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treatment of membranous nephropathy

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https://www.readbyqxmd.com/read/28904948/recent-progress-in-deciphering-the-etiopathogenesis-of-primary-membranous-nephropathy
#1
REVIEW
Andreas Kronbichler, Jun Oh, Björn Meijers, Gert Mayer, Jae Il Shin
Primary membranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. Discovery of several antibodies has contributed to an increased understanding of MN. Antibodies against the M-type phospholipase A2 receptor (PLA2R) are present in 50-100% with primary MN and are associated with a lower frequency of spontaneous remission. High levels are linked with a higher probability of treatment resistance, higher proteinuria, and impaired renal function, as well as a more rapid decline of kidney function during follow-up...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28904430/immunohistochemical-analysis-of-anti-phospholipase-a2-receptor-antibody-on-renal-biopsies-a-single-tertiary-care-center-study
#2
A Gudipati, M S Uppin, R K Kalidindi, G Swarnalatha, U Das, G Taduri, S B Raju, L Rajasekhar, Aruna K Prayaga
Membranous nephropathy (MN) is one of the common cause of nephrotic syndrome. The discrimination between primary MN (iMN) and secondary MN is essential because of treatment implications. Immunohistochemical (IHC) evaluation with the help of anti-phospholipase A2 receptor (PLA2R) antibody helps in tissue evaluation of iMN, which is an easy, cost-effective, and pathologist-friendly technique. The study included 82 cases of MN over a period of 3 years. IHC using PLA2R antibody was performed on iMN and secondary cases with adequate tissue...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28898290/comparative-effectiveness-and-tolerance-of-immunosuppressive-treatments-for-idiopathic-membranous-nephropathy-a-network-meta-analysis
#3
Song Ren, Ying Wang, Li Xian, Tadashi Toyama, Meg Jardine, Guisen Li, Vlado Perkovic, Daqing Hong
BACKGROUND: Immunosuppressive agents in general are shown to prevent renal progression and all-cause mortality in idiopathic membranous nephropathy (IMN) patients with nephrotic syndrome. However, the efficacy and safety of different immunosuppressive treatments have not been systematic assessed and compared. A network meta-analysis was performed to compare different immunosuppressive treatment in IMN. METHODS: Cochrane library, MEDLINE, EMBASE and trial register system were searched for randomized controlled trials reporting the treatments for IMN to May 3, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28885376/clinicopathological-features-of-diabetic-and-nondiabetic-renal-diseases-in-type-2-diabetic-patients-with-nephrotic-range-proteinuria
#4
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/28882100/low-dose-cyclosporine-in-treatment-of-membranous-nephropathy-with-nephrotic-syndrome-effectiveness-and-renal-safety
#5
Xiaojuan Yu, Lin Ruan, Zhen Qu, Zhao Cui, Yimiao Zhang, Xin Wang, Liqiang Meng, Xiaojing Liu, Fang Wang, Ying Zhang, Gang Liu, Li Yang
BACKGROUND: To observe effectiveness and renal safety of long-term low-dose cyclosporine in idiopathic membranous nephropathy (IMN). METHODS: Sixty-eight patients were enrolled in this prospective cohort study. Renal endpoint was defined as a decrease in eGFR ≥50% from baseline and a development of eGFR ≤60 ml/min/1.73m(2). RESULTS: A cyclosporine dose of 2.0 ± 0.5 mg/kg/d and a prednisone of 0.3 ± 0.2 mg/kg/d were prescribed...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28875476/treatment-of-primary-membranous-nephropathy-where-are-we-now
#6
REVIEW
Andrea Angioi, Nicola Lepori, Ana Coloma López, Sanjeev Sethi, Fernando C Fervenza, Antonello Pani
In the last 10 years, basic science and clinical research have made important contributions to the understanding and management of primary membranous nephropathy (MN). The identification of antibodies directed against the M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A protein have added a new perspective on diagnosis, monitoring the immunological activity, predicting prognosis and guiding therapy in patients with primary MN. Mounting evidence suggests that quantification and follow-up of antiPLA2R Abs levels can help in assessing prognosis and evaluate the response to treatment...
September 5, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28871454/non-genetic-mechanisms-of-diabetic-nephropathy
#7
REVIEW
Qiuxia Han, Hanyu Zhu, Xiangmei Chen, Zhangsuo Liu
Diabetic nephropathy (DN) is one of the most common microvascular complications in diabetes mellitus patients and is characterized by thickened glomerular basement membrane, increased extracellular matrix formation, and podocyte loss. These phenomena lead to proteinuria and altered glomerular filtration rate, that is, the rate initially increases but progressively decreases. DN has become the leading cause of end-stage renal disease. Its prevalence shows a rapid growth trend and causes heavy social and economic burden in many countries...
September 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28868127/mori-cortex-prevents-kidney-damage-through-inhibiting-expression-of-inflammatory-factors-in-the-glomerulus-in-streptozocin-induced-diabetic-rats
#8
Lili Ma, Hailai Ni, Xinrong Zou, Yanyan Yuan, Chun Luo, Bingyang Liu, Fuyan Wang, Yang Xi, Yudong Chu, Pangjie Xu, Xiaohui Qiu, Song Li, Shizhong Bu
OBJECTIVES: It has been widely reported that Mori cortex extract (MCE) is used for the treatment of diabetes mellitus in traditional medicine. The present study was designed to investigate its mechanism of action in the treatment of diabetic nephropathy (DN). We assessed whether MCE preventive treatment ameliorates kidney damage in high-fat diet and streptozotocin (STZ)-induced type 2 diabetic rats. MATERIALS AND METHODS: Rats were fed a high-fat diet and injected with STZ...
June 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28863791/translational-aspects-of-primary-membranous-nephropathy
#9
REVIEW
Elion Hoxha, Rolf A K Stahl
Membranous nephropathy (MN) in an autoimmune disease caused by binding of circulating antibodies to podocytic antigens. The search for the responsible target antigens has extended for more than 50 years and led to the identification of the major pathomechanisms leading to MN. The combination of clinical and morphologic observations, experimental work, and technical advancements has enabled us deep insights in the pathophysiology of this disease, simultaneously improving treatment of patients. MN represents a perfect example of how patient care may profit from the convergence of scientific and clinical achievements and the benefits of translational approaches in medicine...
September 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28853699/successful-therapy-with-mycophenolic-acid-in%C3%A2-a-membranous-glomerulonephritis-due-to%C3%A2-kimura-disease%C3%A2
#10
Julien Gaillard, Samuel Rotman, Christophe Girardet, François Spertini
Kimura disease (KD) is a rare inflammatory soft tissue disorder of unknown origin most frequent in Asians, the prevalence of which is growing in Western countries. Painless papules and/or nodules with a predilection for the head and the neck region, lymphadenopathies, parotid gland involvement, eosinophilia, and raised IgE levels are parts of its presentation. Renal involvement with various forms of glomerulonephritis, including membranous nephropathy (MN), can occur and is generally associated with a proteinuria that encompasses nephrotic syndrome...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28852480/intravenous-cyclophosphamide-and-oral-prednisolone-is-a-safe-and-effective-treatment-option-for-idiopathic-membranous-nephropathy
#11
Vinod Mathrani, Abdulfattah Alejmi, Siân Griffin, Gareth Roberts
BACKGROUND: Idiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome in adults. A proportion of patients will experience spontaneous remission and the decision to offer immunosuppression is guided by the presence of adverse prognostic features. Data relating to the efficacy of different immunosuppressive protocols is lacking, in particular there are little data available on the efficacy or benefits of an intravenous (IV) cyclophosphamide-based regimen...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28843828/vinpocetine-mitigates-proteinuria-and-podocytes-injury-in-a-rat-model-of-diabetic-nephropathy
#12
Walaa Wadie, Dalia M El-Tanbouly
Podocyte injury and glomerular basement membrane thickening have been considered as essential pathophysiological events in diabetic nephropathy. The aim of this study was to investigate the possible beneficial effects of vinpocetine on diabetes-associated renal damage. Male Wistar rats were made diabetic by injection of streptozotocin (STZ). Diabetic rats were treated with vinpocetine in a dose of 20mg/kg/day for 6 weeks. Treatment with vinpocetine resulted in a marked decrease in the levels of blood glucose, glycosylated haemoglobin, creatinine, blood urea nitrogen, urinary albumin and albumin/creatinine ratio along with an elevation in creatinine clearance rate...
August 24, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28832357/recurrent-glomerular-disease-after-kidney-transplantation
#13
Christopher D Blosser, Roy D Bloom
PURPOSE OF REVIEW: With improving short-term kidney transplant outcomes, recurrent glomerular disease is being increasingly recognized as an important cause of chronic allograft failure. Further understanding of the risks and pathogenesis of recurrent glomerular disease enable informed transplant decisions, along with the development of preventive and treatment strategies. RECENT FINDINGS: Multiple observational studies have highlighted differences in rates and outcomes for various recurrent glomerular diseases, although these rates have not markedly improved over the last decade...
August 21, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28821363/living-donor-kidney-transplantation-in-atypical-hemolytic-uremic-syndrome-a-case-series
#14
Caroline Duineveld, Jacobien C Verhave, Stefan P Berger, Nicole C A J van de Kar, Jack F M Wetzels
BACKGROUND: The development of complement inhibitors has greatly improved the outcome of patients with atypical hemolytic uremic syndrome (aHUS), making kidney transplantation a more feasible option. Although prophylactic eculizumab therapy may prevent recurrent disease after transplantation, its necessity for all transplant recipients is debated. STUDY DESIGN: A case series. SETTING & PARTICIPANTS: Patients with aHUS who underwent living donor kidney transplantation after 2011 at 2 university centers, prospectively followed up with a protocol of eculizumab therapy limited to only recipients with documented posttransplantation recurrent thrombotic microangiopathy...
August 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28819100/blockage-of-the-lysosome-dependent-autophagic-pathway-contributes-to-complement-membrane-attack-complex-induced-podocyte-injury-in-idiopathic-membranous-nephropathy
#15
Wei Jing Liu, Zhi-Hang Li, Xiao-Cui Chen, Xiao-Lu Zhao, Zhen Zhong, Chen Yang, Hong-Luan Wu, Ning An, Wei-Yan Li, Hua-Feng Liu
Dysregulation of autophagy-mediated podocyte homeostasis is proposed to play a role in idiopathic membranous nephropathy (IMN). In the present study, autophagic activity and lysosomal alterations were investigated in podocytes of IMN patients and in cultured podocytes exposed to sublytic terminal complement complex, C5b-9. C5b-9 upregulated the number of LC3 positive puncta and the expression of p62 in patient podocytes and in C5b-9 injuried podocyte model. The lysosomal turnover of LC3-II was not influenced, although the BECN1 expression level was upregulated after exposure of podocytes to C5b-9...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28781794/a-case-of-membranous-glomerulopathy-associated-with-lung-cancer-and-review-of-the-literature
#16
Aydin Aytekin, Ahmet Ozet, Irem Bilgetekin, Betul Ogut, Aydin Ciltas, Mustafa Benekli
Membraneous nephropathy (MN) is the most commonly occurring nephrotic syndrome in adults as well as the most common paraneoplastic nephropathy associated with solid tumors, and it is mostly associated with gastrointestinal system and lung carcinomas. Accurate diagnosis is important as the treatment of paraneoplastic glomerulonephritis is very varied from that of idiopathic ones. In the current report, a case of a patient that was referred with proteinuria and edema and was diagnosed with lung cancer, and responded markedly to treatment of malignancy, with improvement of MN, is presented...
August 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28745685/-membranous-nephropathy-in-a-russian-population
#17
V A Dobronravov, D A Mayer, O V Berezhnaya, S V Lapin, A V Mazing, V G Sipovsky, A V Smirnov
AIM: To analyze the clinical and morphological manifestations of membranous nephropathy (MN) and to evaluate the efficiency of its therapy. MATERIAL AND METHODS: MN cases in 2009 to 2016 were retrospectively detected with a subsequent analysis of patients with primary MN (PMN). The titer of IgG-autoantibodies to phospholipase A2 receptor (anti-PLA2R Ab) was determined by an indirect immunofluorescence assay. Treatment outcomes, such as the time course of changes in proteinuria, nephrotic syndrome (NS), and the development of complete and partial remissions (CR and PR), were assessed...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28743882/hyperoside-pre-treatment-prevents-glomerular-basement-membrane-damage-in-diabetic-nephropathy-by-inhibiting-podocyte-heparanase-expression
#18
Xiaofei An, Lin Zhang, Yanggang Yuan, Bin Wang, Qiuming Yao, Ling Li, Jisheng Zhang, Ming He, Jinan Zhang
Glomerular basement membrane (GBM) damage plays a pivotal role in pathogenesis of albuminuria in diabetic nephropathy (DN). Heparan sulfate (HS) degradation induced by podocyte heparanase is the major cause of GBM thickening and abnormal perm-selectivity. In the present study, we aimed to examine the prophylactic effect of hyperoside on proteinuria development and GBM damage in DN mouse model and the cultured mouse podocytes. Pre-treatment with hyperoside (30 mg/kg/d) for four weeks could significantly decrease albuminuria, prevent GBM damage and oxidative stress in diabetes mellitus (DM) mice...
July 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28725620/attenuation-of-diabetic-nephropathy-in-streptozotocin-induced-diabetic-rats-by-punica-granatum-linn-leaves-extract
#19
Snehal Nitin Mestry, Jayesh Bachu Dhodi, Sangita Balbhim Kumbhar, Archana Ramesh Juvekar
With an objective to develop Complementary and Alternative Medicine for the treatment of diabetic nephropathy, the present study investigated the protective effects of methanolic extract of Punica granatum leaves (MPGL) in streptozotocin-induced diabetic nephropathy. Diabetic nephropathy has become a leading cause of end stage renal failure worldwide. P. granatum, due to its anti-diabetic, anti-inflammatory and antioxidant activities may retard the progression of diabetic nephropathy. In this study, diabetes was induced by a single injection of streptozotocin (STZ, 45 mg/kg, i...
July 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28711658/betulinic-acid-isolated-from-the-leaves-of-syzygium-cumini-l-skeels-ameliorates-the-proteinuria-in-experimental-membranous-nephropathy-through-regulating-nrf2-nf-%C3%AE%C2%BAb-pathways
#20
Brijesh Sutariya, Neetika Taneja, Madhusudan Saraf
Membranous nephropathy (MN) is associated with increased oxidative stress and inflammatory markers in the kidney. Betulinic acid (BA) is a potent antioxidant and anti-inflammatory compound isolated from the leaves of Syzygium cumini (L.) Skeels. In the present study, we investigated the effects of BA on experimental MN in rats and explored the mechanisms by which it enhances antioxidant activities and resolves inflammatory condition in experimental MN. Passive Heymann nephritis (PHN) was induced in Sprague-Dawley rats by a single tail vein injection of anti- Fx1A antiserum...
August 25, 2017: Chemico-biological Interactions
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