MON-195 TO STUDY CORRELATION OF NAIL CREATININE WITH SERUM CREATININE IN CHRONIC KIDNEY DISEASE STAGE Vd & IN RENAL TRANPLANT RECIPIENT.

摘要

Pauci Immune Glomerulonephritis is the most common cause of rapidly progressive glomerulonephritis. Standard treatment for ANCA associated vasculitis consists of combined use of cyclophosphamide and steroids. Although this treatment had dramati- cally changed the prognosis, 20% of patients with AAV will develop ESRD during their lifetime’ Kidney Transplantation improves both the life expectancy and quality of life in patients with ESRD. For patients with ANCA vasculitis, both the KDIGO and Canadian society of trans- plantation recommend that AAV patients should be in clinical remission for 1 year prior to proceeding for transplantation. ANCA positivity is not acontraindication for transplantation, however it has been reported that patients with ANCA positivity more likely to develop severe vasculop- athy in graft and recurrence of vasculitis in allograft. Rate of recurrence of ANCA vasculitis in the post transplantation period is variable ranging from 1.6%-17.3%. The higher rate of recurrence was reported in patients receiving prednisone, cyclosporine and azathioprine for immunosup- pression, whereas with the current tacrolimus and mycophenolate regi- mens, the rate of relapse in much lower. Average time to recurrence in the above studies was 20 months to 68 months post transplant. Our patient had recurrence of vasculitis day 5 after transplantation despite aggressive induction immunosuppression.