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10.1681/ASN.2006060652

http://scihub22266oqcxt.onion/10.1681/ASN.2006060652
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C4764668!4764668!17135394
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suck abstract from ncbi


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pmid17135394      J+Am+Soc+Nephrol 2007 ; 18 (1): 274-81
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  • Effect of organic solvent exposure on chronic kidney disease progression: the GN-PROGRESS cohort study #MMPMID17135394
  • Jacob S; Héry M; Protois JC; Rossert J; Stengel B
  • J Am Soc Nephrol 2007[Jan]; 18 (1): 274-81 PMID17135394show ga
  • It has been suggested that solvent exposure may have a role in the progression of glomerulonephritis (GN) to end-stage renal failure (ESRD), but this has never been tested with an appropriate cohort study design. We included 338 nonESRD patients with a first biopsy for primary GN between 1994 and 2001: 194 IgA nephropathies (IgAN), 75 membranous nephropathies (MN) and 69 focal and segmental glomerulosclerosis (FSGS). ESRD, defined as an estimated glomerular filtration rate < 15 mL/min/1.73m2 or dialysis, was registered over a mean follow-up period of 5 years. Patients? lifelong solvent exposures before and after diagnosis were recorded by interview and assessed by industrial hygienist experts. We used Cox models to estimate adjusted hazard ratios (HR) of ESRD related to exposures. Overall, 15% of the patients had been exposed at a low level before diagnosis and 14% at a high level. Forty-two with IgA N reached ESRD, 12 with MN, and 22 with FSGS. A graded relationship was observed for MN: age- and gender-adjusted HR [95% confidence interval] for low exposure vs none 3.1 [0.5?18.2], and for high exposure vs none 8.2 [1.9?34.7], as well as for IgA N: 1.6 [0.7?3.9] and 2.2 [1.0?4.8], respectively, but not for FSGS. Solvent risk was only partly mediated by baseline proteinuria: adjusted HR for high exposure vs none = 5.5 [1.3 ? 23.9] for MN and 1.8 [0.8 ? 3.9] for IgA N. In patients with IgA N, there was a trend in increasing HR with exposure duration before and its persistence after diagnosis. These findings support the hypothesized association of solvent exposure with the progression of GN to ESRD. They should prompt clinicians to give greater attention to patients? occupational exposures and possibly to consider professional reclassification.
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