Nephropathy advancing to end-stage renal disease: a novel complication of lysinuric protein intolerance.
OBJECTIVE
To analyze systemically the prevalence of renal involvement in a cohort of Finnish patients with lysinuric protein intolerance (LPI) and to describe the course and outcome of end-stage renal disease in 4 patients.


METHODS
The clinical information in a cohort of 39 Finnish patients with LPI was analyzed retrospectively.


RESULTS
Proteinuria was observed in 74% of the patients and hematuria was observed in 38% of the patients during follow-up. Elevated blood pressure was diagnosed in 36% of the patients. Mean serum creatinine concentration increased in 38% of the patients, and cystatin C concentration increased in 59% of the patients. Four patients required dialysis, and severe anemia with poor response to erythropoietin and iron supplementation also developed in these patients.


CONCLUSIONS
Our findings suggest that renal function of patients with LPI needs to be carefully monitored, and hypertension and hyperlipidemia should be treated effectively. Special attention also should be paid to the prevention of osteoporosis and carnitine deficiency in the patients with end-stage renal disease associated with LPI. The primary disease does not prohibit treatment by dialysis and renal transplantation.
Tanner
Laura M
LM
Department of Pediatrics, University of Turku, Turku, Finland. lamaer@utu.fi
Näntö-Salonen
Kirsti
K
Niinikoski
Harri
H
Jahnukainen
Timo
T
Keskinen
Päivi
P
Saha
Heikki
H
Kananen
Kristiina
K
Helanterä
Antero
A
Metso
Martti
M
Linnanvuo
Marjatta
M
Huoponen
Kirsi
K
Simell
Olli
O
D000293:Adolescent; D000328:Adult; D020157:Amino Acid Transport Disorders, Inborn / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D002956:Citrulline / Q000097:blood; D003404:Creatinine / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation; D008239:Lysine / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology
C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D002956:Citrulline; D003404:Creatinine; D008239:Lysine