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proteinuric children

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...
February 15, 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
P Skrzypczyk, M Panczyk-Tomaszewska, J Przychodzien, M Mizerska-Wasiak, E Kuzma-Mroczkowska, E Gorska, A Stelmaszczyk-Emmel
OBJECTIVE: Renalase is a protein produced mainly by kidneys. Renalase inactivates circulating catecholamines catalyzing process of their oxidation. Studies in adults with kidney disease suggest that renalase may play a role in pathogenesis of hypertension and target organ damage. The aim of the study was to assess level of renalase in children with glomerular kidney diseases and to find the relation between renalase level and clinical parameters in this group of patients. DESIGN AND METHOD: In 78 children (47 M, 31F) aged from 3...
September 2016: Journal of Hypertension
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
Soltysiak Jolanta, Zachwieja Jacek, Benedyk Anna, Lewandowska-Stachowiak Maria, Nowicki Michal, Ostalska-Nowicka Danuta
BACKGROUND: The increase of circulating urokinase plasminogen activator receptor (suPAR) was demonstrated in various diseases showing its prognostic value as well as the link to the inflammatory reaction. In glomerular diseases suPAR was consider to be a causative factor of proteinuria. In present study we aimed to evaluate serum concentration of suPAR in children with primary and secondary glomerulonephritis (GN) and its association with disease severity. METHODS: The study involved 22 children with minimal change disease (MCD), 9 with primary focal segmental glomerulosclerosis (FSGS), 7 with Henoch-Schönlein nephritis (HSN), 7 with lupus nephritis (LN) and 16 controls...
April 12, 2016: Minerva Pediatrica
Debbie S Gipson, Jonathan P Troost, Richard A Lafayette, Michelle A Hladunewich, Howard Trachtman, Crystal A Gadegbeku, John R Sedor, Lawrence B Holzman, Marva M Moxey-Mims, Kalyani Perumal, Frederick J Kaskel, Peter J Nelson, Katherine R Tuttle, Serena M Bagnasco, Marie C Hogan, Katherine M Dell, Gerald B Appel, John C Lieske, Titilayo O Ilori, Christine B Sethna, Fernando C Fervenza, Susan L Hogan, Patrick H Nachman, Avi Z Rosenberg, Larry A Greenbaum, Kevin E C Meyers, Stephen M Hewitt, Michael J Choi, Jeffrey B Kopp, Olga Zhdanova, Jeffrey B Hodgin, Duncan B Johnstone, Sharon G Adler, Carmen Avila-Casado, Alicia M Neu, Sangeeta R Hingorani, Kevin V Lemley, Cynthia C Nast, Tammy M Brady, Laura Barisoni-Thomas, Alessia Fornoni, J Charles Jennette, Daniel C Cattran, Matthew B Palmer, Keisha L Gibson, Heather N Reich, Michele H Mokrzycki, Kamalanathan K Sambandam, Gaston E Zilleruelo, Christoph Licht, Matthew G Sampson, Peter Song, Laura H Mariani, Matthias Kretzler
BACKGROUND AND OBJECTIVES: This analysis from the Nephrotic Syndrome Study Network (NEPTUNE) assessed the phenotypic and pathology characteristics of proteinuric patients undergoing kidney biopsy and defined the frequency and factors associated with complete proteinuria remission (CRever). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We enrolled adults and children with proteinuria ≥0.5 g/d at the time of first clinically indicated renal biopsy at 21 sites in North America from April 2010 to June 2014 into a prospective cohort study...
January 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
T Szabó, L Ambrus, N Zákány, Gy Balla, T Bíró
The glomerular filtration barrier is a highly specialized tri-layer structure with unique functional properties. Podocyte dysfunction and cytoskeletal disorganization leads to disruption of the slit diaphragma, and proteinuria. Inflammatory diseases involving the kidney as well as inherited podocytopathies or diabetic nephropathy cause injury of the podocyte network. Focal segmental glomerulosclerosis (FSGS) is a pathologic entity that is a common cause of nephrotic syndrome with severe proteinuria in both adults and children...
September 2015: Acta Physiologica Hungarica
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
Joanna Sobiak, Matylda Resztak, Danuta Ostalska-Nowicka, Jacek Zachwieja, Karolina Gąsiorowska, Wiktoria Piechanowska, Maria Chrzanowska
The aim of the study was to estimate target values of mycophenolate mofetil (MMF) pharmacokinetic parameters in children with proteinuric glomerulopathies by calculating the pharmacokinetic parameters of MMF metabolites (mycophenolic acid [MPA], free MPA [fMPA] and MPA glucuronide [MPAG]) and assessing their relation to proteinuria recurrence. One hundred and sixty-eight blood samples were collected from children, aged 3-18 years, diagnosed with nephrotic syndrome or lupus nephritis. MMF metabolites concentrations were examined before drug administration (Ctrough) and up to 12h afterward employing high-performance liquid chromatography...
September 18, 2015: European Journal of Pharmaceutical Sciences
Tomáš Rosík, Mária Chadimová, Jiří Dušek, Jaromír Háček, Naděžda Šimánková, Karel Vondrák, Jakub Zieg, Tomáš Seeman
BACKGROUND: Proteinuria is a common manifestation of chronic kidney disease (CKD), and there is a high incidence of CDK and its complications following renal transplantation. However, little data are available on the association between proteinuria and graft/patient survival in the paediatric transplant population. The primary aim of this study was to investigate the associations between posttransplant proteinuria and graft/patient survival in children after renal transplantation. METHODS: In this retrospective study, we screened all 91 children receiving renal allografts at a single institution between 1997 and 2007...
October 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Sevgi Yavuz, Aysel Kıyak, Ali Er, Orhan Korkmaz
UNLABELLED: We aimed to evaluate anthropometric and bioimpedance analysis (BIA) indices of children with nutcracker syndrome (NCS). Eighteen patients and 20 age-gender matched controls were enrolled. Weight, height, body mass index (BMI), mid-arm circumference (MAC), waist circumference (WC), waist/hip ratio measurements, and BIA results were assessed. Laboratory parameters and Doppler sonographic findings were recorded. The weight, BMI, MAC, WC, body fat z scores, and waist/hip ratio were significantly lower in patients than in controls (p < 0...
October 2015: European Journal of Pediatrics
I-Jung Tsai, Chia-Hung Chou, Yao-Hsu Yang, Wei-Chou Lin, Yen-Hung Lin, Lu-Ping Chow, Hsiao-Hui Lee, Pei-Gang Kao, Wan-Ting Liau, Tzuu-Shuh Jou, Yong-Kwei Tsau
Childhood nephrotic syndrome is mainly caused by minimal change disease which is named because only subtle ultrastructural alteration could be observed at electron microscopic level in the pathological kidney. Glomerular podocytes are presumed to be the target cells whose protein sieving capability is compromised by a yet unidentified permeability perturbing factor. In a cohort of children with non-hereditary idiopathic nephrotic syndrome, we found the complement fragment C5a was elevated in their sera during active disease...
August 2015: Cellular and Molecular Life Sciences: CMLS
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
Samet Özer, Resul Yılmaz, Ergün Sönmezgöz, Erhan Karaaslan, Semanur Taşkın, İlknur Bütün, Osman Demir
BACKGROUND: In this study we investigated the potential of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell width distribution (RDW) as new inflammatory markers to identify chronic inflammations during symptom-free periods in children diagnosed with Familial Mediterranean Fever (FMF). MATERIAL/METHODS: The study included 153 children diagnosed with FMF based on the Tel-Hashomer Criteria, and 90 healthy volunteers...
January 23, 2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sophie de Seigneux, Marie Courbebaisse, Joseph M Rutkowski, Alexandra Wilhelm-Bals, Marie Metzger, Stellor Nlandu Khodo, Udo Hasler, Hassib Chehade, Eva Dizin, Arezoo Daryadel, Bénedicte Stengel, E Girardin, Dominique Prié, Carsten A Wagner, Philipp E Scherer, Pierre-Yves Martin, Pascal Houillier, Eric Feraille
Proteinuria and hyperphosphatemia are cardiovascular risk factors independent of GFR. We hypothesized that proteinuria induces relative phosphate retention via increased proximal tubule phosphate reabsorption. To test the clinical relevance of this hypothesis, we studied phosphate handling in nephrotic children and patients with CKD. Plasma fibroblast growth factor 23 (FGF-23) concentration, plasma phosphate concentration, and tubular reabsorption of phosphate increased during the proteinuric phase compared with the remission phase in nephrotic children...
July 2015: Journal of the American Society of Nephrology: JASN
Nuria Olea-Herrero, María Isabel Arenas, Carmen Muñóz-Moreno, Rafael Moreno-Gómez-Toledano, Marta González-Santander, Ignacio Arribas, Ricardo J Bosch
Bisphenol-A, a chemical used in the production of the plastic lining of food and beverage containers, can be found in significant levels in human fluids. Recently, bisphenol-A has been associated with low-grade albuminuria in adults as well as in children. Since glomerular epithelial cells (podocytes) are commonly affected in proteinuric conditions, herein we explored the effects of bisphenol-A on podocytes in vitro and in vivo. On cultured podocytes we first observed that bisphenol-A-at low or high concentrations-(10 nM and 100 nM, respectively) was able to induce hypertrophy, diminish viability, and promote apoptosis...
December 2014: Journal of Cellular Physiology
Maire Beeken, Maja T Lindenmeyer, Simone M Blattner, Victoria Radón, Jun Oh, Tobias N Meyer, Diana Hildebrand, Hartmut Schlüter, Anna T Reinicke, Jan-Hendrik Knop, Anuradha Vivekanandan-Giri, Silvia Münster, Marlies Sachs, Thorsten Wiech, Subramaniam Pennathur, Clemens D Cohen, Matthias Kretzler, Rolf A K Stahl, Catherine Meyer-Schwesinger
Podocytes are the key cells affected in nephrotic glomerular kidney diseases, and they respond uniformly to injury with cytoskeletal rearrangement. In nephrotic diseases, such as membranous nephropathy and FSGS, persistent injury often leads to irreversible structural damage, whereas in minimal change disease, structural alterations are mostly transient. The factors leading to persistent podocyte injury are currently unknown. Proteolysis is an irreversible process and could trigger persistent podocyte injury through degradation of podocyte-specific proteins...
November 2014: Journal of the American Society of Nephrology: JASN
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
Köksal Deveci, Elif Bilge Uysal, Ali Kaya, Enver Sancakdar, Filiz Alkan
The aim of the present study was to evaluate renal involvement in children with Crimean-Congo hemorrhagic fever (CCHF). Forty-four children infected with CCHF virus and 30 controls were enrolled in the study. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine protein levels were measured in the patient and control groups. Clinical and laboratory findings of the patient and control groups were compared. uNGAL levels were higher in the patient group than that in the control group (P < 0.001)...
2013: Japanese Journal of Infectious Diseases
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
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