Acute Kidney Failure in a Young African American Male

Table 2

Alternative therapeutic options for retroperitoneal fibrosis.

Source	Study	n	Study Patients	Outcome
Vaglio et al., Lancet, 2011	Prednisone vs. tamoxifen (0.5 mg/kg/d) for 8 months	36	Patients in remission after 1 month of prednisone	Lower relapse rate in prednisone (17%) vs. tamoxifen (50%) group (p-value 0.04)
Van Bommel et al., Am J Kidney Dis, 2007	Prednisone (60 mg/d for 6 wks, tapered for 3 months to 10 mg/d for 1 y)	24	Patients with first presentation of idiopathic RPF	High initial success rate (75%) with high recurrence rate (72% of successes)
Van Bommel et al., Ann Intern Med, 2006	Tamoxifen (20 mg bid)	19	37% idiopathic RPF; 63% secondary to atherosclerosis	79% reported symptom improvement with 6% recurrence
Jois et al., Rheumatology, 2007	Cyclophosphamide (1 g/2 wks, 6 pulses) plus mycophenolate mofetil [MMF], 2.5 g/d) with reduced prednisolone	1	Relapsing RPF previously treated with reduced dose prednisolone and methotrexate	Asymptomatic; No recurrence at 15 months
Scheel et al., Ann Intern Med, 2011	MMF (1g twice daily for 10-30 m) with prednisone(40 mg/d, tapered over 6 m)	7	1 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, 2012	Cyclophosphamide plus low dose corticosteroid induction; long term azathioprine or methotrexate	35	All patients had chronic periaortitis	Significant reduction of transverse diameter of periaortic mantle; Less time between insertion and removal of ureteral stents
Marcolongo et al., Am J Med, 2004	Prednisone plus either azathioprine or cyclophosphamide for 6 m	26	All patients had idiopathic RPF	Treatment failure rate of ~1 per 100 patient-years (95% CI: 0.02 to 5 per 100 patient-years)
Alberici et al., Ann Rheum Dis, 2012	Methotrexate (15-20 mg/wk) plus prednisone	14	All patients had relapsing idiopathic RPF	79% in remission, fewer relapses in patients continuing treatment; Significant CRP and ESR reduction, no significant mean mass reduction
Maritati et al., Ann Rheum Dis, 2012	Rituximab (375 mg/m^2/wk for 4 wks)	2	Both patients had chronic periaortitis. One relapsing; other administered rituximab plus low dose prednisone	Remission 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.