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therapy membranous nephropathy

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https://www.readbyqxmd.com/read/29441742/the-effect-of-mycophenolate-mofetil-versus-cyclosporine-as-combination-therapy-with-low-dose-corticosteroids-in-high-risk-patients-with-idiopathic-membranous-nephropathy-a-multicenter-randomized-trial
#1
Ji Young Choi, Dong Ki Kim, Yang Wook Kim, Tae Hyun Yoo, Jung Pyo Lee, Hyun Chul Chung, Kyu Hyang Cho, Won Suk An, Duk Hyun Lee, Hee Yeon Jung, Jang Hee Cho, Chan Duck Kim, Yong Lim Kim, Sun Hee Park
BACKGROUND: Appropriate immunosuppressive therapy for patients with idiopathic membranous nephropathy (MN) remains controversial. The effect of mycophenolate mofetil (MMF) versus cyclosporine (CsA) combined with low-dose corticosteroids was evaluated in patients with idiopathic MN in a multi-center randomized trial (www.ClinicalTrials.gov NCT01282073). METHODS: A total of 39 biopsy-proven idiopathic MN patients with severe proteinuria were randomly assigned to receive MMF combined with low-dose corticosteroids (MMF group) versus CsA combined with low-dose corticosteroids (CsA group), respectively, and followed up for 48 weeks...
February 26, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29402844/chlormethine-hydrochloride-is-not-inferior-to-tacrolimus-in-treating-steroid-resistant-nephrotic-syndrome
#2
Yuan Yang, Li Zhao, Li Xiao, Yumei Liang, Chang Wang, Xiao Fu, Xuejing Zhu, Shuguang Yuan, Jianling Zhu, Xiaoping Zhu, Yinghong Liu, Jun Li, Jian Luo, Fuyou Liu, Lin Sun
BACKGROUND/AIMS: The present study aimed to explore the equivalence of CHL and tacrolimus (TAC), despite reports regarding the efficacy and safety of TAC in treating SRNS patients. METHODS: A retrospective cohort study of CHL or TAC treatment was performed by collecting the medical records of SRNS patients with a pathological classification of focal segmental glomurular sclerosis (FSGS) or membranous nephropathy (MN) from December 2008 to December 2014 in a 3A grade hospital in southern China...
January 24, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29349731/membranous-nephropathy-associated-with-pregnancy-an-anti-phospholipase-a2-receptor-antibody-positive-case-report
#3
Eiichiro Uchino, Daisuke Takada, Haruta Mogami, Takeshi Matsubara, Tatsuo Tsukamoto, Motoko Yanagita
Pregnancy and membranous nephropathy (MN) can occur concurrently with nephrotic syndrome. However, the pathophysiology of MN associated with pregnancy remains unclear, including the involvement of anti-M-type phospholipase A2 receptor (PLA2R) antibody, the major antigen of idiopathic MN (iMN). A treatment for the condition is also not established. We present the case of a 43-year-old pregnant female with incidental proteinuria and hypoalbuminemia. We made a diagnosis of nephrotic syndrome at 11 week gestation...
January 18, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29340324/temporal-association-between-pla2r-antibodies-and-clinical-outcomes-in-primary-membranous-nephropathy
#4
R Ramachandran, A K Yadav, V Kumar, N Inamdar, R Nada, K L Gupta, V Jha
Introduction: Autoantibodies to M-type phospholipase A2 receptor (aPLA2R) are seen in two-thirds of patients with primary membranous nephropathy (PMN) and are associated with disease activity. However, the precise temporal dynamics between the presence and amount of aPLA2R in circulation, as well as the clinical activity, are not known. We evaluated the temporal association between disease activity and serum aPLA2R during and after treatment in PMN. Methods: The study included all patients with PMN and elevated aPLA2R who were started on immunosuppressive therapy for persistent nephrotic syndrome at a single center between December 2014 and December 2015...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29310419/proliferative-lupus-nephritis-in-the-absence-of-overt-systemic-lupus-erythematosus-a-historical-study-of-12-adult-patients
#5
MULTICENTER STUDY
Maxime Touzot, Cécile Saint-Pastou Terrier, Stanislas Faguer, Ingrid Masson, Hélène François, Lionel Couzi, Aurélie Hummel, Nathalie Quellard, Guy Touchard, Noémie Jourde-Chiche, Jean-Michel Goujon, Eric Daugas
Severe lupus nephritis in the absence of systemic lupus erythematosus (SLE) is a rare condition with an unclear clinical presentation and outcome.We conducted a historical observational study of 12 adult (age >18 years) patients with biopsy-proven severe lupus nephritis or lupus-like nephritis without SLE immunological markers at diagnosis or during follow-up. Excluded were patients with chronic infections with HIV or hepatitis B or C; patients with a bacterial infectious disease; and patients with pure membranous nephropathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29237409/iga-nephropathy-featuring-massive-wire-loop-like-deposits-in-two-patients-with-alcoholic-cirrhosis
#6
Daisuke Takada, Keiichi Sumida, Akinari Sekine, Ryo Hazue, Masayuki Yamanouchi, Tatsuya Suwabe, Noriko Hayami, Junichi Hoshino, Naoki Sawa, Kenmei Takaichi, Takeshi Fujii, Kenichi Ohashi, Yoshifumi Ubara
BACKGROUND: Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis. CASE PRESENTATION: We evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. Renal biopsy demonstrated massive wire loop-like deposits in the subendothelial space of the glomerular basement membrane and in the mesangium. However, immunofluorescence was only positive for IgA and C3, and electron microscopy did not reveal any organized structures in the electron-dense deposits...
December 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29236656/secondary-syphilis-associated-with-membranous-nephropathy-and-acute-hepatitis-in-a-patient-with-hiv-a-case-report
#7
Zhou Zhang, Aviv Hever, Nitin Bhasin, Dean A Kujubu
INTRODUCTION: We present a case of membranous nephropathy associated with a secondary syphilis infection in a patient with HIV. CASE PRESENTATION: A 37-year-old white man with HIV who was receiving highly active antiretroviral therapy presented to the Emergency Department with 6 weeks of rectal pain. He had a CD3-CD4 count of 656 cells/mm3 and an undetectable viral load. On admission, he was found to have an anal ulcer, a serum creatinine of 1.4 mg/dL (baseline 0...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29208058/low-protein-diet-supplemented-with-ketoacids-delays-the-progression-of-diabetic-nephropathy-by-inhibiting-oxidative-stress-in-the-kkay-mice-model
#8
Dongmei Liu, Ming Wu, Lin Li, Xiang Gao, Bo Yang, Shuqin Mei, Lili Fu, Changlin Mei
Diabetic nephropathy (DN) is a major cause of chronic kidney disease. We aimed to investigate the effect of the low-protein diets (LPD) supplemented with ketoacids (LPD+KA) in KKAy mice, an early type 2 DN model. KKAy mice were treated with normal protein diet (NPD), LPD or LPD+KA from 12 to 24 weeks of age. A period of 12-week treatment with LPD significantly reduced albuminuria as compared with that observed after NPD treatment. Treatment with LPD+KA further reduced albuminuria as compared with that observed with LPD treatment alone...
December 6, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29149305/rituximab-for-non-responsive-idiopathic-membranous-nephropathy-in-a-chinese-cohort
#9
Xin Wang, Zhao Cui, Yi-Miao Zhang, Zhen Qu, Fang Wang, Li-Qiang Meng, Xu-Yang Cheng, Gang Liu, Fu-de Zhou, Ming-Hui Zhao
Background: Rituximab had been shown to be effective in inducing remission of nephrotic syndrome in patients with idiopathic membranous nephropathy (iMN). This study applied rituximab therapy for 36 non-responsive iMN patients to investigate its effects and safety. Methods: Thirty-six iMN patients who were non-responsive to prior immunosuppression were enrolled. Rituximab was used for B-cell depletion in patients, with a goal of <5 B cells/mm3 in the circulation...
November 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29142979/two-year-follow-up-study-of-membranous-nephropathy-treated-with-tacrolimus-and-corticosteroids-versus-cyclical-corticosteroids-and-cyclophosphamide
#10
Raja Ramachandran, Ashok Kumar Yadav, Vinod Kumar, Venkata Siva Tez Pinnamaneni, Ritambhra Nada, Ratan Ghosh, Vivek Kumar, Manish Rathi, Harbir Singh Kohli, Krishan Lal Gupta, Vinay Sakhuja, Vivekanand Jha
Introduction: Both cCTX/GCs and CNIs are recommended as first-line agents in the management of PMN. The present study is an extended report of patients randomized to receive TAC/GCs or cCTX/GCs at 2 years post randomization. Methods: Seventy patients enrolled in the clinical trial Tacrolimus Combined With Corticosteroids Versus Modified Ponticelli Regimen in Treatment of Idiopathic Membranous Nephropathy: Randomized Control Trial were followed quarterly between 12 and 24 months...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#11
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29130997/non-diabetic-kidney-disease-in-type-2-diabetic-patients-prevalence-clinical-predictors-and-outcomes
#12
Siyar Erdogmus, Saba Kiremitci, Zeynep Kendi Celebi, Serkan Akturk, Neval Duman, Kenan Ates, Sehsuvar Erturk, Gokhan Nergizoglu, Sim Kutlay, Sule Sengul, Arzu Ensari, Kenan Keven
BACKGROUND/AIMS: Diabetic kidney disease (DKD) is one of the most frequent microvascular complications of diabetes and is the leading cause of end-stage kidney disease worldwide. In patients with diabetes, non-diabetic kidney disease (NDKD) can also occur. NDKD can be either alone or superimposed with the DKD. In this study, we aimed to investigate the utility of kidney biopsy in patients with type 2 diabetes mellitus (T2DM) and the predictability of diagnosing DKD versus NDKD from clinical and laboratory data...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29114041/phospholipase-a2-receptor-1-epitope-spreading-at-baseline-predicts-reduced-likelihood-of-remission-of-membranous-nephropathy
#13
Barbara Seitz-Polski, Hanna Debiec, Alexandra Rousseau, Karine Dahan, Christelle Zaghrini, Christine Payré, Vincent L M Esnault, Gérard Lambeau, Pierre Ronco
The phospholipase A2 receptor (PLA2R1) is the major autoantigen in primary membranous nephropathy. Several PLA2R1 epitopes have been characterized, and a retrospective study identified PLA2R1 epitope spreading as a potential indicator of poor prognosis. Here, we analyzed the predictive value of anti-PLA2R1 antibody (PLA2R1-Ab) titers and epitope spreading in a prospective cohort of 58 patients positive for PLA2R1-Ab randomly allocated to rituximab (n=29) or antiproteinuric therapy alone (n=29). At baseline, the epitope profile (CysR, CysRC1, CysRC7, or CysRC1C7) did not correlate with age, sex, time from diagnosis, proteinuria, or serum albumin, but epitope spreading strongly correlated with PLA2R1-Ab titer (P<0...
November 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29106654/the-population-level-costs-of-immunosuppression-medications-for-the-treatment-of-glomerulonephritis-are-increasing-over-time-due-to-changing-patterns-of-practice
#14
Sean Barbour, Clifford Lo, Gabriela Espino-Hernandez, Sharareh Sajjadi, John Feehally, Scott Klarenbach, Jagbir Gill
Background: Immunosuppression (IS) is the main treatment for most types of glomerulonephritis (GN). Quantifying the cost of IS is necessary to ensure equitable access to therapies and optimal health outcomes, but the real-world cost of IS treatment for GN is largely unknown. We examined temporal changes in the population-level IS medication costs for GN over a 14-year period in a large Canadian province. Methods: We linked a provincial pathology database (containing all GN cases from 2000 to 2012) with renal and medication administrative databases to capture clinical characteristics and IS medications, with follow-up until 2013...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29094388/peptide-gam-immunoadsorption-therapy-in-primary-membranous-nephropathy-prism-phase-ii-trial-investigating-the-safety-and-feasibility-of-peptide-gam-immunoadsorption-in-anti-pla2-r-positive-primary-membranous-nephropathy
#15
Patrick Hamilton, Durga Kanigicherla, Prasanna Hanumapura, Lars Walz, Dieter Kramer, Moritz Fischer, Paul Brenchley, Sandip Mitra
INTRODUCTION: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in adults worldwide. Most patients have primary MN (PMN), an autoimmune condition associated with the IgG anti-PLA2 R autoantibody. For patients with severe disease, standard of care continues to be a 6-month regime of rotating high dose steroids and immunosuppression that comes with a significant side-effect profile. Immunoadsorption is a relatively safe procedure for the extracorporeal removal of specific immunoglobulins without the need for medications...
November 2, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29068987/membranous-nephropathy-in-a-patient-with-ankylosing-spondylitis-a-case-report
#16
Ruiying Chen, Fang Li, Qionghong Xie, Jun Xue, Lingyun Lai, Shaojun Liu, Liyin Zhang, Chuanming Hao
RATIONALE: Renal complications in ankylosing spondylitis (AS) were rarely observed, and proteinuria associated with AS can be seen often due to amyloidosis in this kind of complications, while membranous nephropathy (MN) is seldom considered. This article reports a case of coexistence of AS and MN, to provide the exact relationship of these 2 entities and recognized some causes of renal involvement in AS. PATIENT CONCERNS: A 44-year-old female presented with pain of the left leg for 4 years and pedal edema for 2 weeks...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29063068/immunoglobulin-g4-related-kidney-disease-pathogenesis-diagnosis-and-treatment
#17
REVIEW
Ke Zheng, Fei Teng, Xue-Mei Li
Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized clinical entity that often involves multiple organs; it is characterized by high levels of serum immunoglobulin G4 (IgG4), dense infiltration of IgG4+ cells, and storiform fibrosis. Cellular immunity, particularly T cell-mediated immunity, has been implicated in the pathogenesis of IgG4-RD. The most frequent renal manifestations of IgG4-RD are IgG4-related tubulointerstitial nephritis, membranous glomerulonephropathy (MGN), and obstructive nephropathy secondary to urinary tract obstruction due to IgG4-related retroperitoneal fibrosis, prostatitis, or ureter inflammation...
September 2017: Chronic diseases and translational medicine
https://www.readbyqxmd.com/read/28977667/successful-use-of-entecavir-in-hepatitis-b-associated-membranous-nephropathy
#18
Vidushi Mahajan, Sanjay D'Cruz, Ritambara Nada, Atul Sachdev
We report the case of a 7-year-old unimmunized boy who presented with generalized anasarca for the first time, along with nephrotic-range proteinuria, hypoalbuminemia, microscopic hematuria and hypertension. Special investigations revealed ELISA test to be positive for hepatitis B surface antigen (HBsAg) and hepatitis B envelope antigen (HBeAg); hepatitis B viral DNA load (HBV DNA) level (real-time polymerase chain reaction) was 54 360 903 IU/ml. For hepatitis B virus (HBV)-related glomerulopathy, he was started on enalapril and lasilactone, and percutaneous renal biopsy was performed, which revealed membranous nephropathy (MN)...
July 27, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28975092/self-limited-membranous-nephropathy-after-intravitreal-bevacizumab-therapy-for-age-related-macular-degeneration
#19
Gebran Khneizer, Ahmad Al-Taee, Bahar Bastani
BACKGROUND: Monoclonal antibodies targeting vascular endothelial growth factor (VEGF), such as bevacizumab, are administered intravitreally for the treatment of wet or exudative age-related macular degeneration (ARMD). Systemic use of bevacizumab has been linked to a wide range of renal adverse effects including proteinuria and hypertension. CASE PRESENTATION: We present the case of a 77-year-old Caucasian male with a past medical history of hypertension, vitamin D deficiency and paroxysmal atrial fibrillation who presented to primary care clinic with a 2-week history of bilateral lower extremity edema, 2 months after completing four monthly intravitreal injections of bevacizumab for ARMD...
July 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28963832/-membranous-glomerulonephritis-mgn-ongoing-studies
#20
REVIEW
Gaetano La Manna, Olga Baraldi, Vania Cunia, Valeria Corradetti, Valeria Aiello, Marco Busutti, Lorenzo Gasperoni, Alessandra Spazzoli, Giorgia Comai
The membranous nephropathy (MN) is the major cause of nephrotic syndrome in in the adult, account for 20% of cases with annual incidence is 1 in 100.000. In the past 10 years, the role of podocytes has been identified; environmental triggers in genetically predisposed patients can activate podocytes to exhibit antigenic epitopes (receptor of phospholipase A2, thrombospondin type 1) that become targets of specific autoantibodies with subsequent complement activation. The discovery of this mechanisms has opened new horizons in the therapy of MN and novel drugs are available with more specific mechanism of action...
September 28, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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