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Titolo:
Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate
Autore:
Markowitz, GS; Appel, GB; Fine, PL; Fenves, AZ; Loon, NR; Jagannath, S; Kuhn, JA; Dratch, AD; DAgati, VD;
Indirizzi:
Columbia Univ Coll Phys & Surg, Dept Pathol, Div Nephrol, New York, NY 10032 USA Columbia Univ Coll Phys & Surg New York NY USA 10032 w York, NY 10032 USA Columbia Univ Coll Phys & Surg, Dept Med, Div Nephrol, New York, NY 10032 USA Columbia Univ Coll Phys & Surg New York NY USA 10032 w York, NY 10032 USA Morristown Mem Hosp Atlantic Hlth Syst, Dept Internal Med, Div Nephrol, Morristown, NJ USA Morristown Mem Hosp Atlantic Hlth Syst Morristown NJ USAristown, NJ USA Baylor Univ, Med Ctr, Div Nephrol, Dallas, TX USA Baylor Univ Dallas TX USA lor Univ, Med Ctr, Div Nephrol, Dallas, TX USA Hilton Head Med Ctr, Dept Internal Med, Div Nephrol, Hilton Head Isl, SC USA Hilton Head Med Ctr Hilton Head Isl SC USA hrol, Hilton Head Isl, SC USA New York Med Coll, Dept Med, New York, NY USA New York Med Coll New York NY USA k Med Coll, Dept Med, New York, NY USA Med Ctr Delaware, Dept Med, Div Nephrol, Newark, DE USA Med Ctr Delaware Newark DE USA re, Dept Med, Div Nephrol, Newark, DE USA Lehigh Valley Nephrol Associates, Bethlehem, PA USA Lehigh Valley Nephrol Associates Bethlehem PA USA tes, Bethlehem, PA USA
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
fascicolo: 6, volume: 12, anno: 2001,
pagine: 1164 - 1172
SICI:
1046-6673(200106)12:6<1164:CFSGFT>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIV-ASSOCIATED NEPHROPATHY; ADVANCED MULTIPLE-MYELOMA; GTP-BINDING PROTEIN; GLOMERULAR-PERMEABILITY; SKELETAL EVENTS; BONE-RESORPTION; RENAL BIOPSY; BISPHOSPHONATES; TOLERABILITY; OSTEOCLASTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: D'Agati, VD Columbia Univ Coll Phys & Surg, Dept Pathol, Div Nephrol, 630 W 168th St,VC 14-224, New York, NY 10032 USA Columbia Univ Coll Phys & Surg630 W 168th St,VC 14-224 New York NY USA 10032
Citazione:
G.S. Markowitz et al., "Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate", J AM S NEPH, 12(6), 2001, pp. 1164-1172

Abstract

Collapsing focal segmental glomerulosclerosis (FSGS) is a distinct clinicopathologic entity seen most commonly in young African American patients whopresent with renal insufficiency and nephrotic syndrome. The only epidemiologic factor previously linked to collapsing FSGS is HIV infection. Here clinicopathologic findings are reported for a distinctive population of sevenpatients, who were older, Caucasian, and HIV negative and developed collapsing FSGS during active treatment of malignancy (multiple myeloma in six patients and metastatic breast carcinoma in one). Although oncologic treatment regimens included vincristine for four patients, doxorubicin for five patients, cisplatin for two patients, and total-body irradiation for one patient, the only agent common to all patients was pamidronate (Aredia). All patients had normal renal function before the administration of pamidronate. Patients began therapy with pamidronate at or below the recommended dose of 90 mg, intravenously, monthly, which was increased to 180 mg monthly in twopatients and 360 mg monthly in three patients. Patients received pamidronate for 15 to 48 mo before presentation with renal insufficiency (mean serumcreatinine, 3.6 mg/dl) and full nephrotic syndrome (mean 24-h urinary protein excretion, 12.4 g/d), Pamidronate, which is a member of the class of bisphosphonates, is widely used in the treatment of hypercalcemia of malignancy and osteolytic metastases. At the recommended dose of 90 mg, intravenously, monthly, renal toxicity is infrequent; however, higher doses have produced nephrotoxicity in animal models. The temporal association between pamidronate therapy and the development of renal insufficiency, the use of escalating doses that exceed recommended levels, and the distinctive pattern of glomerular and tubular injury strongly suggest a mechanism of drug-associated podocyte and tubular toxicity. These data provide the first association of collapsing FSGS with toxicity to a therapeutic agent.

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Documento generato il 01/12/20 alle ore 07:51:45