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Plasma cell dyscrasias can have a heterogenous onset and, also, kidney involvement, associated with various clinical presentations. This mandates always considering plasma cell dyscrasias as a possible diagnosis when faced with a case with unusual progression. We report the case of a 44-year-old male with a sellar mass that was diagnosed first as an atypical pituitary adenoma, who later developed kidney involvement manifested as renal insufficiency and proteinuria, with a pathology report suggesting focal and segmental glomerulosclerosis. Within a year, he was diagnosed with multiple myeloma, prompting pathological reevaluation of the sellar mass and the change of diagnosis to solitary sellar plasmacytoma. [ABSTRACT FROM AUTHOR]

Chronic kidney disease is a major public health problem because of its high prevalence and the influence of its characteristic abnormalities (proteinuria, glomerular filtration rate decline, mineral metabolism disorders, anemia, or dyselectrolytemia) on both kidney function and other organs and systems. The most striking of these later is the cardiovascular involvement, which is the main cause of morbidity and mortality. Therefore, the recognition and treatment of cardiovascular risk factors are major objectives in the management of chronic kidney disease patients, irrespective of the kidney function decrease severity. However, the pathogenic and therapeutical response particularities which are seen in this clinical setting should be always kept in mind. For these reasons, the current paper is a sort overview of the current knowledge about the approach to main cardiovascular risk factors in the presence of chronic kidney disease. [ABSTRACT FROM AUTHOR]

Introduction. Serum immunoglobulin A (IgA)/C3 ratio has been reported as a predictor of histological lesions and prognosis in asian patients with IgA nephropathy (IgAN). Since its validity in other populations is unclear, we aimed to evaluate the relationship between IgA/C3 ratio and renal outcome in Caucasian European patients with biopsy-proven IgAN. Methods. We conducted a retrospective, observational study on 95 patients with primary IgAN patients diagnosed between 2010 to 2017 (70% male, age 41 (34 to 49) years, eGFR 39.4 (25.2 to 56.5) mL/min, proteinuria 1.7 (0.8 to 3.0) g/g). The primary study composite end-point was doubling of serum creatinine, ESRD (dialysis or renal transplant) or death, whichever came first. Results. Median follow-up was 30 (95% CI: 27.5 to 32.4) months; 11% developed ESRD, 10% experienced serum creatinine doubling, and 1% died. The endpoint was reached by 21% of the patients. They had lower eGFR, higher proteinuria and hematuria, and lower serum albumin. The distribution in Oxford classes was alike. The AUROC for IgA/C3 ratio was 0.60 (95% CI: 0.45 to 0.74) and generated an optimal cut-off of 2.91 (sensitivity 68%, specificity 55%). The mean event-free survival of the whole cohort was 5.2 (95% CI: 4.7 to 5.8) years. Patients with IgA/C3 ratio < 2.9 had a tendency to better renal survival (P > .05). In Cox proportional hazard ratio model, the independent predictors of a poorer eventfree survival were higher serum creatinine, higher proteinuria and increased IgA/C3 ratio, while renin angiotensin system inhibitors predicted better outcome. Conclusion. Our study reports evidence that supports IgA/C3 ratio as a reasonable predictor of IgAN prognosis in European patients. [ABSTRACT FROM AUTHOR]