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Lupus , kidney transplant , glomerulonephritis

Michelle M O'Shaughnessy, Sai Liu, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Whether kidney transplantation rates differ by glomerulonephritis (GN) subtype remains largely unknown. METHODS: Using the US Renal Data System, we identified all adult patients with ESRD attributed to 1 of 6 GN subtypes who initiated dialysis in the US (1996-2013). Patients with diabetic nephropathy (DN) and autosomal-dominant polycystic kidney disease (ADPKD) served as "external" non-GN comparators. Using Cox proportional hazards regression, with death considered a competing risk, we estimated hazard ratios [HRs (95% confidence intervals)] for first kidney transplantation, controlling for year, demographics, comorbidities, socioeconomic factors, and Organ Procurement Organization (OPO)...
February 15, 2017: Transplantation
Samuel Chan, Andrew J Mallett, Chirag Patel, Ross S Francis, David W Johnson, David W Mudge, Nicole M Isbel
Disorders in the regulation of the alternate complement pathway often result in complement-mediated damage to the microvascular endothelium and can be associated with both glomerulonephritis and atypical haemolytic uraemic syndrome. Inherited defects in complement regulatory genes or autoantibodies against complement regulatory proteins are predictive of the severity of the disease and the risk of recurrence post kidney transplantation. Heterozygous mutations in CD46, which codes for a transmembrane cofactor glycoprotein membrane cofactor protein, usually have a lower incidence of end-stage kidney disease and decreased risk of recurrent disease post transplant, as wild-type membrane cofactor protein is present in the transplanted kidney...
February 2017: Nephrology
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
May 2017: Pediatric Transplantation
Anna Cyganek, Filip Andrzej Dabrowski, Bronislawa Pietrzak, Zoulikha Jabiry-Zieniewicz, Barbara Grzechocinska, Anna Madej, Miroslaw Wielgos
OBJECTIVES: Delayed motherhood is associated with an increasing number of comorbidities such as glomerulonephritis, systemic lupus erythematosus, and diabetic nephropathy. Women after renal transplant belong to the group of patients who require a highly individualized approach to treatment and diagnosis. The aim of the study was to validate the commonly used diagnostic criteria for preeclampsia which seem to be irrelevant in patients with chronic renal insufficiency. MATERIAL AND METHODS: The course of pregnancy and delivery were retrospectively analyzed in 48 renal transplant patients...
2016: Ginekologia Polska
Terry King-Wing Ma, Stephen P McAdoo, Frederick Wai-Keung Tam
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN)...
2016: Nephron
Cynthia C Lim, Pei Yun Liu, Hui Zhuan Tan, Peishan Lee, Yok Mooi Chin, Irene Yj Mok, Choong Meng Chan, Jason Cj Choo
AIM: Lupus nephritis (LN) is associated with significant morbidity and mortality and hence usually treated aggressively with immunosuppressants. This predisposes LN patients to increased infections, yet few studies have evaluated LN patients for infective complications. We aimed to describe the epidemiology and identify risk factors for infections requiring hospitalisation among patients with biopsy-proven LN. METHODS: This was a single-centre retrospective cohort study of patients with biopsy-proven LN between 1(st) January 2000 and 31(st) May 2009...
May 5, 2016: Nephrology
Rishi Pruthi, Mark McClure, Anna Casula, Paul J Roderick, Damian Fogarty, Mark Harber, Rommel Ravanan
Glomerulonephritis (GN) is the primary diagnosis in 20% to 40% of patients receiving a renal transplant. Here we studied patient survival and graft outcomes in patients with GN transplanted in the UK. UK Renal Registry data were used to analyze patient survival and graft failure in incident transplant patients between 1997 to 2009 who had a diagnosis of primary GN, in comparison to patients transplanted with adult polycystic kidney disease (APKD) or diabetes. Multivariable regression analysis adjusted for age, sex, donor type, ethnicity, donor age, time on dialysis, human leukocyte antigen mismatch, cold ischemic time, and graft failure (for patient survival)...
April 2016: Kidney International
Michelle M O'Shaughnessy, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD), while peritoneal dialysis affords certain benefits over hemodialysis. Distributions and determinants of first ESRD treatment modality have not been compared across glomerulonephritis (GN) subtypes. METHODS: We identified all adult (18-75 years) patients with ESRD attributed to any of six GN subtypes [focal segmental glomerulosclerosis (FSGS), IgA nephropathy (IgAN), membranous nephropathy (MN), membranoproliferative GN (MPGN), lupus nephritis (LN) and vasculitis] who were first registered in the US Renal Data System (USRDS) between 1996 and 2011...
February 2016: Nephrology, Dialysis, Transplantation
Yajuan Li, Wei Li, Chu Liu, Mei Yan, Indu Raman, Yong Du, Xiangdong Fang, Xin J Zhou, Chandra Mohan, Quan-Zhen Li
OBJECTIVE: To elucidate the role of oxidation resistance 1 (OXR1) gene. Oxidative stress plays a pivotal role in pathogenesis of immune-mediated nephritis. Recently we identified oxidation resistance 1 (OXR1) is conventionally expressed in eukaryotes and has an ability to prevent oxidative damage caused by various oxidative stresses. However the protective effect of OXR1 in immune-associated inflammatory response and oxidative damage is not clear and will be investigated in this study...
September 10, 2014: Journal of Stem Cell Research & Therapy
Justine Bacchetta, Pierre Cochat
Primary disease recurrence after renal transplantation is mainly diagnosed by examination of biopsy samples, but can also be associated with clinical symptoms. In some patients, recurrence can lead to graft loss (7-8% of all graft losses). Primary disease recurrence is generally associated with a high risk of graft loss in patients with focal segmental glomerulosclerosis, membranous proliferative glomerulonephritis, primary hyperoxaluria or atypical haemolytic uraemic syndrome. By contrast, disease recurrence is associated with a limited risk of graft loss in patients with IgA nephropathy, renal involvement associated with Henoch-Schönlein purpura, antineutrophil cytoplasmic antibody-associated glomerulonephritis or lupus nephritis...
June 2015: Nature Reviews. Nephrology
Viktor K Denisov, Vadim V Zakharov, Eugeny V Onishchenko, Tatyana S Golubova, Yana G Mitsuk, Olga V Zakharova
OBJECTIVES: To show the effects of different factors on development and outcome of early kidney allograft dysfunction. MATERIALS AND METHODS: Two hundred thirty-one kidney transplant recipients were divided into 2 groups: group 1 (125 patients transplanted from 1999-2004) and group 2 (106 patients transplanted from 2008-2013). Age range was 12 to 62 years (group 1) and 7 to 71 years (group 2). Deceaseddonor transplant was more frequent in group 1 (76.8%), and living-donor transplant in group 2 (68...
April 2015: Experimental and Clinical Transplantation
Thais A Facca, Amelia R Sabino, Jussara Sato, Eduado A Fama, Guilherme S Junior, Gianna Mastroianni-Kirsztajn, Nelson Sass
OBJECTIVES: Evaluation of outpatients with glomerupathies who had pregnancy complicated by arterial hypertension. METHODS: Retrospective study with 52 women who started monitoring of glomerulonephritis during the period of 1989-2014 at outpatient clinics of UNIFESP, Sao Paulo/Brazil and who had pregnancy complicated by arterial hypertension. RESULTS: Women ranged from age 15 to 52years old ± 7.83 (mean 30.67). A total of 88.5% (46/52) had a pregnancy with a hypertensive syndrome, 11...
January 2015: Pregnancy Hypertension
Hanni Menn-Josephy, Laurence H Beck
Glomerulonephritis is responsible for nearly 15% of prevalent end-stage renal disease, and many of these patients will receive kidney transplants with the potential for a long duration of allograft survival. Recurrent glomerular disease, however, is not uncommon and can lead to both substantial morbidity and/or loss of the kidney allograft. The timing of recurrence after transplantation as well as the prevalence of recurrent disease vary by study, especially accounting for differences in protocol versus clinically-indicated biopsies, the use of immunofluorescence or electron microscopy in histopathological evaluation, and length of follow-up...
2015: Frontiers in Bioscience (Elite Edition)
C Chanswangphuwana, N Townamchai, T Intragumtornchai, U Bunworasate
Chronic graft-versus-host disease (cGVHD) is the major complication following allogeneic stem cell transplantation (allo-SCT). Nephrotic syndrome (NS) and other types of glomerulonephritis have been proposed to be the very rare forms of renal cGVHD. From 1991 to 2011, 253 patients underwent allo-SCT at our center. We report here 4 cases (1.6%) presenting with varieties of glomerular manifestations associated with cGVHD. The first case was typical NS. The renal pathology showed membranous nephropathy (MN). The second case was also MN, but this patient also had the pathology of focal segmental glomerulosclrosis (FSGS) and acute tubular necrosis (ATN)...
December 2014: Transplantation Proceedings
Gh Gluhovschi, Silvia Velciov, Ligia Petrica, Cristina Gluhovschi
The kidneys, as an integral part of the body, are in close functional relationship with other organs. Dysfunction of the relationship with one organ will affect the kidney. Chronic kidney disease (CKD) leads in time to alteration of the relationship of the kidney with other organs, sometimes with severe consequences. Thus, cardiovascular involvement in CKD leads to increased severity of CKD, with an increase in mortality rate. At present, the relationship between the kidney and the lung has been less studied...
April 2014: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Ayşen Terzi, Binnaz Handan Özdemir, Firdevs Zeynep Taşlıca, Fatma Nurhan Özdemir, Mahir Kırnap, Mehmet Haberal
OBJECTIVES: The purpose of this study was to evaluate the causes of kidney impairment associated with liver transplant in patients who had kidney biopsy before or after liver transplant. MATERIALS AND METHODS: In 408 patients who had liver transplant from January 1990 to December 2012, there were 10 patients who had kidney biopsy (total, 19 kidney biopsies) for evaluation of kidney dysfunction. A retrospective review of clinical records and kidney biopsies was performed...
March 2014: Experimental and Clinical Transplantation
Osama El Minshawy, Tawfik Ghabrah, Eman El Bassuoni
The purpose of this study was to determine the prevalence, etiology and risk factors of treated end-stage renal disease (ESRD) in the region of Tabuk, Saudi Arabia. We studied 460 renal replacement therapy patients through a review of medical records and patient interviews and obtained patient demographics, family history, risk factors for ESRD, environmental exposure to toxins, work conditions, social history and causes of death. The estimated prevalence of treated ESRD was 460 per million populations (PMP); 350 (76%) were treated by hemodialysis, 30 (7%) by peritoneal dialysis and 80 (17%) by kidney transplantation...
January 2014: Saudi Journal of Kidney Diseases and Transplantation
Barry I Freedman
Marked familial aggregation of chronic kidney disease suggests that inherited factors play a major role in nephropathy susceptibility. Molecular genetics analyses have identified a number of genes reproducibly associated with a broad range of renal phenotypes. Most associations show polygenic inheritance patterns with limited effect size. In contrast, genetic association between the apolipoprotein L1 (APOL1) gene and several severe nondiabetic forms of kidney disease in African Americans approach Mendelian inheritance patterns and account for a large proportion of glomerulosclerosis in populations of African ancestry...
September 2013: Seminars in Nephrology
Colin R Lenihan, Jane C Tan, Neeraja Kambham
Acute transplant glomerulopathy refers to alloimmune mediated endothelial injury and glomerular inflammation that typically occurs early post-kidney transplantation. We report a case of a 48-year old woman with end stage renal disease from lupus nephritis who developed an unexplained rise in serum creatinine 2 months after renal transplant. As immunosuppression, she received alemtuzumab induction followed by a tacrolimus, mycophenolate mofetil and prednisone maintenance regimen. Her biopsy revealed severe glomerular endothelial injury associated with monocyte/macrophage-rich infiltrate in addition to mild acute tubulointerstitial cellular rejection...
December 2013: Transplant Immunology
Katarzyna Kościelska-Kasprzak, Dorota Bartoszek, Marta Myszka, Marcelina Zabińska, Marian Klinger
Serum complement cascade, a part of innate immunity required for host protection against invading pathogens, is also a mediator of various forms of disease and injury. It is activated by classical, lectin, and alternative pathways that lead to activation of C3 component by C3 convertases, release of C3b opsonin, C5 conversion and eventually membrane attack complex formation. The tightly regulated activation process yields also C3a and C5a anaphylatoxins, which target a broad spectrum of immune and non-immune cells...
February 2014: Archivum Immunologiae et Therapiae Experimentalis
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