Serum creatinine on admission was 3.3 mg/100 ml (estimated glomerular filtration rate 15 ml/min). Baseline serum creatinine 7 months previously was 0.9 mg/100 ml. There was no history of diabetes or hypertension and no family history of renal disease. DihydrotestosteroneDHT The patient was diagnosed with metastatic mammary ductal adenocarcinoma in 1993 and underwent radical mastectomy, radiation therapy, and several courses of chemotherapy. Her regular medications included pamidronate (90 mg monthly for 5 years) and abraxane (albumin-bound paclitaxel) 120 mg every other week.

The patient was started on bevacizumab (anti-vascular endothelial growth

factor (VEGF) antibody) 7 months previously (400 mg every other week, increasing to 800 mg every other week after 2 months). However, approximately 3 months after starting anti-VEGF therapy, she developed new onset of leg edema, shortness of breath, generalized weakness, and hypertension (blood pressure 164/83 mmHg). Serum creatinine was noted to be elevated (1.9 mg/100 ml, normal (N) < 1.2 mg/100 ml). Urinalysis was not performed. Bevacizumab was discontinued and the patient was started on furosemide 40 mg daily. Chemotherapy was switched from abraxane to 5-fluoruracil 2 g p.o. b.i.d. Over the next 4 months, GDC-0973 nmr serum creatinine increased to 3.2 mg/100 ml and

the patient was referred for nephrology evaluation. On physical examination, blood pressure remained well controlled (average 140/80 mmHg). There was mild (1+) peripheral edema, but no rash or other physical abnormality was noted. Urinalysis

showed 4+ protein and no cells. A 24-h urine collection contained 3.6 g protein. Serum albumin was decreased (2.9 g/100ml). Serum lactate dehydrogenase was slightly elevated (226 IU/l, N 122-220 IU/l), but all other hematologic studies were within the normal range, including hematocrit (37.2%), white blood cell count (6.3 x 10(3)/mu l), platelet count (230 x 10(3)/mu l), haptoglobin (283 mg/100 ml, N 20-300 mg/100 ml). No schistocytes were seen on peripheral smear. Serologic work revealed negative antinuclear antibody, hepatitis B surface antigen, and hepatitis C virus antibodies. Kidney size was within normal limits and ultrasound showed no selleck chemicals llc evidence of hydronephrosis or obstruction.

A renal biopsy was performed to evaluate the cause of nephrotic range proteinuria and worsening renal function.”
“Etiological research aims to investigate the causal relationship between putative risk factors (or determinants) and a given disease or other outcome. In contrast, prognostic research aims to predict the probability of a given clinical outcome and in this perspective the pathophysiology of the disease is not an issue. Multivariate modeling is a fundamental tool both to infer causality and to investigate prognostic factors in epidemiological research.