Takayasu’s disease effects on the kidneys: current perspectives

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Takayasu arteritis (TA) is a chronic vasculitis disease of unknown etiology. Clinically significant renal disease is relatively common, and renovascular hypertension is the major renal problem. The assessment of TA activity is usually challenging because vascular inflammation may progress to fixed vascular injury without findings of active disease. Until now, the best therapeutic options have not been identified. This review highlights the current perspectives of renal involvement in TA.

Related collections

Most cited references 60

Record: found
Abstract: found
Article: not found

The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis.

W P Arend, B Michel, D Bloch … (1990)

Criteria for the classification of Takayasu arteritis were developed by comparing 63 patients who had this disease with 744 control patients with other forms of vasculitis. Six criteria were selected for the traditional format classification: onset at age less than or equal to 40 years, claudication of an extremity, decreased brachial artery pulse, greater than 10 mm Hg difference in systolic blood pressure between arms, a bruit over the subclavian arteries or the aorta, and arteriographic evidence of narrowing or occlusion of the entire aorta, its primary branches, or large arteries in the proximal upper or lower extremities. The presence of 3 or more of these 6 criteria demonstrated a sensitivity of 90.5% and a specificity of 97.8%. A classification tree also was constructed with 5 of these 6 criteria, omitting claudication of an extremity. The classification tree demonstrated a sensitivity of 92.1% and a specificity of 97.0%.

0 comments Cited 268 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Takayasu arteritis.

J. Giordano, M Rottem, G. Kerr … (1994)

To evaluate prospectively the clinical features, angiographic findings, and response to treatment of patients with Takayasu arteritis. 60 patients with Takayasu arteritis were studied at the National Institute of Allergy and Infectious Diseases between 1970 and 1990 and were followed for 6 months to 20 years (median follow-up, 5.3 years). Data on clinical features, angiographic and laboratory findings, disease course, and response to therapy were all recorded and stored in a computer-based retrieval system. The Warren Magnuson Clinical Center of the National Institutes of Health. In our series of patients, Takayasu arteritis was more common in Asian persons compared with persons from other racial groups. Females (97%) were most frequently affected. The median age at disease onset was 25 years. Juveniles had a delay in diagnosis that was about four times that of adults. The clinical presentation ranged from asymptomatic to catastrophic with stroke. The most common clinical finding was a bruit. Hypertension was most often associated with renal artery stenosis. Only 33% of all patients had systemic symptoms on presentation. Sixty-eight percent of patients had extensive vascular disease; stenotic lesions were 3.6-fold more common than were aneurysms (98% compared with 27%). The erythrocyte sedimentation rate was not a consistently reliable surrogate marker of disease activity. Surgical bypass biopsy specimens from clinically inactive patients showed histologically active disease in 44% of patients. Although clinically significant palliation usually occurred after angioplasty or bypass of severely stenotic vessels, restenosis was common. Medical therapy was required for 80% of patients, whereas 20% had monophasic self-limiting disease. Immunosuppressive treatment with glucocorticoids alone or in combination with a cytotoxic agent failed to induce remission in one fourth of patients; about half of those who achieved remission later relapsed. In North America, Takayasu arteritis is a rare disease. It is heterogeneous in presentation, progression, and response to therapy. Current laboratory markers of disease activity are insufficiently reliable to guide management. Most patients require repeated and, at times, prolonged courses of therapy. Although mortality was low, substantial morbidity occurred in most patients.

0 comments Cited 164 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients.

Matthew G Hoffman, Shawn Clark, Kathleen McKinnon-Maksimowicz (2007)

To describe the clinical, laboratory, and radiographic manifestations of Takayasu arteritis (TA) in a cohort from the US, evaluate the response to interventions, remission and relapse rates, and disease progression, and compare these observations with those from other cohorts in the US, Japan, India, Italy, and Mexico. Seventy-five patients were retrospectively studied using a uniform database that included clinical, laboratory, and imaging data. Vascular imaging studies were performed at least yearly to monitor disease progression. Common manifestations at disease onset included loss or asymmetry of pulses (57%), limb blood pressure discrepancy (53%), and bruits (53%). Eleven percent of patients were asymptomatic prior to disease diagnosis. Initial angiographic studies showed aortic abnormalities in 79% of patients and frequent involvement of the subclavian (65%) and carotid (43%) arteries.Ninety-three percent of longitudinally followed patients attained disease remission of any duration, but only 28% sustained remission of at least 6 months' duration after prednisone was tapered to <10 mg daily. Both angioplasty and vascular surgery were initially successful, but recurrent stenosis occurred in 78% of angioplasty and 36% of bypass/reconstruction procedures. More than two-thirds of patients had difficulty performing routine daily activities and approximately one-fourth of all patients were unable to work. Our cohort was similar to the National Institutes of Health, Italian, Japanese, and Mexican cohorts in terms of the predominance of female subjects and disease manifestations, but differed from the Indian cohort in that the latter group had a higher frequency of male subjects, abdominal aorta and renal artery involvement, and hypertension. Although improvement of symptoms in TA usually follows glucocorticoid therapy, relapses usually occur with dosage reduction. Attempts to restore vascular patency are often initially successful, but restenosis occurs frequently. Chronic morbidity and disability occur in most patients with TA in the US.

0 comments Cited 93 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Int J Nephrol Renovasc Dis

Journal ID (iso-abbrev): Int J Nephrol Renovasc Dis

Journal ID (publisher-id): International Journal of Nephrology and Renovascular Disease

Title: International Journal of Nephrology and Renovascular Disease

Publisher: Dove Medical Press

ISSN (Electronic): 1178-7058

Publication date Collection: 2018

Publication date (Electronic): 15 August 2018

Volume: 11

Pages: 225-233

Affiliations

[1 ]Nephrology, Dialysis and Renal Transplant Department, Civico and Di Cristina Hospital, Palermo, Italy, gioacchinolicavoli@ 123456libero.it

[2 ]Internal Medicine, Cardiovascular and Renal Diseases Department, University of Palermo, Palermo, Italy

[3 ]Radiology Department, Civico and Di Cristina Hospital, Palermo, Italy

Author notes

Correspondence: Gioacchino Li Cavoli, Nephrology, Dialysis and Renal Transplant Department, Civico and Di Cristina Hospital, via Francesco Cilea 43, Palermo 90144, Italy, Tel +39 333 231 8100, Fax +39 91 666 3454, Email gioacchinolicavoli@ 123456libero.it

Article

Publisher ID: ijnrd-11-225

DOI: 10.2147/IJNRD.S146355

PMC ID: 6101009

PubMed ID: 30147353

SO-VID: 9af4fbf8-397b-4479-ab2f-7f3dca0d9edf

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Takayasu’s disease effects on the kidneys: current perspectives

Read this article at

Abstract

Related collections

Karger: Nephrology

Most cited references 60

The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis.

Takayasu arteritis.

Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 639

Cited by 6

Most referenced authors 880