| | - Ioannis Zaganas
- Neurogenetics Laboratory Medical School, University of Crete, Heraklion, Greece
| | - Kostas Stylianou
- Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece.
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Pleros C, Stamataki E, Papadaki A, Damianakis N, Poulidaki R, Gakiopoulou C, Tzanakis I. Dapagliflozin as a cause of acute tubular necrosis with heavy consequences: a case report. CEN Case Rep 2018; 7:17-20. [PMID: 29127652 PMCID: PMC5886915 DOI: 10.1007/s13730-017-0283-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/31/2017] [Indexed: 01/10/2023] Open
Abstract
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter. Sixteen months after initial presentation he is being followed as an outpatient with chronic kidney disease (CKD) stage 3a. Dapagliflozin belongs to a novel class of antidiabetic drugs for which clinical trials show great beneficial effects on cardiovascular outcomes and glycemic control and as with many new drugs, their safety profile is being constantly revised. We report the first biopsy-proven ATN caused by dapagliflozin. Great caution together with continuous monitoring of renal function is advised when implementing SGLT-2 inhibitors in clinical practice.
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Affiliation(s)
- Christos Pleros
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece.
| | - Elisavet Stamataki
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece
| | - Antonia Papadaki
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece
| | - Nikolaos Damianakis
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece
| | - Rafaela Poulidaki
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece
| | - Charikleia Gakiopoulou
- Division of Pathology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Tzanakis
- Department of Nephrology, General Hospital of Chania, Meletiou Metaxaki 25, 73131, Chania, Crete, Greece
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Adamidis KN, Pleros C, Oikonomaki T, Kyratzi I, Exarchos D, Metaxatos G, Drakopoulos S, Nikolopoulou N, Apostolou T. Progression of coronary artery calcification after kidney transplantation. Ren Fail 2013; 35:1075-8. [PMID: 23879313 DOI: 10.3109/0886022x.2013.815090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Calcification of coronary vessels progresses rapidly in hemodialysis (HD) patients and comprises a strong predictor of cardiovascular events. The aim of this prospective study was to evaluate the coronary artery calcification (CAC) in patients with end stage renal disease undergoing regular HD and to determine the effect of renal transplantation (RT) in the progression of CAC, using the Agatston technique for calcium scoring. The study included 20 patients with end-stage renal disease undergoing a regular HD treatment (16 males, 4 females) 54.1 ± 9.5 years old who had just received a renal transplant and 16 more HD patients (11 males, 5 females) 54.4 ± 13.8 years old as control group. The baseline evaluation showed a very high prevalence of CAC in both groups, which was positively correlated with age (p < 0.001) and CRP (p = 0.03). The second (follow-up) evaluation showed a significant slower progression of calcification after RT. In both groups, high calcium score values in the follow-up evaluation had a strong positive correlation with baseline calcium score (p < 0.001).
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