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mofetil and diabetic nephropathy

Jonathan Fridell, Richard Mangus, Jeanne Chen, Tim Taber, Arianna E Cabrales, Asif Sharfuddin, Muhammad Yaqub, John Powelson
Graft survival following pancreas transplant alone (PTA) is inferior to other pancreas transplants. Steroid elimination is appealing, but a two drug maintenance strategy may be inadequate. Additionally, recipients tend to have diabetic nephropathy and do not tolerate nephrotoxic medications. A three-drug maintenance strategy permits immunosuppression through different mechanisms as well as an opportunity to use lower doses of the individual medications. Induction consisted of five doses of rabbit antithymocyte globulin (1 mg/kg/dose)...
May 8, 2018: American Journal of Transplantation
Galina Severova-Andreevska, Ladislava Grcevska, Gordana Petrushevska, Koco Cakalaroski, Aleksandar Sikole, Olivera Stojceva-Taneva, Ilina Danilovska, Ninoslav Ivanovski
INTRODUCTION: Renal transplantation became a routine and successful medical treatment for Chronic Kidney Disease in the last 30 years all over the world. Introduction of Luminex based Single Antigen Beads (SAB) and recent BANFF consensus of histopathological phenotypes of different forms of rejection enables more precise diagnosis and changes the therapeutic approach. The graft biopsies, protocol or cause, indicated, remain a golden diagnostic tool for clinical follow up of kidney transplant recipients (KTR)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
C G Marmanillo, C Langaro, J E Nicoluzzi, R T Belila, M Macri, R Zamprogna, M Luvizotto, M Takahashi
BACKGROUND: The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Paraná, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. METHODS: This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015...
April 2018: Transplantation Proceedings
Dharmendra Bhadauria, Anand Chellappan, Anupma Kaul, Praveen Etta, Vinay Badri, Raj Kumar Sharma, Narayan Prasad, Amit Gupta, Manoj Jain
Background: Proteinuria and renal dysfunction is common in diabetic patients and may occur due to variety of causes. Nondiabetic renal diseases (NDRD) account for 30% of the renal biopsies, and idiopathic membranous nephropathy (iMN) is a common non diabetic glomerular disease that can exist alone or in combination with diabetic nephropathy (DN). Immunosuppressants used in iMN may be associated with complications of worsening glycemic control and recurrent infections. There is a paucity of literature on the clinical course, outcomes and treatment adverse effects of patients with iMN and diabetes...
February 2018: Clinical Kidney Journal
Jin-Hua Hou, Wei-Bo Le, Nan Chen, Wei-Ming Wang, Zhang-Suo Liu, Dong Liu, Jiang-Hua Chen, Jiong Tian, Ping Fu, Zhang-Xue Hu, Cai-Hong Zeng, Shao-Shan Liang, Min-Lin Zhou, Hai-Tao Zhang, Zhi-Hong Liu
BACKGROUND: Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) with active proliferative lesions show a good response to immunosuppressive treatment. STUDY DESIGN: Multicenter, prospective, randomized, controlled trial. SETTING & PARTICIPANTS: 176 patients with IgAN with active proliferative lesions (cellular and fibrocellular crescents, endocapillary hypercellularity, or necrosis), proteinuria with protein excretion ≥ 1...
June 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Abraham Said Arellano-Buendía, Montserrat Tostado-González, Fernando Enrique García-Arroyo, Magdalena Cristóbal-García, María Lilia Loredo-Mendoza, Edilia Tapia, Laura-Gabriela Sánchez-Lozada, Horacio Osorio-Alonso
This study addressed the relationship of proinflammatory cytokines and Nrf2-Keap1 system in diabetic nephropathy. The experimental groups were control, diabetic, and diabetic treated with mycophenolate mofetil (MMF). The renal function, proinflammatory and profibrotic cytokines, oxidative stress, morphology, and nephrin expression were assessed. Diabetic group showed impaired renal function in association with oxidative stress and decreased Nrf2 nuclear translocation. These results were associated with increased mesangial matrix index, interstitial fibrosis, and increased nephrin expression in cortex and urine excretion...
2016: Oxidative Medicine and Cellular Longevity
Medhat A Halim, Torki Al-Otaibi, Osama Gheith, Ahmed Mosaad, Zakaria Zakaria, Tarek Said, Prasad Nair, Narayanan M R Nampoory
OBJECTIVES: There is no active treatment for postrenal transplant BK virus-associated nephropathy proven to be effective so far. We assessed the effectiveness of actively treating this condition with combined leflunomide, intravenous immunoglobulin, and ciprofloxacin on long-term graft outcome compared with minimization of immunosuppressive drugs. MATERIALS AND METHODS: Kidney transplant recipients were screened for BK virus-associated nephropathy. Group 1 comprised 22 kidney trans plant recipients with twice-positive BK virus polymerase chain reaction results in urine and blood...
February 2016: Experimental and Clinical Transplantation
Jung-Woo Seo, Yang Gyun Kim, Sang Ho Lee, Arah Lee, Dong-Jin Kim, Kyung-Hwan Jeong, Kyung Hye Lee, Seung Joon Hwang, Jong Shin Woo, Sung Jig Lim, Weon Kim, Ju-Young Moon
Chronic low-grade inflammation is an important factor in the pathogenesis of diabetic complication. Mycophenolate mofetil (MMF) has an anti-inflammatory effect, inhibiting lymphocyte proliferation. Previous studies showed attenuation of diabetic nephropathy with MMF, but the underlying mechanisms were unclear. This study aimed to identify the effect of MMF on diabetic nephropathy and investigate its action mechanisms in type 2 diabetic mice model. Eight-week-old db/db and control mice (db/m mice) received vehicle or MMF at a dose of 30 mg/kg/day for 12 weeks...
2015: BioMed Research International
Xiaoyan Xiao, Jie Wang, Xiangdi Chang, Junhui Zhen, Gengyin Zhou, Zhao Hu
Recent studies in animal models have revealed that mycophenolate mofetil (MMF) has certain protective effects against experimental diabetic nephropathy. The present study therefore aimed to investigate the hypothesis that diabetic nephropathy may be ameliorated by mycophenolate mofetil and benazepril treatment alone or in combination, and identify the potential underlying mechanisms in a rat model. Diabetes was induced in rats by a single intraperitoneal injection of streptozotocin. Rats were subsequently treated with benazepril, MMF or a combination of the two drugs, and blood glucose, normalized kidney weight, urine protein and serum creatinine were determined...
September 2015: Molecular Medicine Reports
Izumi Nyumura, Kazuho Honda, Tetsuya Babazono, Shigeru Horita, Toru Murakami, Shohei Fuchinoue, Yasuko Uchigata
Post-transplant hyperglycaemia of diabetic patients may cause recurrent diabetic kidney disease (DKD) in kidney allografts. We report a patient with slowly progressive DKD with calcineurin inhibitor toxicity (CNI) toxicity after the kidney transplantation. A 28-year-old female with type 1 diabetes mellitus underwent successful kidney transplantation from her mother in April 2003, and the kidney graft survived for more than 10 years. She was treated with combined immunosuppressive therapy consisting of cyclosporine and mycophenolate mofetil...
July 2015: Nephrology
Su-Mi Kim, Sang-Ho Lee, Arah Lee, Dong-Jin Kim, Yang-Gyun Kim, Se-Yun Kim, Kyung-Hwan Jeong, Tae-Won Lee, Chun-Gyoo Ihm, Sung-Jig Lim, Ju-Young Moon
Proinflammatory T helper 1 (Th1) and T helper 17 (Th17) cell subsets have been reported to have an immunopathogenic role in metabolic disease. We previously demonstrated that CD4(+) T cells are increased in kidneys in type 2 diabetic patients. However, the role of Th1 and Th17 cells in the development and progression of diabetic nephropathy is unclear. In this study, we examined the hypothesis that mycophenolate mofetil (MMF) attenuates diabetic kidney injury by the suppression of renal T-cell proliferation and related cytokines...
October 2015: Translational Research: the Journal of Laboratory and Clinical Medicine
Tarek Fayad, Emad William, Nasr Tawfik, Boulos Habashy, Hazem S Abou-Youssef, Sameh Shokry, Soha Khalil, Ahmed Morsy, Rashad Barsoum
OBJECTIVES: To describe the long-term results of a previously developed a sirolimus-based sequential immunosuppression protocol for kidney transplant comprising 2 phases: sirolimus + cyclosporine + prednisolone for 3 months followed by sirolimus + prednisolone + mycophenolate mofetil with steroid minimization the first year. Two-year outcomes of patients on this protocol (group A) showed equivalent patient and graft survival, yet with significantly better function, compared with those on cyclosporine + mycophenolate mofetil + prednisolone (group B)...
April 2015: Experimental and Clinical Transplantation
Medhat Abdel Halim, Torki Al-Otaibi, Osama Gheith, Zakaria Zkaria, Ahmed Mosaad, Tarek Said, Prasad Nair, Narayanan Nampoory
OBJECTIVES: Thus far, there is no active treatment for BK virus-associated nephropathy after a kidney transplant that has proven to be effective. We sought to assess the effectiveness of treatment with leflunomide, intravenous immunoglobulin, and ciprofloxacin on graft outcome after 1 year compared with a historical group treated with reduced immunosuppressive medications strategy. MATERIALS AND METHODS: Group 1 (n = 19) was composed of kidney transplant recipients with twice positive BK virus-polymerase chain reaction in urine and blood who underwent graft biopsy to confirm BK virus-associated nephropathy...
December 2014: Experimental and Clinical Transplantation
M Kamran Mirza, Lisa Kim, Pradeep V Kadambi, Anthony Chang, Shane M Meehan
We report a case of idiopathic, PLA2R-negative membranous nephropathy (MN) transplanted via a deceased donor kidney. Changes in glomerular immune deposits were followed in serial biopsies. The allograft recipient had end-stage disease without significant proteinuria from ischemic nephropathy due to chronic heart failure, hypertension, atherosclerosis and presumed diabetic nephropathy. Combined cardiac and renal transplants were performed. Maintenance immunosuppression consisted of prednisone, a calcineurin inhibitor and mycophenolate mofetil...
December 2014: Nephrology, Dialysis, Transplantation
Shotaro Kuramitsu, Tomohiro Iguchi, Mizuki Ninomiya, Yo-ichi Yamashita, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yuji Soejima, Ken Shirabe, Hirofumi Kawanaka, Tetsuo Ikeda, Toshiya Furuta, Ryuichiro Tamada, Yoshihiko Maehara
Calcineurin inhibitor (CNI) combined with mycophenolate mofetil (MMF) and steroid is mainly used as immunosuppressive therapy after the living-donor liver transplantation (LDLT). However, the nephrotoxicity caused by CNI remains a critical problem for patients with chronic renal failure, especially on early postoperative period. A 62-year-old woman with decompensated liver cirrhosis secondary to hepatitis B (Child-Pugh C, MELD score 11 points) and chronic renal failure due to diabetic nephropathy (Cr 1.56 mg/dl, GFR 27 ml/min/1...
March 2014: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
Mohamed M Elseweidy, Sahar E Elswefy, Abd Elmoniem Ali, Mohamed Shawky
BACKGROUND: Renal injury may develop in uncontrolled chronic hyperglycemia due to increased oxidative stress and release of pro-inflammatory mediators, leading to diabetic complications. METHODS: Mycophenolate Mofetil (MMF) is an immunosuppressant drug, an inhibitor of inosine monophosphate dehydrogenase (IMPDH), relevant to inflammation processes. MMF effect was tested in alloxan-diabetic rats on selected parameters like oxidative stress, gene expression of tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1), in relation to microalbuminuria and renal function...
December 2014: Pathology, Research and Practice
F Q Chen, Q Y Wang, G Z Wei, X Y Ma, D W Ma, W W Deng, W B Sun
The effects of high glucose on the expression of monocyte chemoattractant protein-1 (MCP-1) and the main component of the extracellular matrix, fibronectin (FN), were explored in human mesangial cells (HMCs), along with the intervention effects of mycophenolate mofetil (MMF) on these indicators. Cultured HMCs were divided into five groups: 1) normal control group (5 mM glucose); 2) high glucose group (30 mM glucose); 3) mannitol osmotic pressure control group (5 mM glucose + 25 mM mannitol); 4) high glucose + MMF-10 group (30 mM glucose + 10 μg/mL MMF); 5) high glucose + MMF-100 group (30 mM glucose + 100 μg/mL MMF)...
April 17, 2014: Genetics and Molecular Research: GMR
Julie Belliere, Laure Esposito, Peggy Gandia, Jean Pierre Duffas, Federico Sallusto, Isabelle Cardeau-Desangles, Arnaud Del Bello, Lionel Rostaing, Nassim Kamar
BACKGROUND: Patients with a simultaneous pancreas-kidney transplant (SPKT), especially those with gastroparesis, often have gastro-intestinal (GI) disorders that can modify immunosuppressant pharmacokinetics. We compared the MPA 12-hours area under the curve (AUC(0-12)) in SKPT patients with severe gastroparesis receiving mycophenolate mofetil (MMF) or enteric-coated mycophenolate sodium (EC-MPS). MATERIAL/METHODS: Fifteen SKPT patients having a severe gastroparesis were switched, at 182 (69-1523) days post-transplantation, from MMF to EC-MPS because of GI disorders...
February 10, 2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Wei Lv, Yan Zhang, Guangju Guan, Peng Li, Jianping Wang, Dong Qi
AIM: To investigate the effects of mycophenolate mofetil on apoptosis and the expression of Bax and Bcl-2 of podocytes in rats with diabetic nephropathy. METHODS: A total of 40 male rats were randomly divided into two groups: healthy control group (NC, n = 8) and diabetic nephropathy group (DN, n = 32). The diabetic rat models were induced by streptozotocin, which was injected intraperitoneally. After the DN model was established successfully, the DN group was subdivided into four groups: (1) group treated with the dissolvent (DN), (2) group treated with mycophenolate mofetil (DN + M), (3) group treated with valsartan (DN + V) and (4) group treated with mycophenolate mofetil and valsartan (DN + MV)...
2013: Pharmacology
Uttara Das, Kaligotla Venkata Dakshinamurty
Chronic allograft nephropathy (CAN) is a major cause of late kidney allograft loss. Everolimus, a novel proliferation signal inhibitor, ameliorates CAN by its antiproliferative or apoptosis-enhancing effects. This study aims to evaluate the safety and efficacy of everolimus in renal transplant recipients with calcineurin inhibitor (CNI) withdrawal either due to CAN or cal-cineurin inhibitor toxicity (CNIT). A total 21 patients with CAN or CNIT converted from CNI to everolimus were prospectively studied from 2006 to 2009...
September 2013: Saudi Journal of Kidney Diseases and Transplantation
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