Case Reports in Nephrology / 2019 / Article / Tab 2

Case Report

Acute Kidney Failure in a Young African American Male

Table 2

Alternative therapeutic options for retroperitoneal fibrosis.

SourceStudynStudy PatientsOutcome

Vaglio et al., Lancet, 2011Prednisone vs. tamoxifen (0.5 mg/kg/d) for 8 months36Patients in remission after 1 month of prednisoneLower relapse rate in prednisone (17%) vs. tamoxifen (50%) group (p-value 0.04)

Van Bommel et al., Am J Kidney Dis, 2007Prednisone (60 mg/d for 6 wks, tapered for 3 months to 10 mg/d for 1 y)24Patients with first presentation of idiopathic RPFHigh initial success rate (75%) with high recurrence rate (72% of successes)

Van Bommel et al., Ann Intern Med, 2006Tamoxifen (20 mg bid)1937% idiopathic RPF; 63% secondary to atherosclerosis79% reported symptom improvement with 6% recurrence

Jois et al., Rheumatology, 2007Cyclophosphamide (1 g/2 wks, 6 pulses) plus mycophenolate mofetil [MMF], 2.5 g/d) with reduced prednisolone1Relapsing RPF previously treated with reduced dose prednisolone and methotrexateAsymptomatic
No recurrence at 15 months

Scheel et al., Ann Intern Med, 2011MMF (1g twice daily for 10-30 m) with prednisone(40 mg/d, tapered over 6 m)71 patient had known RPF risk factor (external beam radiation)Idiopathic RPF patients had 16%-62% mass regression; 10/11 ureters not obstructed after stent removal

Binder et al., Ann Rheum Dis, 2012Cyclophosphamide plus low dose corticosteroid induction; long term azathioprine or methotrexate35All patients had chronic periaortitisSignificant reduction of transverse diameter of periaortic mantle
Less time between insertion and removal of ureteral stents

Marcolongo et al., Am J Med, 2004Prednisone plus either azathioprine or cyclophosphamide for 6 m26All patients had idiopathic RPFTreatment failure rate of ~1 per 100 patient-years (95% CI: 0.02 to 5 per 100 patient-years)

Alberici et al., Ann Rheum Dis, 2012Methotrexate (15-20 mg/wk) plus prednisone14All patients had relapsing idiopathic RPF79% in remission, fewer relapses in patients continuing treatment; Significant CRP and ESR reduction, no significant mean mass reduction

Maritati et al., Ann Rheum Dis, 2012Rituximab (375 mg/m2/wk for 4 wks)2Both patients had chronic periaortitis. One relapsing; other administered rituximab plus low dose prednisoneRemission achieved in both patients

n, number of patients; RPF, retroperitoneal fibrosis; MMF, mycophenolate mofetil; CI, confidence interval; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

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