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proteinuric pediatric

Jiro Kino, Shoji Tsuji, Tetsuya Kitao, Yuko Akagawa, Sohsaku Yamanouchi, Takahisa Kimata, Kazunari Kaneko
BACKGROUND: The pathogenesis of idiopathic nephrotic syndrome (INS) remains unclear although recent studies suggest endothelin 1 (ET-1) and CD80 of podocytes are involved. We investigated the potential of antagonist to ET-1 receptor type A (ETRA) as therapeutic agent through suppression of CD80 in rat model of INS. METHODS: Puromycin aminonucleoside (PAN) was injected to Wister rats to induce proteinuria: some were treated with ETRA antagonist and others were treated with 0...
January 23, 2018: Pediatric Research
Maria Pereira, Eyal Muscal, Karen Eldin, M John Hicks, Anna Carmela P Sagcal-Gironella, Marietta DeGuzman, Scott E Wenderfer
BACKGROUND: Best practices for managing childhood-onset membranous lupus nephritis (MLN) are not yet established. Most studies involve primarily or exclusively adult cohorts or pediatric cohorts with combinations of pure or mixed membranous and proliferative nephritis. METHODS: We performed a single-center cohort study of consecutively diagnosed children with pure MLN from 1990 and 2016. Patients received care in Houston, Texas, one of the most diverse metropolitan areas in North America...
December 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Antonio De Pascalis, Alessandro Balducci
The progression of chronic kidney disease CKD is largely independent of the underlying kidney disorder once renal function has fallen below a critical level. Hypertension is an independent risk factor for disease progression in both adult and pediatric patients with kidney disorders. Optimal blood pressure control (130 /80mm Hg) represents a main goal of conservative therapy in patients with chronic kidney disease CKD but it is rarely achieved in clinical practice. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are more effective than other drugs in slowing progression of proteinuric CKD...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Jean Daniel Delbet, Julien Hogan, Bilal Aoun, Iulia Stoica, Rémi Salomon, Stéphane Decramer, Isabelle Brocheriou, Georges Deschênes, Tim Ulinski
BACKGROUND: Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. METHODS: All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files...
July 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Piero Ruggenenti, Paolo Cravedi, Antonietta Chianca, MariaRosa Caruso, Giuseppe Remuzzi
BACKGROUND: A multidrug treatment strategy that targets urinary proteins with an angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) up-titrated to the respective maximum tolerated dose combined with intensified blood pressure (BP) control has been found to prevent renal function loss in adults with proteinuric nephropathies. Herein, we investigated the effects of this treatment protocol in the pediatric patient population. METHODS: From May 2002 to September 2014 we included in this observational, longitudinal, cohort study 20 consecutive children with chronic nephropathies and 24-h proteinuria of >200 mg who had received ramipril and losartan up-titrated to the respective maximum approved and tolerated doses [mean (standard deviation) dose:2...
February 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Kevin V Lemley, Serena M Bagnasco, Cynthia C Nast, Laura Barisoni, Catherine M Conway, Stephen M Hewitt, Peter X K Song
OBJECTIVE: Most predictive models of kidney disease progression have not incorporated structural data. If structural variables have been used in models, they have generally been only semi-quantitative. METHODS: We examined the predictive utility of quantitative structural parameters measured on the digital images of baseline kidney biopsies from the NEPTUNE study of primary proteinuric glomerulopathies. These variables were included in longitudinal statistical models predicting the change in estimated glomerular filtration rate (eGFR) over up to 55 months of follow-up...
2016: PloS One
Afsana Jahan, Ratna Prabha, Swasti Chaturvedi, Binu Mathew, Denise Fleming, Indira Agarwal
BACKGROUND: Tacrolimus has gained acceptance in the management of steroid-resistant nephrotic syndrome (SRNS) in children. Due to limited data, therapeutic range is extrapolated from pediatric renal transplant recipients. This study was designed to assess therapeutic efficacy of tacrolimus in children with SRNS and its correlation with inter-dose area under concentration curve (AUC0-12 h) and trough concentration (C0). METHODS: Pre dose, 0.5, 1.0, 1.5, 2.0, 2.5, 3, 4, 8, and 12 h after drug administration blood samples were collected in 25 children who were on tacrolimus for a minimum of 3 months and AUC0-12 h was calculated...
November 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Hiroshi Tanaka, Kazushi Tsuruga, Taddatsu Imaizumi
BACKGROUND: Mizoribine (MZR) is a selective inhibitor of inosine monophosphate dehydrogenase, a key enzyme in the pathway responsible for de novo synthesis of guanine nucleotides. As an immunosuppressant, MZR has been used successfully without any serious adverse effects in the treatment of renal diseases in children as well as adults. Besides its immunosuppressive effect, MZR has been reported to ameliorate tubulointerstitial fibrosis in rats via suppression of macrophage infiltration...
May 2015: World Journal of Pediatrics: WJP
Aditi Sinha, Jaya Bajpai, Savita Saini, Divya Bhatia, Aarti Gupta, Mamta Puraswani, Amit K Dinda, Sanjay K Agarwal, Shailaja Sopory, Ravindra M Pandey, Pankaj Hari, Arvind Bagga
In this prospective study, we measured serum levels of the soluble urokinase receptor (suPAR) in pediatric patients with nephrotic syndrome of various etiologies. Mean levels of suPAR were 3316 pg/ml in 99 patients with steroid-resistant focal segmental glomerulosclerosis and 3253 pg/ml in 117 patients with biopsy-proven minimal change disease, which were similar to that of 138 patients with steroid-sensitive nephrotic syndrome (3150 pg/ml) and 83 healthy controls (3021 pg/ml). Similar proportions of patients in each group had suPAR over 3000 pg/ml...
March 2014: Kidney International
Tom D Blydt-Hansen, Christopher B Pierce, Yi Cai, Dmitri Samsonov, Susan Massengill, Marva Moxey-Mims, Bradley A Warady, Susan L Furth
BACKGROUND AND OBJECTIVES: The complexity of CKD management in children is increased by the number of comorbid conditions. This study assessed the prevalence of comorbidities in pediatric CKD and the frequency with which multiple comorbidities present together by assessing prevalent medication use by CKD stage and diagnosis and their association with clinical or sociodemographic factors. The association between number and frequency of dosing of medications prescribed and self-report of nonadherence was also assessed...
February 2014: Clinical Journal of the American Society of Nephrology: CJASN
Pankaj Hari, Jitender Sahu, Aditi Sinha, Ravinder Mohan Pandey, Chandra Shekhar Bal, Arvind Bagga
OBJECTIVE: To evaluate the efficacy of enalapril treatment on decline in glomerular filtration rate and reduction in proteinuria in children with chronic kidney disease (CKD). DESIGN: Open-label, randomized controlled trial. SETTING: Pediatric nephrology clinic at a tertiary-care referral hospital. INTERVENTION: Children with GFR between 15-60 mL/min/1.73 m2 were randomized to receive either enalapril at 0.4 mg/kg /day or no enalapril for 1 year...
October 2013: Indian Pediatrics
Alok Sharma, Ruchika Gupta, Arvind Bagga, Amit K Dinda
Nephrotic syndrome (NS) is a common proteinuric disorder with defect in the perm-selectivity of the glomerular filtration barrier (GFB). Ultrastructural morphometric evaluation of the GFB in pediatric NS has been attempted in only a few studies. This study was aimed at qualitative and quantitative evaluation of the alterations involving the GFB in pediatric idiopathic NS with an attempt to correlate these alterations with the clinico-laboratory data. For this study, renal biopsies from nine patients with NS and two children with interstitial nephritis were included...
March 2013: Saudi Journal of Kidney Diseases and Transplantation
Damien Noone, Christoph Licht
The concept of renoprotection has evolved significantly, driven by improved understanding of the pathophysiology of chronic kidney disease (CKD) and the advent of novel treatment options. Glomerular hyperfiltration, hypertension and proteinuria represent key mediators of CKD progression. It is increasingly recognized that proteinuria may actually be pathological and etiological in CKD progression and not just symptomatic. It initiates a sequence of events involving activation of proinflammatory and profibrotic signaling pathways in proximal tubular epithelial cells with transmission of the disease to the tubulointerstitium and progression to end-stage kidney disease (ESKD)...
May 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Kwanchai Pirojsakul, Kanchana Tangnararatchakit, Panas Chalermsanyakorn, Wiwat Tapaneya-Olarn
OBJECTIVE: Evaluate the outcomes of pediatric patients with Henoch-Sch6nlein purpura nephritis andfind the parameters correlated with outcomes of treatment. MATERIAL AND METHOD: Review of medical records was performed in twenty patients diagnosed with Henoch-Schinlein purpura nephritis. Demographic data, clinical parameters and records of treatment at diagnosis and the last visit were collected and analyzed. RESULTS: Median age at diagnosis was 8-year-old and median follow-up time was 39 months...
July 2012: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Tim Ulinski
PURPOSE OF REVIEW: Steroid-resistant nephrotic syndrome/focal segmental glomerulonephritis (FSGS) is the primary renal disease in approximately 10% of pediatric patients receiving a renal allograft. Risk factors for recurrence are a chronological age between 6 and 15 years at onset of the nephrotic syndrome and a rapid progression of the disease in the native kidneys leading to end-stage renal disease in less than 3 years. With rapid recurrence of FSGS and loss of the allograft, further renal transplants also carry a high likelihood of recurrence of nephrotic syndrome...
October 2010: Current Opinion in Organ Transplantation
Masashi Nishida, Hidekazu Kawakatsu, Yasuko Okumura, Kenji Hamaoka
BACKGROUND: Recent studies showed that serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) represents a novel, sensitive, specific biomarker for early detection of acute kidney injury. However, the clinical significance of measuring serum and urinary NGAL on chronic renal diseases remains unclear. METHODS: In this study, we measured serum and urinary NGAL levels in patients with several common pediatric renal diseases such as renal dysfunction (estimated glomerular filtration rate < 90 mL/min/1...
August 2010: Pediatrics International: Official Journal of the Japan Pediatric Society
Erkin Serdaroglu, Sevgi Mir
Proteinuria is an important factor for renal injury and prognosis in many diseases. The most valuable method for evaluation of proteinuria is quantitative protein analysis in appropriately 24-h collected urine. But urine collection is difficult and cumbersome especially in children and working adults. The aim of the present study is to define the usefulness of urinary protein/urine osmolality (Uprot/Uosm) ratio in quantification of proteinuria. One hundred and seventy-one patients whose age ranged between 3 and 14 years were included in the study...
October 2008: Clinical and Experimental Nephrology
Kai Immonen, Anneli Savolainen, Hannu Kautiainen, Markku Hakala
OBJECTIVE: To determine the outcome of amyloidosis associated with juvenile idiopathic arthritis (JIA) in a hospital-based series. METHODS: Patient registers and amyloidosis biopsy files of the Department of Pediatrics of Rheumatism Foundation Hospital, the main tertiary center for inflammatory joint disorders in children in Finland, were scrutinized from 1976 to the end of 2003 to look for amyloidosis in patients under age 19 years. Medical records were reviewed and patients were interviewed by telephone...
May 2008: Journal of Rheumatology
Jin Hui Tang, Yu Wen, Fei Wu, Xiao Y Zhao, Mei X Zhang, Jie Mi, Katherine Cianflone
Hyperlipidemia has been well recognized as a striking feature of nephrotic syndrome and other renal diseases. However, the underlying pathophysiological mechanisms still have not yet been elucidated. In this study, we evaluated acylation-stimulating protein (ASP) and complement component 3 (C3) in children (n=48) with various forms of proteinuric renal disease [nephrotic syndrome, acute poststreptococcal infection glomerulonephritis (APSGN), and lupus nephritis (LN)] in comparison with age- and gender-matched controls (n=279)...
June 2008: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
C N Inoue, Y Chiba, T Morimoto, T Nishio, Y Kondo, M Adachi, S Matsutani
The exact pathophysiology of HSN remains to be elucidated. Hence, a therapeutic strategy that enables curative treatments for all the various grades of HSN patients has yet to be established. We report our experience performing tonsillectomy combined with steroid therapy for 16 pediatric proteinuric Henoch-Schönlein nephritis (HSN) patients. All patients exhibited hematuria and proteinuria in their first HSN attack with the mean age of onset 7.7 years (range 4.75 - 13.9 years). Nine patients were diagnosed with clinically severe HSN presenting with massive proteinuria (> 1 g/m(2)/day)...
May 2007: Clinical Nephrology
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