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Vol. 94, No. 2, 2003
Issue release date: June 2003
Section title: Original Paper
Nephron Clin Pract 2003;94:c33–c39
(DOI:10.1159/000071279)

Hemoperfusion with Polymyxin B-Immobilized Fiber in Septic Patients with Methicillin-Resistant Staphylococcus aureus-Associated Glomerulonephritis

Nakamura T. · Ushiyama C. · Suzuki Y. · Osada S. · Inoue T. · Shoji H. · Hara M. · Shimada N. · Koide H.
Departments of aMedicine and bSurgery, Misato Junshin Hospital, cDepartment of Medicine, National Rehabilitation Center, and dDepartment of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama; eArtificial Organ Department, Toray Medical Co., Ltd., Tokyo; fDepartment of Pediatrics, Yoshida Hospital, Niigata; gDepartment of Medicine, Koto Hospital, Tokyo, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/29/2002
Accepted: 1/14/2003
Published online: 11/17/2004

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 3

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background/Aims: We investigated whether urinary podocytes are present in septic patients with methicillin-resistant Staphylococcus aureus (MRSA)-associated glomerulonephritis and whether polymyxin B-immobilized fiber (PMX-F) treatment affects proteinuria and urinary podocyte excretion in these patients. Methods: Twenty septic patients with MRSA-associated glomerulonephritis (mean age: 63.7 years) and 80 septic patients whose MRSA infection was not followed by glomerulonephritis (mean age: 60.5 years) were included in this study. All septic patients were treated with fosfomycin sodium, β-lactams, arbekacin sulfate, and teicoplanin, or a combination of these. Twenty septic patients with MRSA-associated glomerulonephritis were randomly assigned to one of two treatments: PMX-F treatment (group A, n = 10) and conventional treatment (group B, n = 10). PMX-F treatment was repeated twice. Results: Urinary podocytes and urinary protein excretion were not detected in MRSA septic patients without glomerulonephritis. However, urinary podocytes (1.7 ± 0.6 cells/ml) and proteinuria (2.6 ± 0.6 g/d) were detected in the 20 septic patients with MRSA-associated glomerulonephritis. Plasma endotoxin levels were decreased from 13.6 ± 4.6 pg/ml to 6.6 ± 2.2 pg/ml (p < 0.05) in group A. Levels in group B, however, showed little difference after treatment. Urinary podocytes were reduced in group A (from 1.8 ± 0.6 cells/ml to 0.4 ± 0.2 cells/ml, p < 0.01) as was urinary protein excretion (from 3.0 ± 0.5 g/d to 0.8 ± 0.4 g/d, p < 0.01) but urinary podocytes and protein excretion levels showed little difference after treatment in group B. Conclusion: PMX-F treatment may be effective in reducing urinary protein and urinary podocyte excretion in septic patients with MRSA-associated glomerulonephritis.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/29/2002
Accepted: 1/14/2003
Published online: 11/17/2004

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 3

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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