VA Report: What is the etiology and treatment options for Rapidly progressive crescentic glomerulonephritis?

The Bottom Line:  Early treatment is of paramount importance for patients with crescentic GN. The current approach is based on a combination of corticosteroids and cytotoxic drugs with the aims of quenching the active inflammation and abating the cellular response and the antibody production

The etiology and the initial pathogenetic factors are different in the three types, but the final mechanisms leading to crescent formation and the renal symptoms and signs are similar.

Moroni, G., & Ponticelli, C. (n.d.). Rapidly progressive crescentic glomerulonephritis: Early treatment is a must. Autoimmunity Reviews, 13(7), 723-729.

The term crescentic glomerulonephritis (GN) refers to a pathologic condition characterized by extracapillary proliferation in > 50% of glomeruli. Clinically crescentic GN is characterized by a nephritic syndrome rapidly progressing to end stage renal disease (ESRD).


EUHM Resident Report: How is hypokalemia associated with HIV?

The Bottom Line: Adverse events in HIV patients taking tenofovir are relatively rare, postmarketing reports of nephrotoxicity have alerted physicians to other potentially serious outcomes. This study presents a series of 40 patients who developed hypokalemia associated with tenofovir. Identified risk factors included concomitant ritonavir or didanosine use, a lower weight and longer duration of tenofovir use.

References: Cirino, C., & Kan, V. (n.d.). Hypokalemia in HIV patients on tenofovirAIDS.,20(12), 1671-1673.

Summary: Table 1. Summary of demographic and clinical data from our patient and 39 individual safety reports for hypokalemia on tenofovir.

The overall incidence of toxicity with tenofovir is low. Risk factors of developing renal insufficiency or failure while on tenofovir include those with low body weight, baseline renal insufficiency, or regimens containing ritonavir and didanosine.