Long term follow up of renal function in IgA nephropathy

Article Abstract:

Immunoglobulin A (IgA) nephropathy is a kidney disease associated with IgA, the primary immune protein found in exocrine secretions, such as breast milk, saliva, and tears. IgA may function to protect mucosal surfaces from infection with bacteria and viruses. Although IgA nephropathy was previously considered benign, studies now show that this condition can lead to kidney failure. The prognosis is less favorable for males. IgA nephropathy does not appear to be associated with a persistent decrease in the glomerular filtration rate (GFR; speed at which blood is filtered through the kidneys). This suggests that an irreversible decrease in kidney function is rare in children with the disorder. While previous studies examined the course of IgA nephropathy over a short period, the prognosis of children with IgA nephropathy should be evaluated over the long term. The relation between symptoms and changes in kidney function was assessed in 51 children who developed IgA nephropathy in childhood. The children were followed for periods ranging from 0.4 to 16.8 years. Kidney function was assessed by measuring GFR and effective renal plasma flow (ERPF; a measure of blood flow through the kidneys). Creatinine levels, which are increased in advanced stages of kidney disease, were elevated in 15 children at the start of the study, whereas GFR was lower in children with IgA nephropathy than in normal children. At the eight year follow-up, GFR and ERPF were both decreased. Kidney function was markedly decreased in patients with proteinuria (the presence of blood proteins in the urine); this was particularly true in boys with decreased GFR and ERPF values of about 17 percent over a 4.7-year period. Patients who had increased creatinine levels at the start of the study had low GFR values. Kidney function was not impaired in patients with hematuria (blood in the urine). These findings suggest that the prognosis of IgA nephropathy is not mild, and boys with proteinuria are at risk for developing impaired kidney function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Demographic aspects, Kidney function tests, IgA glomerulonephritis

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Lung function abnormalities at 6 months of age after neonatal intensive care

Article Abstract:

Premature birth is often complicated by chronic lung damage, which is associated with high rates of death, disability, rehospitalization, and respiratory infection. Premature infants with chronic lung damage may develop a wheeze and abnormalities of lung function. Positive end-expiratory pressure is a method of keeping the alveoli, the tiny gas-exchanging sacs of the lungs, in the open state during expiration (exhaling). However, studies show that positive pressure support contributes to the development of chronic lung disease. The most severe form of chronic lung disease, bronchopulmonary dysplasia, is associated with this method of mechanical ventilation (breathing assistance). The amount of positive pressure, specifically pressure in excess of 35 centimeters of water (cm H2O), is an important factor in the development of lung damage. Recent improvements in methods of newborn ventilation and changes in ventilators have decreased the damaging effects of positive pressure support. The respiratory function of 46 6-month-old premature infants was assessed; 34 of the infants received newborn ventilation with intermittent positive pressure ventilation (IPPV). The infants were divided into three groups: A, those who did not receive IPPV; B, those who received IPPV for seven days or less; and C, those who received IPPV for more than seven days. Respiratory function was similar among all infants. These findings suggest that newborn ventilation does not play a primary role in the development of abnormalities of lung function in premature infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Diseases, Infants (Premature), Premature infants, Pulmonary function tests, Positive pressure respiration, Bronchopulmonary dysplasia

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