title: Clinical features and outcomes of 98 children and adults with dense deposit disease.
abstract: BACKGROUND
  Dense deposit disease (DDD) is an ultra-rare renal disease.
  
  
  METHODS
  In the study reported here, 98 patients and their families participated in a descriptive patient-centered survey using an online research format. Reports were completed by patients (38%) or their parents (62%). Age at diagnosis ranged from 1.9 to 38.9 years (mean 14 years).
  
  
  RESULTS
  The majority of patients presented with proteinuria and hematuria; 50% had hypertension and edema. Steroids were commonly prescribed, although their use was not evidence-based. One-half of the patients with DDD for 10 years progressed to end-stage renal disease (ESRD), with young females having the greatest risk for renal failure. Of first allografts, 45% failed within 5 years, most frequently due to recurrent disease (70%). Type 1 diabetes (T1D) was present in over 16% of families, which represents a 116-fold increase in incidence compared with the general population (p < 0.001).
  
  
  CONCLUSIONS
  Based on these findings, we suggest that initiatives are needed to explore the high incidence of T1D in family members of DDD patients and the greater risk for progression to ESRD in young females with DDD. These efforts must be supported by sufficient numbers of patients to establish evidence-based practice guidelines for disease management. An international collaborative research survey should be implemented to encourage broad access and participation.
authors: University of Iowa College of Nursing, 426 Nursing Building, Iowa City, IA 52242, USA. der-fa-lu@uiowa.edu
authors: Der-Fa
authors: DF
authors: Lu
authors: Mikyung
authors: M
authors: Moon
authors: Lynne D
authors: LD
authors: Lanning
authors: Ann Marie
authors: AM
authors: McCarthy
authors: Richard J H
authors: RJ
authors: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003625:Data Collection; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D005006:Ethnicity; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D008297:Male; D010361:Patients; D011241:Prednisone / Q000627:therapeutic use; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D004232:Diuretics; D011241:Prednisone