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https://www.readbyqxmd.com/read/29020719/diagnosis-and-management-of-nephrotic-syndrome
#1
Oonagh McCloskey, Alexander P Maxwell
Nephrotic syndrome is defined by a triad of clinical features: oedema, substantial proteinuria (> 3.5 g/24 hours) and hypoalbuminaemia (< 30 g/L). It is often associated with hyperlipidaemia, thromboembolism and an increased risk of infection. Nephrotic syndrome develops following pathological injury to renal glomeruli. This may be a primary problem, with a disease specific to the kidneys, or secondary to a systemic disorder such as diabetes mellitus. The most common cause in children is minimal change glomerulonephritis...
February 2017: Practitioner
https://www.readbyqxmd.com/read/28992235/treatment-by-immunoadsorption-for-recurrent-focal-segmental-glomerulosclerosis-after-paediatric-kidney-transplantation-a-multicentre-french-cohort
#2
Lise Allard, Theresa Kwon, Saoussen Krid, Justine Bacchetta, Arnaud Garnier, Robert Novo, Georges Deschenes, Rémi Salomon, Gwenaëlle Roussey, Emma Allain-Launay
Background: Primary focal segmental glomerulosclerosis (FSGS) frequently recurs after kidney transplantation (KTx) in children. This can lead to delayed graft loss. As the management of children with recurrent FSGS is not well established, apheresis strategies could be a cornerstone to control the disease. Immunoadsorption (IA) is a recent apheresis therapy. There have been few studies examining IA in this setting. We report the results of IA for management of recurrent FSGS after KTx in children in France...
July 28, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28990729/renoprotective-effects-of-topiroxostat-for-hyperuremic-patients-with-overt-diabetic-nephropathy-study-etude-study-a-prospective-randomized-multicenter-clinical-trial
#3
Toshihiro Mizukoshi, Sawako Kato, Masahiko Ando, Hiroshi Sobajima, Norimi Ohashi, Tomohiko Naruse, Yosuke Saka, Hideaki Shimizu, Takanobu Nagata, Shoichi Maruyama
AIM: We aimed to evaluate the anti-albuminuric effects of topiroxostat in Japanese hyperuricemic patients with diabetic nephropathy. METHODS: In this 24-week, multicenter, open-label, randomized (1:1) trial, we assigned hyperuricemic patients with diabetic nephropathy (estimated glomerular filtration rate ≥ 20 mL/min/1.73m(2) ) and overt proteinuria (0.3 ≤ urine protein to creatinine ratio (UPCR) <3.5 g/g Cr) to either high dose (160 mg daily) or low dose (40 mg daily) topiroxostat...
October 9, 2017: Nephrology
https://www.readbyqxmd.com/read/28965223/bariatric-surgery-can-reduce-albuminuria-in-patients-with-severe-obesity-and-normal-kidney-function-by-reducing-systemic-inflammation
#4
Samel Park, Yong Jin Kim, Chi-Young Choi, Nam-Jun Cho, Hyo-Wook Gil, Eun Young Lee
BACKGROUND: Obesity causes renal problems including albuminuria. Bariatric surgery (BS) improves albuminuria. We investigated whether albuminuria is reduced by weight loss per se or by improved systemic inflammation induced by weight loss after BS. METHODS: Patients older than 18 years who received BS in Soonchunhyang University Hospital from 01 January 2011 to 31 December 2011 were included. Other inclusion criteria included body mass index (BMI) ≥ 30 kg/m(2), creatinine level ≤ 1...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28963279/urine-and-serum-midkine-levels-in-an-australian-chronic-kidney-disease-clinic-population-an-observational-study
#5
Victoria K Campbell, Chris M Anstey, Ryan P Gately, Drew C Comeau, Carolyn J Clark, Euan P Noble, Kumar Mahadevan, Peter R Hollett, Andrea J Pollock, Sharron T Hall, Darren R Jones, Dominic Burg, Nicholas A Gray
BACKGROUND AND OBJECTIVES: The cytokine midkine (MK) is pathologically implicated in progressive chronic kidney disease (CKD) and its systemic consequences and has potential as both a biomarker and therapeutic target. To date, there are no published data on MK levels in patients with different stages of CKD. This study aims to quantify MK levels in patients with CKD and to identify any correlation with CKD stage, cause, progression, comorbid disease or prescribed medication. METHODS: In this observational, single-centre study, demographic data were collected, and serum and urine assayed from 197 patients with CKD and 19 healthy volunteers in an outpatient setting...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28954270/urinary-rbp-and-ngal-levels-are-associated-with-nephropathy-in-patients-with-type-2-diabetes
#6
Jian Wu, Xiaohong Shao, Kan Lu, Jing Zhou, Miaomiao Ren, Xin Xie, Jibo Liu, Yi Xu, Yaqin Ding, Xiaoyu Shen, Chunling Zhu
BACKGROUND/AIMS: The diagnosis of type 2 diabetic nephropathy (T2DN) patients is important to prevent the long-term damaging effects of kidney loss in patients with diabetes and is decisive for patient outcomes. The aim of this study was to explore urine retinol binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) in T2DN patients with and without albuminuria. METHODS: A total of 293 T2DN patients were divided into three groups according to their urine albumin/urine creatinine ratio (UACR): normoalbuminuria group (UACR<30 mg/g, n=100), microalbuminuria group (UACR 30-300 mg/g, n=100) and macroalbuminuria group (UACR>300 mg/g, n=93); 50 non-diabetic subjects were recruited as the control group...
2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28941297/clinical-consequences-of-hypertriglyceridemia-associated-proteinuria-in-miniature-schnauzers
#7
R E Smith, J L Granick, C D Stauthammer, D J Polzin, D A Heinrich, E Furrow
BACKGROUND: Primary hypertriglyceridemia is a common condition in older Miniature Schnauzers that recently has been associated with proteinuria and underlying glomerular pathology, particularly glomerular lipid thromboemboli. Consequences of glomerular disease can include hypertension, thromboembolic disease, and cardiac disease. The incidence of these sequelae in Miniature Schnauzers with hypertriglyceridemia-associated proteinuria (HTGP) is unknown. OBJECTIVE: To investigate prevalence of hypertension, decreased antithrombin III activity, and cardiac disease in Miniature Schnauzers with and without HTGP...
September 23, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28921709/kidney-allograft-failure-in-the-steroid-free-immunosuppression-era-a-matched-case-control-study
#8
Mohamad M Alkadi, Jim Kim, Meredith J Aull, Joseph E Schwartz, John R Lee, Anthony Watkins, Jun B Lee, Darshana M Dadhania, Surya V Seshan, David Serur, Sandip Kapur, Manikkam Suthanthiran, Choli Hartono, Thangamani Muthukumar
We studied the causes and predictors of death-censored kidney allograft failure among 1670 kidney recipients transplanted at our center in the corticosteroid-free maintenance immunosuppression era. As of January 1, 2012, we identified 137 recipients with allograft failure; 130 of them (cases) were matched 1-1 for recipient age, calendar year of transplant and donor type with 130 recipients with functioning grafts (controls). Median time to allograft failure was 29 months (interquartile range 18-51). Physician validated and biopsy confirmed categories of allograft failure were: acute rejection (21%), glomerular disease (19%), transplant glomerulopathy (13%), interstitial fibrosis tubular atrophy (10%), and polyomavirus-associated nephropathy (7%)...
September 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28920786/cryptococcus-neoformans-var-grubii-associated-renal-amyloidosis-causing-protein-losing-nephropathy-in-a-red-kangaroo-macropus-rufus
#9
Mary Irene Thurber, Jenessa Gjeltema, Matthew Sheley, Ray F Wack
A 10-year-old male castrated red kangaroo (Macropus rufus) presented with mandibular swelling. Examination findings included pitting edema with no dental disease evident on examination or radiographs. The results of blood work were moderate azotemia, hypoalbuminemia, and severely elevated urine protein:creatinine ratio (9.9). Radiographs showed an interstitial pattern of the caudal right lung, and an abdominal ultrasound demonstrated scant effusion. Symptomatic and empirical therapy with antibiotics, anti-inflammatory drugs, and an angiotensin-converting enzyme (ACE) inhibitor did not resolve clinical signs...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28914167/nephrotic-syndrome-in-infants-and-children-pathophysiology-and-management
#10
Mallory L Downie, Claire Gallibois, Rulan S Parekh, Damien G Noone
Nephrotic syndrome is defined by nephrotic-range proteinuria (≥40 mg/m(2)/hour or urine protein/creatinine ratio ≥200 mg/mL or 3+ protein on urine dipstick), hypoalbuminaemia (<25 g/L) and oedema. This review focuses on the classification, epidemiology, pathophysiology, management strategies and prognosis of idiopathic nephrotic syndrome of childhood, and includes a brief overview of the congenital forms.
September 15, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28912839/addition-of-nonalbumin-proteinuria-to-albuminuria-improves-prediction-of-type-2-diabetic-nephropathy-progression
#11
Jong Ho Kim, Seo Young Oh, Eun Heui Kim, Min Jin Lee, Yun Kyung Jeon, Bo Hyun Kim, Jin Mi Kim, Yong Ki Kim, Sang Soo Kim, In Joo Kim
BACKGROUND: Albuminuria is generally accepted as a sensitive marker of diabetic nephropathy but has limitations in predicting its progression. The aim of this study was to evaluate the use of nonalbumin proteinuria in addition to albuminuria for predicting the progression of type 2 diabetic nephropathy. METHODS: In this retrospective observational study, the urine albumin-to-creatinine ratio (ACR) and the nonalbumin protein-to-creatinine ratio (NAPCR) were measured in 325 patients with type 2 diabetes and estimated glomerular filtration rates (eGFR) ≥30 mL/min/1...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28912373/the-association-of-sleep-duration-and-quality-with-ckd-progression
#12
Ana C Ricardo, Kristen Knutson, Jinsong Chen, Lawrence J Appel, Lydia Bazzano, Eunice Carmona-Powell, Janet Cohan, Manjula Kurella Tamura, Susan Steigerwalt, John Daryl Thornton, Matthew Weir, Nicolas F Turek, Mahboob Rahman, Eve Van Cauter, James P Lash
Evidence suggests that sleep disorders are common in individuals with CKD, but the influence of sleep duration and quality on CKD progression is unknown. We examined the association of habitual sleep duration and quality with CKD progression in 431 Chronic Renal Insufficiency Cohort (CRIC) Study participants, of whom 48% were women and 50% had diabetes (mean age of 60 years old, mean eGFR =38 ml/min per 1.73 m(2), and median urine protein-to-creatinine ratio [UPCR] =0.20 g/g). We assessed sleep duration and quality by 5-7 days of wrist actigraphy and self-report...
September 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28903970/urinary-fibrinogen-as-a-predictor-of-progression-of-ckd
#13
Hongtian Wang, Chunxia Zheng, Yinghui Lu, Qi Jiang, Ru Yin, Ping Zhu, Minlin Zhou, Zhihong Liu
BACKGROUND AND OBJECTIVES: Fibrinogen has been reported to be involved in kidney tubulointerstitial fibrosis and podocyte injury in mouse models. However, the relationship between urinary fibrinogen and kidney outcomes has not been clarified in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We evaluated 402 patients with CKD and kidney biopsies, including 101 with diabetic nephropathy, 94 with idiopathic membranous nephropathy, 55 with idiopathic FSGS, and 152 with IgA nephropathy...
September 13, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28899347/case-report-of-hyperglycemic-nonketotic-chorea-with-rapid-radiological-resolution
#14
H M M T B Herath, S P Pahalagamage, Sunethra Senanayake
BACKGROUND: Hemichorea is a rare manifestation of nonketotic hyperglycemia that usually affects elderly Asian women with poor glycemic control. Non-contrast computerized Tomography and T1- weighted Magnetic Resonance Imaging shows characteristic hyperintense basal ganglia lesions. CASE PRESENTATION: A Fifty-seven year old Sri Lankan female presented with a two-day history of right upper limb chorea. She had been diagnosed with diabetes mellitus one year ago, but was not on any treatment and did not have any micro vascular or macro vascular complications...
September 12, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28898114/diagnostic-challenges-of-kidney-diseases-in-hiv-infected-patients
#15
Robin Chazot, Elisabeth Botelho-Nevers, Anne Frésard, Nicolas Maillard, Christophe Mariat, Frédéric Lucht, Amandine Gagneux-Brunon
Chronic kidney disease (CKD) is a prevalent comorbidity in persons living with HIV infection (PLWH) associated with an increase in cardiovascular morbidity and all-cause mortality. Furthermore, early diagnosis of CKD is difficult in PLWH. Areas covered: We reviewed the main diagnostic tools for CKD in PLWH, and discussed their strengths and limits. We performed a literature search on PubMed to identify reviews and clinical trials dealing with attractive kidney biomarkers of CKD in PLWH, with the following key words: 'HIV AND kidney', 'HIV AND Kidney biomarkers', 'CKD AND Kidney biomarkers'...
September 22, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28885376/clinicopathological-features-of-diabetic-and-nondiabetic-renal-diseases-in-type-2-diabetic-patients-with-nephrotic-range-proteinuria
#16
Yu Ho Lee, Ki-Pyo Kim, Yang Gyun Kim, Ju-Young Moon, Su Woong Jung, Eunji Park, Jin Sug Kim, Kyung-Hwan Jeong, Tae Won Lee, Chun-Gyoo Ihm, Young-Il Jo, Hoon-Young Choi, Hyeong-Cheon Park, So-Young Lee, Dong-Ho Yang, Joo-Hark Yi, Sang-Woong Han, Sang-Ho Lee
Heavy proteinuria with or without features of nephrotic syndrome is associated with many primary and systemic diseases. For diabetic patients, distinguishing nondiabetic renal disease (NDRD) from diabetic nephropathy (DN) is important in choosing treatment modalities and determining renal prognosis. However, clinical relevance of heavy proteinuria is inconsistent with clinical DN assessments. This study investigated the clinicopathological features and renal outcomes of DN and NDRD in type 2 diabetic patients with nephrotic-range proteinuria...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28877834/clinicopathological-features-of-idiopathic-membranous-nephropathy-in-33-adolescents
#17
Chao Li, Hang Li, Yu-Bing Wen, Jia-Ning Li, Wei-Feng Lin, Jian-Fang Cai, Lin Duan, Yan Li, Xue-Mei Li, Xue-Wang Li
Objective To investigate the clinicopathological features and prognosis of idiopathic membranous nephropathy(IMN)in adolescents. Methods This was a retrospective study on IMN patients hospitalized between June 2012 and December 2014,and a total of 33 IMN patients aged between 13 and 24 years old were enrolled in the study.Meanwhile,33 IMN patients aged more than 24 years old were selected randomly as control group during the same period.Diagnosis was confirmed by renal biopsy,and the secondary causes of membranous nephropathy were ruled out...
August 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28858977/the-value-of-uromodulin-as-a-new-serum-marker-to-predict-decline-in-renal-function
#18
Andreas Leiherer, Axel Muendlein, Christoph H Saely, Eva M Brandtner, Kathrin Geiger, Peter Fraunberger, Heinz Drexel
BACKGROUND: Uromodulin is the most abundant protein in urine. Low uromodulin has been found associated with diabetes as well as with chronic kidney disease (CKD). Whether it also predicts a future decline in kidney function is not known. METHODS: We evaluated the association between serum uromodulin and kidney function in 529 patients and performed a genome-wide association study. Clinical parameters including renal function were determined at baseline and reassessed at a 4-year follow-up visit...
August 30, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28819780/preliminary-research-on-syndrome-types-of-chinese-medicine-in-children-with-primary-nephrotic-syndrome
#19
Wen Sun, Jian Yu, Gu-Lan Zeng, Bing-Feng Zhang
OBJECTIVE: To provide an objective reference for the syndrome types of Chinese medicine (CM) associated with pediatric primary nephrotic syndrome (PNS). METHODS: A cross-sectional study was performed. Data on clinical symptoms, CM syndrome types, biochemical indices, and medications used were collected from 98 children with PNS. Then, the correlation between CM syndromes and biochemical indices, as well as medications used, was analyzed. RESULTS: The four most common symptoms in children with PNS were brown urine, red tongue, excessive sweating, and swelling of the face and limbs...
August 17, 2017: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28816766/comparison-of-spot-urine-protein-to-creatinine-ratio-to-24-hour-proteinuria-to-identify-important-change-over-time-in-proteinuria-in-lupus
#20
Jorge Medina-Rosas, Jiandong Su, Richard J Cook, Arthy Sabapathy, Zahi Touma
OBJECTIVES: The aim of this study was to determine whether spot urine protein-to-creatinine ratio (PCR) accurately measures the change in proteinuria compared with 24-hour proteinuria (24H-P). METHODS: This was a retrospective analysis on patients' paired visits and paired urine samples for PCR and 24H-P. Patients with both abnormal 24H-P (>0.5 g/d) and PCR (>0.05 g/mmol) or both normal 24H-P (≤0.5 g/d) and PCR (≤0.05 g/mmol) at baseline visit were identified...
September 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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