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Glomerular nephritis

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https://www.readbyqxmd.com/read/28540445/indications-for-kidney-biopsy-in-idiopathic-childhood-nephrotic-syndrome
#1
Alanoud Alshami, Abishek Roshan, Marisa Catapang, Jasper J Jöbsis, Trevor Kwok, Nonnie Polderman, Jennifer Sibley, Matt Sibley, Cherry Mammen, Douglas G Matsell
BACKGROUND: Most cases of childhood nephrotic syndrome (NS) are due to minimal change disease (MCD), while a minority of children have focal segmental glomerulosclerosis (FSGS) and an unfavorable clinical course, requiring a kidney biopsy to confirm diagnosis. We hypothesized that clinical characteristics at diagnosis and initial response to corticosteroid treatment accurately predict FSGS and can be used to guide consistent practice in the indications for kidney biopsy. METHODS: This was a case control study (1990-2012)...
May 24, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#2
Kimberly Blom, Ayodele Odutayo, Kate Bramham, Michelle A Hladunewich
During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28515361/lupus-and-proliferative-nephritis-are-pad4-independent-in-murine-models
#3
Rachael A Gordon, Jan M Herter, Florencia Rosetti, Allison M Campbell, Hiroshi Nishi, Michael Kashgarian, Sheldon I Bastacky, Anthony Marinov, Kevin M Nickerson, Tanya N Mayadas, Mark J Shlomchik
Though recent reports suggest that neutrophil extracellular traps (NETs) are a source of antigenic nucleic acids in systemic lupus erythematosus (SLE), we recently showed that inhibition of NETs by targeting the NADPH oxidase complex via cytochrome b-245, β polypeptide (cybb) deletion exacerbated disease in the MRL.Faslpr lupus mouse model. While these data challenge the paradigm that NETs promote lupus, it is conceivable that global regulatory properties of cybb and cybb-independent NETs confound these findings...
May 18, 2017: JCI Insight
https://www.readbyqxmd.com/read/28509121/antithyroid-drug-associated-mpo-anca-positive-tubulointerstitial-nephritis-in-a-type-2-diabetes-patient-a-case-report
#4
Shinsuke Nishimura, Kazushi Nakao, Masaya Takeda, Ikuko Matsuura, Yoshihisa Nomura, Sonei Shojima, Yuriko Yamamura, Kazuyuki Fujita, Noriya Momoki, Keisuke Maruyama, Masahiro Yamamura, Makoto Hiramatsu
A 54-year-old man diagnosed with type 2 diabetes and hyperthyroidism was prescribed propylthiouracil (PTU) after the patient developed hepatic dysfunction on thiamazole. At 50 mg/day of PTU, he was stable with thyroid-stimulating hormone receptor and thyrotropic antibody titers remaining stable. After four years of taking PTU, he was referred to the Department of Nephrology due to a rapid increase in his serum creatinine (Cr) level. He showed impaired renal function (Cr 2.26 mg/dL; estimated glomerular filtration rate (eGFR), 25 mL/min)...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28495931/neutrophil-extracellular-traps-drive-endothelial-to-mesenchymal-transition
#5
Elmar Pieterse, Nils Rother, Marjolein Garsen, Julia Hofstra, Simon Satchell, Markus Hoffmann, Markus Loeven, Hanneke Knaapen, Olivier van der Heijden, Jo Berden, Luuk Hilbrands, Johan van der Vlag
OBJECTIVE: An excessive release and impaired degradation of neutrophil extracellular traps (NETs) leads to the continuous exposure of NETs to the endothelium in a variety of hematologic and autoimmune disorders, including lupus nephritis. This study aims to unravel the mechanisms through which NETs jeopardize vascular integrity. APPROACH AND RESULTS: Microvascular and macrovascular endothelial cells were exposed to NETs, and subsequent effects on endothelial integrity and function were determined in vitro and in vivo...
May 11, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28444577/comparison-of-clinical-serological-and-prognostic-differences-among-juvenile-adult-and-late-onset-lupus-nephritis-in-korean-patients
#6
Ji-Hyoun Kang, Dong-Jin Park, Kyung-Eun Lee, Ji Shin Lee, Yoo-Duk Choi, Shin-Seok Lee
We investigated whether lupus nephritis (LN) patients could be distinguished based on the time of disease onset and, if so, whether the groups differed in their clinical and laboratory features and long-term prognosis in ethnically homogeneous Korean patients. We enrolled 117 systemic lupus erythematosus patients with available clinical data at the time of renal biopsy of LN. Sociodemographic, clinical, and laboratory data and concomitant diseases were evaluated at the time of renal biopsy. We divided LN patients, according to age at LN diagnosis, into three groups: juvenile-onset LN (JLN, diagnosed at ≤18 years), adult-onset LN (ALN, diagnosed at 18-50 years), and late-onset LN (LLN, diagnosed at >50 years) and compared demographic, clinical, histological, and laboratory findings...
April 25, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28444337/utility-of-a-repeat-renal-biopsy-in-lupus-nephritis-a-single-centre-experience
#7
Angela Pakozdi, Debasish Pyne, Michael Sheaff, Ravindra Rajakariar
Background.: The role of repeat renal biopsy in lupus nephritis (LN) to guide treatment or predict prognosis has been controversial. We assessed glomerular and tubulointerstitial histological characteristics of serial renal biopsies, correlations with clinical variables and the impact on subsequent management. Methods.: Out of a large single-centre cohort of 270 biopsy- proven LN patients, 66 (24%) had serial biopsies. LN classes based on glomerular pathology were defined according to the International Society of Nephrology/Renal Pathology Society 2003 classification, while tubulointerstitial pathologies were evaluated using the revised Austin's semi-quantitative scoring system...
April 22, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28435765/chronic-nephropathy-from-dietary-hyperoxaluria-sustained-improvement-of-renal-function-after-dietary-intervention
#8
Yijuan Sun, Bruce L Horowitz, Karen S Servilla, Joanna R Fair, Darlene Vigil, Kavitha Ganta, Larry Massie, Antonios H Tzamaloukas
A 56-year-old man with stable chronic kidney disease (CKD) for two years following a single episode of calcium oxalate urolithiasis developed progressive elevation of his serum creatinine concentration. Urinalysis revealed pyuria and white cell casts, a few red blood cells, minimal proteinuria, and no crystals. Urine culture was sterile. Gallium scintigraphy was consistent with interstitial nephritis. Proton pump inhibitor intake was discontinued, and a short course of oral corticosteroids was initiated. Percutaneous kidney biopsy, performed because of the continued deterioration of renal function to a minimum estimated glomerular filtration rate (eGFR) value of 15 mL/min per 1...
March 20, 2017: Curēus
https://www.readbyqxmd.com/read/28428258/deletion-of-inositol-requiring-enzyme-1%C3%AE-in-podocytes-disrupts-glomerular-capillary-integrity-and-autophagy
#9
Daniel Robert Kaufman, Joan Papillon, Louise Larose, Takao Iwawaki, Andrey V Cybulsky
Inositol-requiring enzyme-1α (IRE1α) is an endoplasmic reticulum (ER)-transmembrane endoribonuclease-kinase, which plays an essential function in extraembryonic tissues during normal development, and is activated during ER stress. To address the functional role of IRE1α in glomerular podocytes, we produced podocyte-specific IRE1α deletion mice. In male mice, deletion of IRE1α in podocytes resulted in albuminuria beginning at 5 months of age, and worsening with time. Electron microscopy revealed focal podocyte foot process effacement in 9-month old male IRE1α deletion mice, as well as microvillous transformation of podocyte plasma membranes...
April 20, 2017: Molecular Biology of the Cell
https://www.readbyqxmd.com/read/28420060/risk-factors-to-predict-the-development-of-chronic-kidney-disease-in-patients-with-lupus-nephritis
#10
D J Park, J H Kang, J W Lee, K E Lee, T J Kim, Y W Park, J S Lee, Y D Choi, S S Lee
Objectives We analyzed the clinical follow-up results of 88 lupus nephritis patients to find prognostic factors for the development of chronic kidney disease in ethnically homogeneous Korean patients with biopsy-proven lupus nephritis. Methods Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained. Renal biopsy specimens were reclassified according to the International Society of Pathology/Renal Pathology Society classification, separately, by two renal pathologists blinded to the previous classification...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28420058/clinico-pathological-features-of-repeat-renal-biopsies-in-patients-with-lupus-nephritis-at-groote-schuur-hospital-cape-town
#11
S Kajawo, F C J Botha, I G Okpechi
Background Repeat renal biopsies in patients with lupus nephritis are usually done to guide treatment or to establish disease chronicity. Their value is not clear from available literature. There are also no available data in Africa to guide clinicians. Methods This was a retrospective study of patients undergoing a repeat renal biopsy between January 2003 and December 2014 from a single centre in Cape Town, South Africa. Relevant demographic, clinical and histological records of patients with repeat renal biopsies were documented...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28419296/urinary-podocyte-and-tgf-%C3%AE-1-mrna-as-markers-for-disease-activity-and-progression-in-anti-glomerular-basement-membrane-nephritis
#12
Akihiro Fukuda, Akihiro Minakawa, Yuji Sato, Takashi Iwakiri, Shuji Iwatsubo, Hiroyuki Komatsu, Masao Kikuchi, Kazuo Kitamura, Roger C Wiggins, Shouichi Fujimoto
Background.: Podocyte depletion causes glomerulosclerosis, with persistent podocyte loss being a major factor driving disease progression. Urinary podocyte mRNA is potentially useful for monitoring disease progression in both animal models and in humans. To determine whether the same principles apply to crescentic glomerular injury, a rat model of anti-glomerular basement membrane (anti-GBM) nephritis was studied in parallel with a patient with anti-GBM nephritis. Methods...
April 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28407133/con-mesoamerican-nephropathy-is-the-problem-dehydration-or-rehydration
#13
Vito M Campese
In recent years, an increasing number of inhabitants of Central America have developed a form of chronic kidney disease, now named Mesoamerican nephropathy. This disease is characterized by minimal proteinuria, hyperuricemia, hypokalemia and reduced glomerular filtration rate. Histologically the kidneys manifest tubulointerstitial nephritis. The cause(s) of this disease remain unknown. Some have proposed that dehydration, in combination with hyperuricemia, may be primarily responsible for Mesoamerican nephropathy...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28405610/btk-specific-inhibition-blocks-pathogenic-plasma-cell-signatures-and-myeloid-cell-associated-damage-in-ifn%C3%AE-driven-lupus-nephritis
#14
Arna Katewa, Yugang Wang, Jason A Hackney, Tao Huang, Eric Suto, Nandhini Ramamoorthi, Cary D Austin, Meire Bremer, Jacob Zhi Chen, James J Crawford, Kevin S Currie, Peter Blomgren, Jason DeVoss, Julie A DiPaolo, Jonathan Hau, Adam Johnson, Justin Lesch, Laura E DeForge, Zhonghua Lin, Marya Liimatta, Joseph W Lubach, Sami McVay, Zora Modrusan, Allen Nguyen, Chungkee Poon, Jianyong Wang, Lichuan Liu, Wyne P Lee, Harvey Wong, Wendy B Young, Michael J Townsend, Karin Reif
Systemic lupus erythematosus (SLE) is often associated with exaggerated B cell activation promoting plasma cell generation, immune-complex deposition in the kidney, renal infiltration of myeloid cells, and glomerular nephritis. Type-I IFNs amplify these autoimmune processes and promote severe disease. Bruton's tyrosine kinase (Btk) inhibitors are considered novel therapies for SLE. We describe the characterization of a highly selective reversible Btk inhibitor, G-744. G-744 is efficacious, and superior to blocking BAFF and Syk, in ameliorating severe lupus nephritis in both spontaneous and IFNα-accelerated lupus in NZB/W_F1 mice in therapeutic regimens...
April 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28396742/single-centre-experience-of-granulomatous-interstitial-nephritis-time-for-a-new-approach
#15
Ben Oliveira, Satish Jayawardene, Sapna Shah
Background: Differentiating between renal-limited sarcoidosis and tuberculosis (TB) infection as a cause of granulomatous interstitial nephritis (GIN) can be difficult. This series compares clinical features and response to treatment between the different underlying aetiologies in order to propose a management algorithm for GIN to assist with diagnosis and treatment. Methods: This retrospective study reports on all patients presenting with a histological diagnosis of GIN between 2000 and 2012 at our unit. Results: Twenty-one patients were identified, 57% were male and the mean age was 53 years...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28396740/long-term-outcome-in-biopsy-proven-acute-interstitial-nephritis-treated-with-steroids
#16
Maria Prendecki, Anisha Tanna, Alan D Salama, Frederick W K Tam, Tom Cairns, David Taube, H Terence Cook, Damien Ashby, Neil D Duncan, Charles D Pusey
Background: There are no prospective randomized controlled trials describing the outcome of acute interstitial nephritis (AIN) treated with steroids, and retrospective studies are limited. Methods: We identified adult patients with a diagnosis of AIN without glomerular pathology over a 14-year period. Treated patients all received oral prednisolone and three also recieved IV methylprednisolone. Data were collected retrospectively on estimated glomerular filtration rate (eGFR), change in eGFR from time of biopsy, dependence on renal replacement therapy (RRT) and mortality, and outcomes were analysed according to the treatment prescribed...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28391344/is-there-a-role-for-tnf%C3%AE-blockade-in-anca-associated-vasculitis-and-glomerulonephritis
#17
Stephen P McAdoo, Charles D Pusey
Tumour necrosis factor alpha (TNFα) is a cytokine that is pivotal in the inflammatory response. Blockade of TNFα has been shown to be effective in a number of human autoimmune diseases, including rheumatoid arthritis, raising the question of whether this approach may be effective in inflammatory kidney disease, such as ANCA-associated vasculitis (AAV). In AAV, there is considerable evidence for the role of TNFα in the pathophysiology of disease, including increased expression of TNFα mRNA in leucocytes and in renal tissue...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28391337/managing-glomerular-disease-in-pregnancy
#18
Michelle A Hladunewich, Kate Bramham, Belinda Jim, Sharon Maynard
Glomerular disease, especially lupus nephritis, is common in young women of childbearing age. As such, practicing nephrologists must have adequate knowledge and expertise to prepare these women for pregnancy, to diagnose and manage the numerous pregnancy-associated complications that are common in this vulnerable patient population and finally to support these young women who often struggle to manage both their young children along with an often onerous chronic disease. In this article we will review the pre-pregnancy counseling these women should ideally receive to allow them to make an informed decision about proceeding with a pregnancy, an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies, including immunosuppression, antihypertensive agents and other medications necessary for the management of nephrotic syndrome...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28387859/altered-expression-of-signalling-lymphocyte-activation-molecule-receptors-in-t-cells-from-lupus-nephritis-patients-a-potential-biomarker-of-disease-activity
#19
Victoria Stratigou, Anne F Doyle, Francesco Carlucci, Lauren Stephens, Valentina Foschi, Marco Castelli, Nicola McKenna, H Terence Cook, Liz Lightstone, Thomas D Cairns, Matthew C Pickering, Marina Botto
Objectives.: The aim was to investigate whether the signalling lymphocyte activation molecule (SLAM) signalling pathways contribute to LN and whether SLAM receptors could be valuable biomarkers of disease activity. Methods.: Peripheral blood mononuclear cells from 30National Research Ethics Service SLE patients with biopsy-proven LN were analysed by flow cytometry. Clinical measures of disease activity were assessed. The expression of the SLAM family receptors on T-cell subpopulations [CD4, CD8 and double negative (DN) T cells] was measured and compared between lupus patients with active renal disease and those in remission...
April 5, 2017: Rheumatology
https://www.readbyqxmd.com/read/28382508/clinicopathological-characteristics-of-typical-and-atypical-anti-glomerular-basement-membrane-nephritis
#20
REVIEW
Vincenzo L'Imperio, Elena Ajello, Federico Pieruzzi, Manuela Nebuloni, Antonella Tosoni, Franco Ferrario, Fabio Pagni
Anti-glomerular basement membrane (GBM) antibody disease is a rare pathological condition that mainly involves renal and/or pulmonary parenchyma. It is characterized by the presence of circulating anti-GBM antibodies accompanied by a linear deposition of immunoglobulins (Ig) detected through immunofluorescence (IF) technique and typical signs and symptoms of organ dysfunction, such as rapidly progressive glomerulonephritis (RPGN) and pulmonary hemorrhage (PH). However, recently atypical forms of anti-GBM disease have been described and the presence of overlapping diseases contributed to make its diagnosis challenging...
April 5, 2017: Journal of Nephrology
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