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therapy membranous nephropathy

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https://www.readbyqxmd.com/read/27852608/dba2j-db-db-mice-are-susceptible-to-early-albuminuria-and-glomerulosclerosis-that-correlates-with-systemic-insulin-resistance
#1
Mette Viberg Østergaard, Vanda Pinto, Kirsty Stevenson, Jesper Worm, Lisbeth N Fink, Richard John Mark Coward
Diabetic nephropathy (DN) is the leading cause of kidney failure in the world. To understand important mechanisms underlying this condition, and to develop new therapies, good animal models are required. In mouse models of type-1 diabetes, the DBA/2J strain has been shown to be more susceptible to develop kidney disease than other common strains. We hypothesized this would also be the case in type-2 diabetes. We studied db/db and wt DBA/2J mice and compared these with the db/db BLKS/J mouse, which is currently the most widely used type-2 DN model...
November 16, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27816946/advanced-glycation-end-products-mediated-cellular-and-molecular-events-in-the-pathology-of-diabetic-nephropathy
#2
Anil Kumar Pasupulati, P Swathi Chitra, G Bhanuprakash Reddy
Diabetic nephropathy (DN) is a major cause of morbidity and mortality in diabetic patients and a leading cause of end-stage renal disease (ESRD). Degenerative changes such as glomerular hypertrophy, hyperfiltration, widening of basement membranes, tubulointerstitial fibrosis, glomerulosclerosis and podocytopathy manifest in various degrees of proteinuria in DN. One of the key mechanisms implicated in the pathogenesis of DN is non-enzymatic glycation (NEG). NEG is the irreversible attachment of reducing sugars onto free amino groups of proteins by a series of events, which include the formation of Schiff's base and an Amadori product to yield advanced glycation end products (AGEs)...
December 1, 2016: Biomolecular Concepts
https://www.readbyqxmd.com/read/27790518/adult-idiopathic-renal-vein-thrombosis-mimicking-acute-pyelonephritis
#3
Arpan Choudhary, Prasenjit Majee, Rupesh Gupta, Supriyo Basu, Ranjit Kumar Das
Renal Vein Thrombosis (RVT) is a rarely encountered condition. It occurs due to a hypercoagulable state in the body, caused by nephrotic syndrome and membranous nephropathy in the adults. Mode of presentation is variable. In chronic form, it may remain silent for a long time and presenting later with symptoms of pedal oedema, varicocele, proteinuria. In acute state, it manifests as flank pain, nausea or haematuria. We present a case of 25-year-old male, with left sided flank pain, haematuria and nausea for 4 days...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27783276/mizoribine-therapy-combined-with-steroids-and-mizoribine-blood-concentration-monitoring-for-idiopathic-membranous-nephropathy-with-steroid-resistant-nephrotic-syndrome
#4
Takao Saito, Masayuki Iwano, Koichi Matsumoto, Tetsuya Mitarai, Hitoshi Yokoyama, Noriaki Yorioka, Shinichi Nishi, Ashio Yoshimura, Hiroshi Sato, Satoru Ogahara, Yoshie Sasatomi, Yasufumi Kataoka, Shiro Ueda, Akio Koyama, Shoichi Maruyama, Masaomi Nangaku, Enyu Imai, Seiichi Matsuo, Yasuhiko Tomino
BACKGROUND: We designed a prospective and randomized trial of mizoribine (MZR) therapy combined with prednisolone (PSL) for idiopathic membranous nephropathy (IMN) with steroid-resistant nephrotic syndrome (SRNS). METHODS: Patients with IMN were divided into 2 groups, and MZR combined with PSL was administered for 2 years. PSL was initially prescribed at 40 mg/day and tapered. MZR was given once-a-day at 150 mg and 3-times-a-day at 50 mg each to groups 1 and 2...
October 25, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27778424/intravenous-pulse-cyclophosphamide-and-steroids-induce-immunological-and-clinical-remission-in-new-incident-and-relapsing-primary-membranous-nephropathy
#5
Durga Anil K Kanigicherla, Patrick Hamilton, Krystyna Czapla, Paul Ec Brenchley
AIM: Primary membranous nephropathy (PMN) is associated with progression to end stage renal disease in some patients. Standard immunosuppressive therapy with cyclical cyclophosphamide and corticosteroids can be associated with significant adverse effects. We aimed to assess immunological and clinical response with intravenous pulse cyclophosphamide and oral steroids in patients with severe nephrotic syndrome - in a prospective observational cohort study at our centre. METHODS: 17 consecutive patients (9 New-incident and 8 relapses) with severe nephrotic syndrome received intravenous pulse cyclophosphamide and daily oral steroids after failure to achieve remission with supportive therapy alone...
October 24, 2016: Nephrology
https://www.readbyqxmd.com/read/27777266/a-proposal-for-a-serology-based-approach-to-membranous-nephropathy
#6
An S De Vriese, Richard J Glassock, Karl A Nath, Sanjeev Sethi, Fernando C Fervenza
Primary membranous nephropathy (MN) is an autoimmune disease mainly caused by autoantibodies against the recently discovered podocyte antigens: the M-type phospholipase A2 receptor 1 (PLA2R) and thrombospondin type 1 domain-containing 7A (THSD7A). Assays for quantitative assessment of anti-PLA2R antibodies are commercially available, but a semiquantitative test to detect anti-THSD7A antibodies has been only recently developed. The presence or absence of anti-PLA2R and anti-THSD7A antibodies adds important information to clinical and immunopathologic data in discriminating between primary and secondary MN...
October 24, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27773781/the-na-d-glucose-cotransporters-sglt1-and-sglt2-are-targets-for-the-treatment-of-diabetes-and-cancer
#7
REVIEW
Hermann Koepsell
Orally applied SGLT2 (SLC5A2) inhibitors that enter the blood and decrease renal reabsorption of glucose have been approved as antidiabetic drugs. They decrease blood glucose levels, slightly reduce body weight and blood pressure, and decrease the risk for diabetic nephropathy. The SGLT2 inhibitor empagliflozin has been shown to reduce the risk of severe cardiac failure. This review summarizes knowledge about the functions of SGLT2 and the pathophysiology of type 2 diabetes (T2D) and diabetic follow-up diseases...
October 20, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27764902/urinary-n-acetyl-%C3%AE-glucosaminidase-and-egfr-may-identify-patients-to-be-treated-with-immuno-suppression-at-diagnosis-in-idiopathic-membranous-nephropathy
#8
Claudio Bazzi, Tomoko Usui, Virginia Rizza, Daniela Casellato, Maurizio Gallieni, Masaomi Nangaku
BACKGROUND: The clinical course of idiopathic membranous nephropathy (IMN) varies from spontaneous remission of nephrotic syndrome (NS) to end-stage renal disease (ESRD). Selecting patients with high risk of progression for immunosuppressive therapy is mandatory. METHODS: 86 IMN subjects were followed for median of 69 months (range 6-253). Receiver operating characteristic curve and Cox proportional hazards model were used to evaluate prognostic factors for progression, defined as ESRD or eGFR reduction ≥50% of baseline...
October 20, 2016: Nephrology
https://www.readbyqxmd.com/read/27725943/reversal-of-early-diabetic-nephropathy-by-islet-transplantation-under-the-kidney-capsule-in-a-rat-model
#9
Yunqiang He, Ziqiang Xu, Mingshi Zhou, Minmin Wu, Xuehai Chen, Silu Wang, Kaiyan Qiu, Yong Cai, Hongxing Fu, Bicheng Chen, Mengtao Zhou
Objective. Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus, and insulin therapy has many side effects in the treatment of DN. Islet transplantation has emerged as a promising therapy for diabetic patients. This study was established to investigate its advantageous effects in a rat model of early DN. Methods. Streptozotocin was administered to the rats to induce diabetes. Twelve weeks later, the diabetic rats were divided into 3 groups: the islet-transplanted group (IT group), the insulin-treated group (IN group), and the untreated group (DN group)...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27721233/treatment-of-ormond-disease-and-idiopathic-membranous-glomerulonephritis-by-using-rituximab
#10
Ivana Dedinská, Daniel Svetlík, Katarina Adamicova, Katarina Machalekova, Pavel Makovicky, Alena Jezikova, Ludovít Laca, Juraj Miklusica, Peter Galajda, Marian Mokan
Treatment of retroperitoneal fibrosis usually involves corticosteroids with or without other immunomodulating medications or tamoxifen.  Rituximab, a monoclonal antibody that specifically targets CD20 on the surface of B-cells, is effective in achieving complete remission of proteinuria in patients with idiopathic membranous nephropathy. We describe a case of a 45 years old man with idiopathic membranous glomerulonephritis (with proteinuria of more than 30 grams/24 hours) and simultaneously with idiopathic retroperitoneal fibrosis (with large number of cells CD20 in the histologic image)...
September 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27692613/-membranous-nephropathy-diagnosis-new-insights-in-pathophysiology-and-therapeutic-approach
#11
K Dahan
Membranous nephropathy (MN) accounts for about 20% of cases of nephrotic syndrome in the adult. Thickening of glomerular capillary walls results from subepithelial formation of immune deposits containing IgG and the membrane attack complex of complement, which is the major mediator of proteinuria, and antigens. Idiopathic forms of MN (IMN) represent 70 to 80% of all cases. A major breakthrough was the identification of the podocyte antigen PLA2R as the target of circulating antibodies in about 70% of IMN, which confirmed that the disease was auto-immune in nature...
May 25, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27646819/current-treatments-for-renal-failure-due-to-multiple-myeloma
#12
Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos
INTRODUCTION: Renal impairment (RI) is one of the most common complication of multiple myeloma (MM). RI is present in almost 20% of MM patients at diagnosis and in 40%-50% of patients during the course of their disease. AREAS COVERED: Biology along with tools for diagnosis and management of RI are reported in this paper. Papers published in PubMed and reported abstracts up to May 2016 were used. EXPERT OPINION: Moderate and severe RI increases the risk of early death; thus rapid intervention and initiation of anti-myeloma treatment is essential and improves renal outcomes in RI patients...
September 27, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27621641/rituximab-use-in-adult-primary-glomerulopathy-where-is-the-evidence
#13
REVIEW
Samir G Mallat, Houssam S Itani, Rana M Abou-Mrad, Rima Abou Arkoub, Bassem Y Tanios
Rituximab is a chimeric anti-CD20 antibody that results in depletion of B-cell lymphocytes. It is currently used in the treatment of a variety of autoimmune diseases, in addition to CD20-positive lymphomas. The use of rituximab in the treatment of the adult primary glomerular diseases has emerged recently, although not yet established as first-line therapy in international guidelines. In patients with steroid-dependent minimal change disease or frequently relapsing disease, and in patients with idiopathic membranous nephropathy (IMN), several retrospective and prospective studies support the use of rituximab to induce remission, whereas in idiopathic focal and segmental glomerulosclerosis (FSGS), the use of rituximab has resulted in variable results...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27598699/a-meta-analysis-of-antiviral-therapy-for-hepatitis-b-virus-associated-membranous-nephropathy
#14
Yue Yang, Ye-Ping Ma, Da-Peng Chen, Li Zhuo, Wen-Ge Li
Hepatitis B virus-associated membranous nephropathy (HBV-MN) is the most common renal extra-hepatic manifestation in patients with chronic HBV infection. In September 2015, we searched the MEDLINE, EMBASE, and CENTRAL databases, and the reference lists of retrieved articles, to identify relevant studies. Descriptions of antiviral drugs used to treat HBV-MN were included in our review. Two authors independently screened all relevant articles, extracted data, and assessed the risk of bias. Nine hundred and fifty-four papers have been considered after electronic and manual searching, only five relevant studies were identified...
2016: PloS One
https://www.readbyqxmd.com/read/27596627/biopsy-proven-kidney-diseases-in-the-elderly-clinical-characteristics-renal-histopathological-spectrum-and-prognostic-factors
#15
Yue Chen, Ping Li, Chunli Cui, Aihong Yuan, Kun Zhang, Chen Yu
OBJECTIVE: To explore the clinical characteristics, renal histopathological spectrum and prognostic factors of biopsy-proven kidney diseases in the elderly. METHODS: A retrospective observational study was conducted in elderly patients who had received renal biopsies. Demographic, clinical and pathological data at the time of the biopsy were collected from the medical records. Follow-up records and prognostic factors were studied. RESULTS: The elderly (≥60 years) accounted for 74 of 434 (17...
September 5, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27582107/extracellular-vesicles-in-diagnosis-and-therapy-of-kidney-diseases
#16
REVIEW
Wei Zhang, Xiangjun Zhou, Hao Zhang, Qisheng Yao, Yutao Liu, Zheng Dong
Extracellular vesicles (EV) are endogenously produced, membrane-bound vesicles that contain various molecules. Depending on their size and origins, EVs are classified into apoptotic bodies, microvesicles, and exosomes. A fundamental function of EVs is to mediate intercellular communication. In kidneys, recent research has begun to suggest a role of EVs, especially exosomes, in cell-cell communication by transferring proteins, mRNAs, and microRNAs to recipient cells as nanovectors. EVs may mediate the cross talk between various cell types within kidneys for the maintenance of tissue homeostasis...
November 1, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27554390/detection-and-clinical-significance-of-glomerular-m-type-phospholipase-a2-receptor-in-patients-with-idiopathic-membranous-nephropathy
#17
Hong Liu, Weili Luo, Shaomin Gong, Xiaoqiang Ding
BACKGROUND: Glomerular M-type phospholipase A2 receptor (PLA2 R) is important for diagnosing idiopathic membranous nephropathy (IMN). The relation between glomerular PLA2 R expression and response to treatment remained to explore. AIMS: We conducted the study to explore the positive rate and clinical significance of glomerular M-type PLA2 R in IMN patients. METHODS: 122 IMN patients receiving neither glucocorticoid nor immunosuppressant therapy prior to renal biopsies were included and followed for more than 1 year...
August 24, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27542602/isolated-diplopia-associated-with-calcineurin-inhibitor-therapy-in-a-patient-with-idiopathic-membranous-nephropathy-a-case-report
#18
Ashwani K Gupta, Nader Bahri
BACKGROUND: Neurotoxicity is a common side effect of treatment with calcineurin inhibitors. Tremors are frequently reported as the most common manifestation. Variable presentations can include headaches, seizures, visual hallucinations or blindness. Sixth nerve palsy has been reported in previous cases of bone marrow and cardiac transplant patients receiving calcineurin inhibitors. In many of these previously reported cases, the drug was administered intravenously and very high drug levels were found...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27536673/management-of-membranous-nephropathy-in-western-countries
#19
REVIEW
Talal Alfaadhel, Daniel Cattran
BACKGROUND: Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults in Western countries. In 2012, the KDIGO (Kidney Disease: Improving Global Outcomes) working group published guidelines for the management of glomerulonephritis, thus providing a template for the treatment of this condition. While being aware of the impact of the clinicians' acumen and that patients may choose a different therapeutic option due to the risks of specific drugs and also of the evolving guidelines, this review details our approach to the management of patients with IMN in a Western center (Toronto)...
September 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27536672/management-of-membranous-nephropathy-in-asia
#20
REVIEW
Jing Xu, Xiaofan Hu, Jingyuan Xie, Nan Chen
BACKGROUND: Membranous nephropathy (MN) is the most common cause of nephrotic syndrome (NS) in adults, accounting for about 20.0% of all NS cases. With an increasing prevalence, especially in the elderly, it has received great attention in Asia. SUMMARY: Recently, the prevalence of idiopathic MN (IMN) has significantly increased among the elderly people in Asia and other places in the world. Although the exact mechanism of IMN remains unveiled, the identification of new antigens such as PLA2R and THSD7A has greatly enhanced our understanding of its pathogenesis...
September 2015: Kidney Diseases
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