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A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction
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A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction

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Long-term outcome of biopsy-proven cholesterol crystal embolism

Naoya Toriu1, Keiichi Sumida2, Hiroki Mizuno2

  • 1Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Takatsu, Kawasaki, Tokyo, Kanagawa, 212-0015, Japan. ntoriu@kuhp.kyoto-u.ac.jp.

Clinical and Experimental Nephrology
|June 5, 2019
PubMed

Insights

Cholesterol crystal embolism (CCE) causes kidney damage and increases the risk of dialysis. Renal function decline after CCE, even after six weeks, significantly elevates the risk of needing dialysis.

Area of Science:

  • Nephrology
  • Cardiovascular Science
  • Pathology

Background:

  • Cholesterol crystal embolism (CCE) is a known cause of renal damage, with a high risk of end-stage renal disease.
  • The temporal pattern of CCE-induced kidney deterioration and subsequent dialysis risk remains poorly understood.
  • This study investigates the long-term renal outcomes and dialysis risk in patients with biopsy-proven CCE.

Purpose of the Study:

  • To determine the association between declining renal function after CCE and the risk of requiring dialysis.
  • To analyze the impact of different time courses (acute, subacute, chronic) of renal function decline on dialysis risk.
  • To identify predictors of dialysis initiation in patients with CCE.

Main Methods:

  • Retrospective cohort study of 38 Japanese patients diagnosed with CCE between 1992 and 2005.
  • Competing risk regression analysis was used to assess the relationship between renal function decline and dialysis risk.
  • Adjustments were made for age, baseline serum creatinine, and the cause of CCE (iatrogenic or spontaneous).

Main Results:

  • During a median follow-up of 25.9 weeks, 35.9% of patients initiated dialysis.
  • Declining renal function was significantly associated with an increased risk of dialysis (SHR 9.47).
  • Subacute and chronic patterns of renal function decline showed a significantly higher risk of dialysis compared to no decline.

Conclusions:

  • Declining renal function following CCE is a significant predictor of subsequent dialysis initiation.
  • The risk of dialysis is elevated even when renal function decline occurs later than six weeks post-CCE.
  • These findings highlight the importance of monitoring renal function in CCE patients to predict long-term outcomes.
Abstract

Keywords:
Cholesterol crystal embolismDialysis

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