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therapy membranous nephropathy

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https://www.readbyqxmd.com/read/28102816/clinicopathological-features-diagnosis-and-treatment-of-iga-nephropathy-with-minimal-change-disease-related-to-exposure-to-mercury-containing-cosmetics-a-case-report%C3%A2
#1
Hong-Xin Niu, Shen-Heng Li, Hong-Ying Li, Yi-Hua Chen, Wei-Wei Liu, Pei-Lin Li, Hai-Bo Long
AIM: Membranous nephropathy and minimal change disease (MCD) have been involved in mercury-induced nephrotic syndrome. IgA nephropathy is not known to be a common pathological type. In the present article, we report a case of IgA nephropathy with MCD following exposure to mercury-containing skin lightening cream. MATERIAL AND METHODS: The patient was a 39-year-old woman who presented with nephrotic syndrome. She had a 6-month history of using as many as 8 kinds of skin-lightening creams, and urinary mercury excretion was high...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28065518/membranous-nephropathy-integrating-basic-science-into-improved-clinical-management
#2
REVIEW
Daniel C Cattran, Paul E Brenchley
Idiopathic membranous nephropathy (INM) remains a common cause of the nephrotic syndrome in adults. The autoimmune nature of IMN was clearly delineated in 2009 with the identification of the glomerular-deposited IgG to be a podocyte receptor, phospholipase A2 receptor (PLA2R) in 70% to 75% of cases. This anti-PLA2R autoantibody, predominantly the IgG4 subclass, has been quantitated in serum using an enzyme-linked immunosorbent assay and has been used to aid diagnosis and monitor response to immunosuppressive therapy...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28056860/evaluating-tacrolimus-treatment-in-idiopathic-membranous-nephropathy-in-a-cohort-of-408-patients
#3
Hua-Zhang Qin, Lei Liu, Shao-Shan Liang, Jing-Song Shi, Chun-Xia Zheng, Qing Hou, Ying-Hui Lu, Wei-Bo Le
BACKGROUND: The KDIGO Clinical Practice Guidelines for Glomerulonephritis recommended tacrolimus as an alternative regimen for the initial therapy for Idiopathic membranous nephropathy (IMN), however, large observational studies evaluating tacrolimus treatment in IMN remains rare. METHODS: A total of 408 consecutive IMN patients with nephrotic syndrome who were treated with tacrolimus in Jinling Hospital were included. The effectiveness and safety of tacrolimus treatment in IMN were analyzed in this study...
January 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28035718/thsd7a-expression-in-human-cancer
#4
Phillip R Stahl, Elion Hoxha, Thorsten Wiech, Cornelia Schröder, Ronald Simon, Rolf A K Stahl
We recently described a case of a Thrombospondin Type-1 Domain containing 7A (THSD7A) associated membranous nephropathy in a female patient who was synchronously suffering from a THSD7A-positive malignancy. We here investigated the role of THSD7A as a new potential tumor antigen by evaluating over 20,000 tissue spots in more than 70 different tumor entities by immunohistochemistry using tissue microarrays. THSD7A expression was highly variable in different neoplasias with differing staining patterns. Both gain and loss of THSD7A expression compared to expression status in non-tumor tissue were linked to tumor-specific markers in the different tumor entities and were of prognostic value...
December 30, 2016: Genes, Chromosomes & Cancer
https://www.readbyqxmd.com/read/27999961/long-term-outcomes-of-initial-therapy-for-idiopathic-membranous-nephropathy
#5
Masayo Sato, Takashi Takei, Takahito Moriyama, Mitsuyo Itabashi, Kosaku Nitta
BACKGROUND: The objective of this study is to determine whether initial steroid therapy is actually effective for the treatment of iMN, and we examined a 40% reduction in estimated glomerular filtration rate (eGFR) and remission rates. METHODS: This was a retrospective study between 1993 and 2013. First, we divided patients with iMN having a urinary protein level of ≥1 g/gCre into two groups: those who had received steroid therapy (Group S1; n = 52) within 6 months of diagnosis and those who had received supportive therapy (Group H1; n = 31)...
December 20, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27994855/treatment-with-rituximab-in-idiopathic-membranous-nephropathy
#6
Marco Fiorentino, Francesco Tondolo, Francesca Bruno, Barbara Infante, Giuseppe Grandaliano, Loreto Gesualdo, Carlo Manno
BACKGROUND: Rituximab represents a valid therapeutic option to induce remission in patients with primary glomerulonephritis. Despite several studies proving its efficacy in improving outcomes in patients with membranous nephropathy (MN), its role in therapeutic protocols is not yet defined. METHODS: We studied 38 patients with idiopathic MN treated with rituximab (in 13 patients as first-line therapy, in the remaining 25 after conventional immunosuppressive therapy)...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27974710/clinical-predictors-of-response-to-prednisone-plus-cyclophosphamide-in-patients-with-idiopathic-membranous-nephropathy
#7
Shu Li, Ling Wang, Minfang Zhang, Wenyan Zhou, Wei Fang, Qin Wang, Chaojun Qi, Shan Mou, Xinghua Shao, Zhaohui Ni
BACKGROUND: Complete remission (CR) and partial remission (PR) are beneficial to the long-term outcome of patients with idiopathic membranous nephropathy (iMN). However, we are lacking in studies that evaluate the clinical predictors of response to treatment with prednisone plus cyclophosphamide (CP). The objectives of the study are to identify clinical factors that could predict clinical remission or relapse in patients with iMN who were treated with prednisone plus i.v. CP therapy. METHODS: This retrospective study recruited a total of 102 eligible patients diagnosed with biopsy-proven iMN between January 2010 and December 2013 in our center...
December 15, 2016: Nephron
https://www.readbyqxmd.com/read/27942609/membranous-nephropathy-pilot-study-of-a-novel-regimen-combining-cyclosporine-and-rituximab
#8
Meryl Waldman, Laurence H Beck, Michelle Braun, Kenneth Wilkins, James E Balow, Howard A Austin
INTRODUCTION: There is broad consensus that high grade basal proteinuria and failure to achieve remission of proteinuria are key determinants of adverse renal prognosis in patients with primary membranous nephropathy. Based on the fact that current regimens are not ideal due to short and long-term toxicity and propensity to relapse after treatment withdrawal, we developed a treatment protocol based on a novel combination of rituximab and cyclosporine which targets both the B and T cell limbs of the immune system...
July 2016: KI Reports
https://www.readbyqxmd.com/read/27852608/dba2j-db-db-mice-are-susceptible-to-early-albuminuria-and-glomerulosclerosis-that-correlates-with-systemic-insulin-resistance
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos
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...
November 2016: Expert Opinion on Pharmacotherapy
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