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Revista Colombiana de Nefrología
On-line version ISSN 2500-5006
Abstract
FABRIS, José Luis et al. Renal compromise in a patient with Wegener's granulomatosis: clinical case and literature review. Rev. colom. nefrol. [online]. 2017, vol.4, n.1, pp.99-111. ISSN 2500-5006. https://doi.org/10.22265/acnef.4.1.234.
Wegener's granulomatosis (WG) is characterized by small vessel vasculitis that affects the upper respiratory tract, lungs and kidneys. Renal involvement may occur between 40 and 100% of cases. The disease varies from asymptomatic to fulminant rapidly progressive glomerulonephritis forms, leading to terminal renal failure in days.
Methodology
We present a case of a patient diagnosed with WG in the Hospital de San José in Bogotá, Colombia, and a literature review focused on renal involvement. Literature search was conducted in the following databases: PubMEed, LILAC, SciELO and Cochrane. Articles in english and spanish were selected and no restriction date was made, but at least 70% of selected references were published after 2010.
Conclusions
Renal involvement in patients with WG is common and can be lethal. A high percent may even require renal replacement therapy, although patients can return to normal renal function. Factors associated with return to normal renal function are unclear, but it depends on early therapy and high doses of immunomodulators. Rituximab has shown greater effectiveness and fewer side effects than conventional treatments, so it's a valid therapeutic option for the management of patients with WG and renal involvement.
Keywords : Renal impairment; Adverse events; Wegener's granulomatosis; Renal replacement therapy.
