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recent treatment for IgA Nephropathy

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https://www.readbyqxmd.com/read/29740706/biomarkers-for-iga-nephropathy-on-the-basis-of-multi-hit-pathogenesis
#1
REVIEW
Hitoshi Suzuki
IgA nephropathy (IgAN) is the most prevalent glomerular disease worldwide and is associated with a poor prognosis. Development of curative treatment strategies and approaches for early diagnosis is necessary. Renal biopsy is the gold standard for the diagnosis and assessment of disease activity. However, reliable biomarkers are needed for the noninvasive diagnosis of this disease and to more fully delineate the risk of progression. With regard to the pathogenesis of IgAN, the multi-hit hypothesis, including production of galactose-deficient IgA1 (Gd-IgA1; Hit 1), IgG or IgA autoantibodies that recognize Gd-IgA1 (Hit 2), and their subsequent immune complexes formation (Hit 3) and glomerular deposition (Hit 4), has been widely supported by many studies...
May 8, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29724226/a-validation-study-of-crescents-in-predicting-esrd-in-patients-with-iga-nephropathy
#2
Xiaoyan Zhang, Sufang Shi, Yan Ouyang, Meng Yang, Manman Shi, Xiaoxia Pan, Jicheng Lv, Zhaohui Wang, Hong Ren, Pingyan Shen, Weiming Wang, Hong Zhang, Jingyuan Xie, Nan Chen
BACKGROUND: A working group on the Oxford classification of IgA nephropathy (IgAN) recently reported that crescents detected in kidney tissue predicted a worse renal outcome. However, this finding must be validated in independent cohorts before it can be widely applied to clinical practice. METHODS: Biopsy-proven IgAN patients were continuously recruited from two large renal centers in China from 1989 to 2014. All patients were followed for more than 1 year unless end stage renal disease (ESRD) occurred within 12 months...
May 3, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29695925/primary-iga-nephropathy-current-challenges-and-future-prospects
#3
REVIEW
Rose S Penfold, Maria Prendecki, Stephen McAdoo, Frederick Wk Tam
IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide, exhibiting a variable clinical and pathological course and significantly contributing to the global burden of chronic kidney disease and end-stage renal disease. Current standards of care focus on optimization of antihypertensive and antiproteinuric therapies (typically renin- angiotensin system blockade) to reduce disease progression. Much recent attention has focused on whether additional immunosuppression confers better outcomes than supportive management alone, and indeed, several trials have demonstrated renoprotective effects following the use of oral corticosteroids...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29606258/treatment-of-iga-nephropathy-recent-advances-and-prospects
#4
REVIEW
Rosanna Coppo
IgA nephropathy, identified 50 years ago in France, is the most frequent glomerular disease worldwide. The course is variable, but in most of the cases there is a relentless decline in renal function, reaching end-stage renal failure in 10-60% of the cases after 10 years and in 40% after 20 years. These data justify the interest for finding a suitable therapeutic approach particularly in progressive cases. A supportive care, including renin-angiotensin system inhibitors is the priority in cases with slowly declining renal function, particularly when developing proteinuria...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29519995/clinical-features-treatment-and-prognostic-factors-of-post-transplant-immunoglobulin-a-nephropathy
#5
Diogo Buarque Cordeiro Cabral, Tainá Veras de Sandes-Freitas, José Osmar Medina-Pestana, Gianna Mastroianni-Kirsztajn
BACKGROUND Initially described as a relatively benign condition, recent studies report graft loss in up to 50% of the patients with post-transplant IgA nephropathy. There is no evidence for the best therapeutic approach, and prognostic factors remain to be elucidated. MATERIAL AND METHODS Single center retrospective analysis of patients >12 years old, with clinically relevant post-transplant IgA nephropathy (proteinuria ≥1.0 g/g and/or graft dysfunction) and ≥6 months follow-up after diagnosis (n=47)...
March 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29312588/tripterygium-wilfordii-inhibits-tonsillar-iga-production-by-downregulating-iga-class-switching-in-iga-nephropathy
#6
Huining Li, Dan Kong, Yangyang Xu, Xiaomei Li, Guodong Yao, Kexin Chen, Qi You, Qingtao Shi, Lei Zhang, Xin Wang, Dawei Yuan, Shusheng Miao, Jingshu Geng, Xiaoming Jin, Hongxue Meng
IgA nephropathy (IgAN) is characterized by high serum IgA levels and IgA deposition in the renal mesangium. Recent research has indicated that pathogenic IgA may originate from affected tonsils, where present enhancement of IgA production by IgA class switching and immuno-activation. Tripterygium Wilfordii (TW) was found to be especially effective in IgAN by its' immunosuppression effect. Given this background, we investigated the mechanisms underlying the role of TW in the generation of IgA and IgA class switching in tonsillar GCs of IgAN patients...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29230705/crosstalk-between-tlr4-and-notch1-signaling-in-the-iga-nephropathy-during-inflammatory-response
#7
Xuxiang Sheng, Xiaoyan Zuo, Xihui Liu, Yang Zhou, Xia Sun
PURPOSE: IgA nephropathy (IgAN) is an immune complex-mediated disease involved in the kidney disease. Recent studies have revealed that Notch signaling-related genes are aberrantly expressed in various cell types and maybe associate with inflammation-induced carcinogenesis. The aim of our study was to investigate the function of Notch1 in the inflammatory response of IgAN. METHODS: The expression of Notch1, Jagged1 and NICD1 in 52 IgAN renal tissues and 20 control renal tissues was first determined using quantitative real-time PCR and Western blot...
December 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29199436/-considerations-on-the-treatment-of-iga-nephropathy-on-the-basis-of-the-results-of-the-latest-studies-stop-igan-testing-nefigan
#8
Judit Nagy, Balázs Sági, Judit Máté, Tibor Vas, Tibor Kovács
IgA nephropathy is an immune-mediated chronic glomerulonephritis with a great variability in clinical presentation and outcome. The disease can progress to end-stage renal failure in 25% of patients. For this reason we should identify patients with potential to progress. Most important risk factors for progression are persistent proteinuria, hypertension, decreased renal function and some histological lesions. The actually suggested treatment is summarized in KDIGO Clinical Practice Guideline from 2012. They suggest to give firstly non-specific supportive treatment (especially renin-angiotensin system blocking agents)...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29197971/comparison-of-long-term-follow-up-outcomes-between-multiple-drugs-combination-therapy-and-tonsillectomy-pulse-therapy-for-pediatric-iga-nephropathy
#9
Yukihiko Kawasaki, Ryo Maeda, Syuto Kanno, Yuichi Suzuki, Shinichiro Ohara, Kazuhide Suyama, Mitsuaki Hosoya
BACKGROUND: To clarify the long-term efficacy of multiple-drugs combination therapy (PWDM) and tonsillectomy pulse therapy (TPT) for pediatric IgA nephropathy (IgAN), we retrospectively evaluated the clinical and laboratory findings as well as the prognosis for IgAN patients treated with each treatment at long-term follow-up. METHODS: We collected data on 61 children who had been diagnosed with severe IgAN. The children were retrospectively divided into two groups...
December 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28399021/an-update-on-the-treatment-of-iga-nephropathy
#10
REVIEW
Sean Barbour, John Feehally
PURPOSE OF REVIEW: The treatment of IgA nephropathy (IgAN) has been limited by several controversies in the literature, including the benefits of corticosteroids in addition to optimized renin-angiotensin system blockers (RASBs), in those with lower estimated glomerular filtration rate (eGFR), or in different ethnic groups. Recent studies have attempted to address these issues. RECENT FINDINGS: Two observational studies suggest the efficacy of corticosteroids in those with lower eGFR, but with a higher risk of adverse events...
July 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28391341/is-there-a-role-for-immunosuppression-in-immunoglobulin-a-nephropathy
#11
REVIEW
Ali I Al-Lawati, Heather N Reich
The most common primary glomerular disease globally is IgA nephropathy (IgAN). It is often a slowly progressive disease, and ∼40% of patients will progress to kidney failure. Due to a lack of large clinical trial networks and a lack of surrogate markers of treatment efficacy, there are relatively few large multicenter clinical trials in IgAN. Given that both the pathogenesis and progression of IgAN are linked to defects in mucosal immune regulation and inflammation, use of immunosuppression to prevent kidney failure is well founded...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28389744/the-gut-kidney-axis-in-iga-nephropathy-role-of-microbiota-and-diet-on-genetic-predisposition
#12
Rosanna Coppo
Recent data suggest that gut-associated lymphoid tissue (GALT) plays a major role in the development of immunoglobulin A (IgA) nephropathy (IgAN). A genome-wide association study showed that most loci associated with the risk of IgAN are also associated with immune-mediated inflammatory bowel diseases, maintenance of the intestinal barrier and regulation of response to gut pathogens. Studies involving experimental models have demonstrated a pivotal role of intestinal microbiota in the development of IgAN in mice producing high levels of IgA and in transgenic mice overexpressing BAFF, a B-cell factor crucial for IgA synthesis, indicating the role of genetic background, B-cell activity, GALT intestinal immunity and diet...
January 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28293726/inflammation-in-iga-nephropathy
#13
Thomas Rauen, Jürgen Floege
Immunoglobulin A nephropathy (IgAN) is the most frequently occurring primary glomerulonephritis in Caucasian and Asian populations. Nonetheless, therapeutic recommendations are based on weak evidence, large controlled trials are scarce and, in particular, the additional value of immunosuppression beyond comprehensive supportive measures is not well-established. The use of immunosuppressants is supported by experimental insights into IgAN pathogenesis that suggest an autoimmune component in disease development...
December 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28240316/p53-induces-mir199a-3p-to-suppress-socs7-for-stat3-activation-and-renal-fibrosis-in-uuo
#14
Ruhao Yang, Xuan Xu, Huiling Li, Jinwen Chen, Xudong Xiang, Zheng Dong, Dongshan Zhang
The role of p53 in renal fibrosis has recently been suggested, however, its function remains controversial and the underlying mechanism is unclear. Here, we show that pharmacological and genetic blockade of p53 attenuated renal interstitial fibrosis, apoptosis, and inflammation in mice with unilateral urethral obstruction (UUO). Interestingly, p53 blockade was associated with the suppression of miR-215-5p, miR-199a-5p&3p, and STAT3. In cultured human kidney tubular epithelial cells (HK-2), TGF-β1 treatment induced fibrotic changes, including collagen I and vimentin expression, being associated with p53 accumulation, p53 Ser15 phosphorylation, and miR-199a-3p expression...
February 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28221174/iga-nephropathy-an-update
#15
Maria F Soares, Ian S D Roberts
PURPOSE OF REVIEW: To provide an update on recent developments since the publication of the Oxford Classification of IgA nephropathy and to consider lesions that were not included in the original classification. RECENT FINDINGS: Over 20 validation studies of the Oxford Classification have been published. Tubular atrophy/interstitial fibrosis is consistently the strongest predictor of renal survival, whereas mesangial hypercellularity predicts rate of loss of renal function...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28161838/anticoagulant-related-nephropathy-a-case-report-and-review-of-the-literature-of-an-increasingly-recognized-entity
#16
REVIEW
Rigas G Kalaitzidis, Anila Duni, Georgios Liapis, Olga Balafa, Sofia Xiromeriti, Paulos Karolos Rapsomanikis, Moses S Elisaf
Treatment with oral anticoagulants has been associated with worsening kidney function in patients with chronic kidney disease (CKD) as well as among patients without underlying CKD. Thus, anticoagulant-related nephropathy (ARN) is an increasingly recognized entity nowadays, mainly associated with warfarin anticoagulation. Recent evidence indicates that patients treated with the direct anticoagulants may also be at risk of ARN. However, the true incidence of anticoagulant-related nephropathy is difficult to determine...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/27714465/iga-nephropathy-with-presentation-of-nephrotic-syndrome-at-onset-in-children
#17
Yuko Shima, Koichi Nakanishi, Masashi Sato, Taketsugu Hama, Hironobu Mukaiyama, Hiroko Togawa, Ryojiro Tanaka, Kandai Nozu, Mayumi Sako, Kazumoto Iijima, Hiroyuki Suzuki, Norishige Yoshikawa
BACKGROUND: Despite a low incidence, nephrotic syndrome (NS) can present with IgA nephropathy (IgAN). The clinical characteristics and long-term outcomes of pediatric patients with IgAN presenting with NS (NS-IgAN) at onset have not been fully elucidated. METHODS: We retrospectively analyzed 426 patients, and compared clinical and pathological (Oxford) findings between those with NS-IgAN and those with non-NS-IgAN. RESULTS: Among 426 patients, 30 (7...
March 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27671778/corticosteroids-in-iga-nephropathy-lessons-from-recent-studies
#18
REVIEW
Rosanna Coppo
IgA nephropathy (IgAN) is a common chronic glomerular disease that, in most patients, slowly progresses to ESRD. The immune and autoimmune responses that characterize IgAN indicate a potential benefit for corticosteroids. The 2012 Kidney Disease Improving Global Outcome (KDIGO) guidelines suggest giving corticosteroids to patients with rather preserved renal function (GFR>50 ml/min per 1.73 m2 ) and persistent proteinuria >1 g/d, despite 3-6 months of optimized supportive care with renin-angiotensin system blockers...
January 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27596164/the-possible-involvement-of-intestine-derived-iga1-a-case-of-iga-nephropathy-associated-with-crohn-s-disease
#19
Tomohiro Terasaka, Haruhito A Uchida, Ryoko Umebayashi, Keiko Tsukamoto, Keiko Tanaka, Masashi Kitagawa, Hitoshi Sugiyama, Hiroaki Tanioka, Jun Wada
BACKGROUND: A link between IgA nephropathy and Crohn's disease has recently been reported. Other researchers hypothesize that intestine-derived IgA complexes deposit in glomerular mesangial cells, eliciting IgA nephropathy. Intestinal mucosal plasma cells mainly secrete IgA2. Nevertheless, IgA1 deposition is strongly implicated as being the primary cause of IgA nephropathy. CASE PRESENTATION: A 46-year-old Japanese man developed IgA nephropathy 29 years ago, following tonsillectomy...
September 5, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27536690/autophagy-in-chronic-kidney-diseases
#20
REVIEW
Na Liu, Yingfeng Shi, Shougang Zhuang
BACKGROUND: Autophagy is the degrading process of protein and organelles mediated by lysosomes. This process is involved in purging senescent organelles and subversive proteins while maintaining the stability of the intracellular environment. This phenomenon is highly conservative, existing in nearly every species, and is involved in cell growth, proliferation and tumorigenesis. SUMMARY: In recent decades, with the discovery of autophagy-related genes and proteins in conjunction with the improvement in detection methods, the study of autophagy is constantly achieving new breakthroughs...
April 2016: Kidney Diseases
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