Posterior reversible encephalopathy syndrome in rapid progressive glomerulonephritis

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Abstract

Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiological syndrome affecting the posterior cerebral regions and is associated with an accelerated rise in blood pressure, renal disease or autoimmune disorders. Our objective was to review the association of PRES with renal outcome. Materials and Methods: Retrospective review of all nephrology patients diagnosed with PRES from 2010 to 2013 at our institution. The diagnosis of PRES was based on the presence of clinical features such as headache, altered mental status, visual disturbances and seizures with positive radiological findings on either Magnetic Resonance Imaging or Computed Tomography of the brain. Their demographic and laboratory result were analysed in particular, progression to end stage renal disease (ESRD). Results: Seven patients (3 males: 4 females), median age of 21 (IQR 17-24) years were recruited. Majority had lupus nephritis except one patient who had crescenteric IgA nephropathy. Median duration of their disease was 52.83 (IQR 3.3-58.17) months. Mean systolic and diastolic blood pressure were 186.43 ± 18.87 and 110.43 ± 14.02 mm Hg. Mean serum albumin and creatinine were 27.3 ± 8.7 g/L and 403.4 ± 183.6 umol/L respectively, at presentation. Two patients developed ESRD at the development of PRES whereas three patients progressed to ESRD at 2.73, 5.77 and 17.13 months. The other two patients had complete recovery of renal function to normal levels. All patients had full neurological recovery within one week. Conclusion: Development of PRES in patients with underlying chronic kidney disease may be a predictor of poor renal survival.

Original languageEnglish
Pages (from-to)270-276
Number of pages7
JournalBrunei International Medical Journal
Volume10
Issue number5
Publication statusPublished - 2014

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Posterior Leukoencephalopathy Syndrome
Glomerulonephritis
Chronic Kidney Failure
Kidney
Blood Pressure
Lupus Nephritis
Nephrology
Recovery of Function
Chronic Renal Insufficiency
Serum Albumin
Immunoglobulin A
Autoimmune Diseases
Headache
Creatinine
Seizures
Tomography
Magnetic Resonance Imaging
Demography

Keywords

  • Chronic kidney disease
  • End stage renal disease
  • Hypertension
  • Lupus nephritis
  • Posterior reversible encephalopathy syndrome

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Posterior reversible encephalopathy syndrome in rapid progressive glomerulonephritis",
abstract = "Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiological syndrome affecting the posterior cerebral regions and is associated with an accelerated rise in blood pressure, renal disease or autoimmune disorders. Our objective was to review the association of PRES with renal outcome. Materials and Methods: Retrospective review of all nephrology patients diagnosed with PRES from 2010 to 2013 at our institution. The diagnosis of PRES was based on the presence of clinical features such as headache, altered mental status, visual disturbances and seizures with positive radiological findings on either Magnetic Resonance Imaging or Computed Tomography of the brain. Their demographic and laboratory result were analysed in particular, progression to end stage renal disease (ESRD). Results: Seven patients (3 males: 4 females), median age of 21 (IQR 17-24) years were recruited. Majority had lupus nephritis except one patient who had crescenteric IgA nephropathy. Median duration of their disease was 52.83 (IQR 3.3-58.17) months. Mean systolic and diastolic blood pressure were 186.43 ± 18.87 and 110.43 ± 14.02 mm Hg. Mean serum albumin and creatinine were 27.3 ± 8.7 g/L and 403.4 ± 183.6 umol/L respectively, at presentation. Two patients developed ESRD at the development of PRES whereas three patients progressed to ESRD at 2.73, 5.77 and 17.13 months. The other two patients had complete recovery of renal function to normal levels. All patients had full neurological recovery within one week. Conclusion: Development of PRES in patients with underlying chronic kidney disease may be a predictor of poor renal survival.",
keywords = "Chronic kidney disease, End stage renal disease, Hypertension, Lupus nephritis, Posterior reversible encephalopathy syndrome",
author = "Rozita Mohd and {Abdul Gafor}, {Abdul Halim} and {Abdul Cader}, Rizna",
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journal = "Brunei International Medical Journal",
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T1 - Posterior reversible encephalopathy syndrome in rapid progressive glomerulonephritis

AU - Mohd, Rozita

AU - Abdul Gafor, Abdul Halim

AU - Abdul Cader, Rizna

PY - 2014

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N2 - Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiological syndrome affecting the posterior cerebral regions and is associated with an accelerated rise in blood pressure, renal disease or autoimmune disorders. Our objective was to review the association of PRES with renal outcome. Materials and Methods: Retrospective review of all nephrology patients diagnosed with PRES from 2010 to 2013 at our institution. The diagnosis of PRES was based on the presence of clinical features such as headache, altered mental status, visual disturbances and seizures with positive radiological findings on either Magnetic Resonance Imaging or Computed Tomography of the brain. Their demographic and laboratory result were analysed in particular, progression to end stage renal disease (ESRD). Results: Seven patients (3 males: 4 females), median age of 21 (IQR 17-24) years were recruited. Majority had lupus nephritis except one patient who had crescenteric IgA nephropathy. Median duration of their disease was 52.83 (IQR 3.3-58.17) months. Mean systolic and diastolic blood pressure were 186.43 ± 18.87 and 110.43 ± 14.02 mm Hg. Mean serum albumin and creatinine were 27.3 ± 8.7 g/L and 403.4 ± 183.6 umol/L respectively, at presentation. Two patients developed ESRD at the development of PRES whereas three patients progressed to ESRD at 2.73, 5.77 and 17.13 months. The other two patients had complete recovery of renal function to normal levels. All patients had full neurological recovery within one week. Conclusion: Development of PRES in patients with underlying chronic kidney disease may be a predictor of poor renal survival.

AB - Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiological syndrome affecting the posterior cerebral regions and is associated with an accelerated rise in blood pressure, renal disease or autoimmune disorders. Our objective was to review the association of PRES with renal outcome. Materials and Methods: Retrospective review of all nephrology patients diagnosed with PRES from 2010 to 2013 at our institution. The diagnosis of PRES was based on the presence of clinical features such as headache, altered mental status, visual disturbances and seizures with positive radiological findings on either Magnetic Resonance Imaging or Computed Tomography of the brain. Their demographic and laboratory result were analysed in particular, progression to end stage renal disease (ESRD). Results: Seven patients (3 males: 4 females), median age of 21 (IQR 17-24) years were recruited. Majority had lupus nephritis except one patient who had crescenteric IgA nephropathy. Median duration of their disease was 52.83 (IQR 3.3-58.17) months. Mean systolic and diastolic blood pressure were 186.43 ± 18.87 and 110.43 ± 14.02 mm Hg. Mean serum albumin and creatinine were 27.3 ± 8.7 g/L and 403.4 ± 183.6 umol/L respectively, at presentation. Two patients developed ESRD at the development of PRES whereas three patients progressed to ESRD at 2.73, 5.77 and 17.13 months. The other two patients had complete recovery of renal function to normal levels. All patients had full neurological recovery within one week. Conclusion: Development of PRES in patients with underlying chronic kidney disease may be a predictor of poor renal survival.

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