P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES
Abstract Background and Aims A real progress in treating patients more than diseases, would rest on tailored medicine and go beyond the hypothesis that “one size fits all”. Glomerular diseases are not an exception to this consideration, and deserve case-by-case evaluation for choosing both the most...
Gespeichert in:
Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2020-06, Vol.35 (Supplement_3) |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | |
---|---|
container_issue | Supplement_3 |
container_start_page | |
container_title | Nephrology, dialysis, transplantation |
container_volume | 35 |
creator | Siligato, Rossella Laudani, Alfredo Gembillo, Guido Calabrese, Vincenzo Calderaro, Alessandra Vienna, Federica giada Laurendi, Francesco Cernaro, Valeria Santoro, Domenico |
description | Abstract
Background and Aims
A real progress in treating patients more than diseases, would rest on tailored medicine and go beyond the hypothesis that “one size fits all”. Glomerular diseases are not an exception to this consideration, and deserve case-by-case evaluation for choosing both the most suitable therapeutic agent and its appropriate dose, because a standardized treatment may result in worse prognosis.
We analyzed the role of body mass index (BMI) in modifying renal outcomes of patients with nephrotic syndrome due to membranous nephropathy (MN) treated with immunosuppressive drugs.
Method
We performed a retrospective analysis of 29 MN patients related to our center (M 19, F 10), checking their anti PLA2R status at kidney biopsy time and any change in proteinuria, serum creatinine (SCr) and body mass index (BMI) between diagnosis and at last follow-up visit, in search of a correlation with their response to immunosuppressive treatment. Data with non normal distribution are expressed as median and interquartile range [IQR].
Results
The median follow-up of our patients lasted 49 months [IQR 14-80]. At biopsy time, almost half of them was anti-PLA2R positive (n=14 subjects) while the other resulted to be negative and were thus screened for secondary causes of MN (n=15). Irrespective either of anti-PLA2R status or the administration of Ponticelli regimen or Rituximab, complete remission was achieved in 31% of patients, while 34.5% experienced a partial remission and 34.5% resulted non responder to at least a therapeutic protocol. Median proteinuria reduction was of 3.732g/24h [IQR 7.636-1.77 g/24h]. Median rise in SCr was 0.140 mg/dl [IQR -0.11 – 0.4 mg/dl]. Direct association between the proteinuria/BMI ratio at diagnosis and remission of proteinuria at last follow up was statistically significant (r=-0.7506; P |
doi_str_mv | 10.1093/ndt/gfaa142.P0491 |
format | Article |
fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ndt_gfaa142_P0491</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfaa142.P0491</oup_id><sourcerecordid>10.1093/ndt/gfaa142.P0491</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1221-b29162a85d1bfacc316b44deccaa62627ec87fb8c2de72258465bebcc92c5d693</originalsourceid><addsrcrecordid>eNqNkEtOwzAURS0EEqWwAGZeAGntl8SJmbmNIRbNR2mCVCaR4zgIBLRKyoDdE9ougNEb3HOv9A5Ct5TMKOHu_Kvdz187rakHs5x4nJ6hCfUYccAN_XM0GRnqEJ_wS3Q1DO-EEA5BMEH2AJexxEVWlRKXGVZppJ5VVImVepERHrNC5EquxwDnhUpEscGJTBaFSLNqjVOZx0WWizLe3ONForBII_ykolRu8Di5zBK5vkYXnf4Y7M3pTlH1IMtl7KyyR7UUK8dQAOo0wCkDHfotbTptjEtZ43mtNUZrBgwCa8Kga0IDrQ0A_NBjfmMbYzgYv2XcnSJ63DX9dhh629W7_u1T9z81JfWfp3r0VJ881YfXx87dsbP93v0D_wW8wGP8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES</title><source>Oxford Journals Online</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Siligato, Rossella ; Laudani, Alfredo ; Gembillo, Guido ; Calabrese, Vincenzo ; Calderaro, Alessandra ; Vienna, Federica giada ; Laurendi, Francesco ; Cernaro, Valeria ; Santoro, Domenico</creator><creatorcontrib>Siligato, Rossella ; Laudani, Alfredo ; Gembillo, Guido ; Calabrese, Vincenzo ; Calderaro, Alessandra ; Vienna, Federica giada ; Laurendi, Francesco ; Cernaro, Valeria ; Santoro, Domenico</creatorcontrib><description>Abstract
Background and Aims
A real progress in treating patients more than diseases, would rest on tailored medicine and go beyond the hypothesis that “one size fits all”. Glomerular diseases are not an exception to this consideration, and deserve case-by-case evaluation for choosing both the most suitable therapeutic agent and its appropriate dose, because a standardized treatment may result in worse prognosis.
We analyzed the role of body mass index (BMI) in modifying renal outcomes of patients with nephrotic syndrome due to membranous nephropathy (MN) treated with immunosuppressive drugs.
Method
We performed a retrospective analysis of 29 MN patients related to our center (M 19, F 10), checking their anti PLA2R status at kidney biopsy time and any change in proteinuria, serum creatinine (SCr) and body mass index (BMI) between diagnosis and at last follow-up visit, in search of a correlation with their response to immunosuppressive treatment. Data with non normal distribution are expressed as median and interquartile range [IQR].
Results
The median follow-up of our patients lasted 49 months [IQR 14-80]. At biopsy time, almost half of them was anti-PLA2R positive (n=14 subjects) while the other resulted to be negative and were thus screened for secondary causes of MN (n=15). Irrespective either of anti-PLA2R status or the administration of Ponticelli regimen or Rituximab, complete remission was achieved in 31% of patients, while 34.5% experienced a partial remission and 34.5% resulted non responder to at least a therapeutic protocol. Median proteinuria reduction was of 3.732g/24h [IQR 7.636-1.77 g/24h]. Median rise in SCr was 0.140 mg/dl [IQR -0.11 – 0.4 mg/dl]. Direct association between the proteinuria/BMI ratio at diagnosis and remission of proteinuria at last follow up was statistically significant (r=-0.7506; P<0.0001) (Fig.1).
Conclusion
Albeit remission is not directly correlated with basal BMI, our results appear to confirm that an appropriate drug posology, not only according to patients’ renal or hepatic function but also to their body mass, may result in more effective individualized therapies in MN; nevertheless, this recorded association must be confirmed by large scale randomized clinical trials.
Figure:</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfaa142.P0491</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>Nephrology, dialysis, transplantation, 2020-06, Vol.35 (Supplement_3)</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids></links><search><creatorcontrib>Siligato, Rossella</creatorcontrib><creatorcontrib>Laudani, Alfredo</creatorcontrib><creatorcontrib>Gembillo, Guido</creatorcontrib><creatorcontrib>Calabrese, Vincenzo</creatorcontrib><creatorcontrib>Calderaro, Alessandra</creatorcontrib><creatorcontrib>Vienna, Federica giada</creatorcontrib><creatorcontrib>Laurendi, Francesco</creatorcontrib><creatorcontrib>Cernaro, Valeria</creatorcontrib><creatorcontrib>Santoro, Domenico</creatorcontrib><title>P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES</title><title>Nephrology, dialysis, transplantation</title><description>Abstract
Background and Aims
A real progress in treating patients more than diseases, would rest on tailored medicine and go beyond the hypothesis that “one size fits all”. Glomerular diseases are not an exception to this consideration, and deserve case-by-case evaluation for choosing both the most suitable therapeutic agent and its appropriate dose, because a standardized treatment may result in worse prognosis.
We analyzed the role of body mass index (BMI) in modifying renal outcomes of patients with nephrotic syndrome due to membranous nephropathy (MN) treated with immunosuppressive drugs.
Method
We performed a retrospective analysis of 29 MN patients related to our center (M 19, F 10), checking their anti PLA2R status at kidney biopsy time and any change in proteinuria, serum creatinine (SCr) and body mass index (BMI) between diagnosis and at last follow-up visit, in search of a correlation with their response to immunosuppressive treatment. Data with non normal distribution are expressed as median and interquartile range [IQR].
Results
The median follow-up of our patients lasted 49 months [IQR 14-80]. At biopsy time, almost half of them was anti-PLA2R positive (n=14 subjects) while the other resulted to be negative and were thus screened for secondary causes of MN (n=15). Irrespective either of anti-PLA2R status or the administration of Ponticelli regimen or Rituximab, complete remission was achieved in 31% of patients, while 34.5% experienced a partial remission and 34.5% resulted non responder to at least a therapeutic protocol. Median proteinuria reduction was of 3.732g/24h [IQR 7.636-1.77 g/24h]. Median rise in SCr was 0.140 mg/dl [IQR -0.11 – 0.4 mg/dl]. Direct association between the proteinuria/BMI ratio at diagnosis and remission of proteinuria at last follow up was statistically significant (r=-0.7506; P<0.0001) (Fig.1).
Conclusion
Albeit remission is not directly correlated with basal BMI, our results appear to confirm that an appropriate drug posology, not only according to patients’ renal or hepatic function but also to their body mass, may result in more effective individualized therapies in MN; nevertheless, this recorded association must be confirmed by large scale randomized clinical trials.
Figure:</description><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkEtOwzAURS0EEqWwAGZeAGntl8SJmbmNIRbNR2mCVCaR4zgIBLRKyoDdE9ougNEb3HOv9A5Ct5TMKOHu_Kvdz187rakHs5x4nJ6hCfUYccAN_XM0GRnqEJ_wS3Q1DO-EEA5BMEH2AJexxEVWlRKXGVZppJ5VVImVepERHrNC5EquxwDnhUpEscGJTBaFSLNqjVOZx0WWizLe3ONForBII_ykolRu8Di5zBK5vkYXnf4Y7M3pTlH1IMtl7KyyR7UUK8dQAOo0wCkDHfotbTptjEtZ43mtNUZrBgwCa8Kga0IDrQ0A_NBjfmMbYzgYv2XcnSJ63DX9dhh629W7_u1T9z81JfWfp3r0VJ881YfXx87dsbP93v0D_wW8wGP8</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Siligato, Rossella</creator><creator>Laudani, Alfredo</creator><creator>Gembillo, Guido</creator><creator>Calabrese, Vincenzo</creator><creator>Calderaro, Alessandra</creator><creator>Vienna, Federica giada</creator><creator>Laurendi, Francesco</creator><creator>Cernaro, Valeria</creator><creator>Santoro, Domenico</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20200601</creationdate><title>P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES</title><author>Siligato, Rossella ; Laudani, Alfredo ; Gembillo, Guido ; Calabrese, Vincenzo ; Calderaro, Alessandra ; Vienna, Federica giada ; Laurendi, Francesco ; Cernaro, Valeria ; Santoro, Domenico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1221-b29162a85d1bfacc316b44deccaa62627ec87fb8c2de72258465bebcc92c5d693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siligato, Rossella</creatorcontrib><creatorcontrib>Laudani, Alfredo</creatorcontrib><creatorcontrib>Gembillo, Guido</creatorcontrib><creatorcontrib>Calabrese, Vincenzo</creatorcontrib><creatorcontrib>Calderaro, Alessandra</creatorcontrib><creatorcontrib>Vienna, Federica giada</creatorcontrib><creatorcontrib>Laurendi, Francesco</creatorcontrib><creatorcontrib>Cernaro, Valeria</creatorcontrib><creatorcontrib>Santoro, Domenico</creatorcontrib><collection>CrossRef</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siligato, Rossella</au><au>Laudani, Alfredo</au><au>Gembillo, Guido</au><au>Calabrese, Vincenzo</au><au>Calderaro, Alessandra</au><au>Vienna, Federica giada</au><au>Laurendi, Francesco</au><au>Cernaro, Valeria</au><au>Santoro, Domenico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><date>2020-06-01</date><risdate>2020</risdate><volume>35</volume><issue>Supplement_3</issue><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract
Background and Aims
A real progress in treating patients more than diseases, would rest on tailored medicine and go beyond the hypothesis that “one size fits all”. Glomerular diseases are not an exception to this consideration, and deserve case-by-case evaluation for choosing both the most suitable therapeutic agent and its appropriate dose, because a standardized treatment may result in worse prognosis.
We analyzed the role of body mass index (BMI) in modifying renal outcomes of patients with nephrotic syndrome due to membranous nephropathy (MN) treated with immunosuppressive drugs.
Method
We performed a retrospective analysis of 29 MN patients related to our center (M 19, F 10), checking their anti PLA2R status at kidney biopsy time and any change in proteinuria, serum creatinine (SCr) and body mass index (BMI) between diagnosis and at last follow-up visit, in search of a correlation with their response to immunosuppressive treatment. Data with non normal distribution are expressed as median and interquartile range [IQR].
Results
The median follow-up of our patients lasted 49 months [IQR 14-80]. At biopsy time, almost half of them was anti-PLA2R positive (n=14 subjects) while the other resulted to be negative and were thus screened for secondary causes of MN (n=15). Irrespective either of anti-PLA2R status or the administration of Ponticelli regimen or Rituximab, complete remission was achieved in 31% of patients, while 34.5% experienced a partial remission and 34.5% resulted non responder to at least a therapeutic protocol. Median proteinuria reduction was of 3.732g/24h [IQR 7.636-1.77 g/24h]. Median rise in SCr was 0.140 mg/dl [IQR -0.11 – 0.4 mg/dl]. Direct association between the proteinuria/BMI ratio at diagnosis and remission of proteinuria at last follow up was statistically significant (r=-0.7506; P<0.0001) (Fig.1).
Conclusion
Albeit remission is not directly correlated with basal BMI, our results appear to confirm that an appropriate drug posology, not only according to patients’ renal or hepatic function but also to their body mass, may result in more effective individualized therapies in MN; nevertheless, this recorded association must be confirmed by large scale randomized clinical trials.
Figure:</abstract><pub>Oxford University Press</pub><doi>10.1093/ndt/gfaa142.P0491</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0931-0509 |
ispartof | Nephrology, dialysis, transplantation, 2020-06, Vol.35 (Supplement_3) |
issn | 0931-0509 1460-2385 |
language | eng |
recordid | cdi_crossref_primary_10_1093_ndt_gfaa142_P0491 |
source | Oxford Journals Online; Alma/SFX Local Collection; EZB Electronic Journals Library |
title | P0491THE ROUTE TO INDIVIDUALIZED THERAPIES IN PRIMARY MEMBRANOUS NEPHROPATHY: BMI AND KIDNEY OUTCOMES |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T08%3A31%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=P0491THE%20ROUTE%20TO%20INDIVIDUALIZED%20THERAPIES%20IN%20PRIMARY%20MEMBRANOUS%20NEPHROPATHY:%20BMI%20AND%20KIDNEY%20OUTCOMES&rft.jtitle=Nephrology,%20dialysis,%20transplantation&rft.au=Siligato,%20Rossella&rft.date=2020-06-01&rft.volume=35&rft.issue=Supplement_3&rft.issn=0931-0509&rft.eissn=1460-2385&rft_id=info:doi/10.1093/ndt/gfaa142.P0491&rft_dat=%3Coup_cross%3E10.1093/ndt/gfaa142.P0491%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/ndt/gfaa142.P0491&rfr_iscdi=true |