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treatment of membranous nephropathy

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https://www.readbyqxmd.com/read/28218466/bullous-pemphigoid-arising-in-a-patient-with-acquired-perforating-dermatosis
#1
S Tani, N Ishii, T Hashimoto, K Tsujioka
A middle-aged Japanese man who had been on haemodialysis treatment for diabetic nephropathy developed multiple itchy papules and nodules, which were histopathologically diagnosed as acquired perforating dermatosis. Two years later he developed oral lesions and subsequently numerous erosive plaques with necrotic crusts on the trunk and extremities. Histopathology of a papule showed a parakeratotic plug intermingled with basophilic, necrotic debris and collagen bundles, along with penetration of collagen bundles across the epidermis and subepidermal blister...
February 20, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28202222/early-initiation-of-immunosuppressive-treatment-in-membranous-nephropathy-patients
#2
Chieh Kai Chan, Tai Shuan Lai, Ping Min Chen, Yu Hsiang Chou, Ching Fang Wu, Yen Ling Chiu, Wen Chih Chiang, Yung Ming Chen, Tzong-Shinn Chu, Kwan Dun Wu
BACKGROUND: Suggestion for the management of idiopathic membranous nephropathy (IMN) includes 6 months of observation, followed with steroid plus alkylating agent. However, delayed immunosuppression exposes the kidneys to persistent damage. This study aimed to examine the benefit of early immunosuppression in IMN patients. METHOD: A retrospective study was performed. From 1993 to 2013, 161 IMN patients were enrolled. Patients receiving immunosuppression within 6 months after diagnosis were classified as initial-treatment group, whereas other patients as initial-no-treatment group...
February 12, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28176019/long-term-treatment-with-egfr-inhibitor-erlotinib-attenuates-renal-inflammatory-cytokines-but-not-nephropathy-in-alport-syndrome-mouse-model
#3
Kohei Omachi, Rui Miyakita, Ryosuke Fukuda, Yukari Kai, Mary Ann Suico, Tsubasa Yokota, Misato Kamura, Tsuyoshi Shuto, Hirofumi Kai
BACKGROUND: Alport syndrome (AS) is a hereditary kidney disease caused by mutation of type IV collagen. Loss of collagen network induces collapse of glomerular basement membrane (GBM) structure. The previous studies showed that upregulation of some tyrosine kinase receptors signaling accompanied GBM disorder in AS mouse model. EGFR signaling is one of the well-known receptor kinase signaling that is involved in glomerular diseases. However, whether EGFR signaling is relevant to AS progression is still uninvestigated...
February 8, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28143416/combination-therapy-with-rituximab-low-dose-cyclophosphamide-and-prednisone-for-idiopathic-membranous-nephropathy-a-case-series
#4
Frank B Cortazar, David E Leaf, Charles T Owens, Karen Laliberte, William F Pendergraft, John L Niles
BACKGROUND: Membranous nephropathy is a common cause of the nephrotic syndrome. Treatment with standard regimens fails to induce complete remission in most patients. We evaluated the efficacy of combination therapy with rituximab, low-dose, oral cyclophosphamide, and an accelerated prednisone taper (RCP) for the treatment of idiopathic membranous nephropathy. METHODS: We analyzed 15 consecutive patients with idiopathic membranous nephropathy treated with RCP at Massachusetts General Hospital...
February 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28128727/membranous-nephropathy-occurring-with-type%C3%A2-2%C3%A2-diabetes-mellitus%C3%A2
#5
Yujun Qian, Ke Zuo, Shijun Li, Caihong Zeng, Zhihong Liu, Yan Wu
BACKGROUND: The incidence of type 2 diabetes mellitus (T2DM) is increasing, and membranous nephropathy (MN) occurs frequently with T2DM. We investigated the clinicopathological features and outcomes of patients with T2DM and MN. METHODS: A total of 137 patients with biopsy-proven MN and T2DM were enrolled in this retrospective study. Another 100 MN patients without diabetes mellitus served as a control group. The clinicopathological features, treatment responses, and outcomes were analyzed and compared between groups...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28123632/effects-of-averrhoa-carambola-l-oxalidaceae-juice-mediated-on-hyperglycemia-hyperlipidemia-and-its-influence-on-regulatory-protein-expression-in-the-injured-kidneys-of-streptozotocin-induced-diabetic-mice
#6
Hoa Thi Thai Pham, Wansu Huang, Chuangye Han, Juman Li, Qiuqiao Xie, Jinbin Wei, Xiaohui Xu, Zefeng Lai, Xiang Huang, Renbin Huang, Qingwei Wen
Recently, many reports have shown that Averrhoa carambola L. (Oxalidaceae) juice (EACJ) could reduce blood glucose in humans. However, its mechanisms have not been well explored; therefore, our study aimed to investigate the beneficial effects of EACJ on hyperglycemia, hyperlipidemia and renal injury in streptozotocin (STZ)-induced diabetic mice. Those mice were injected with STZ via the tail vein (120 mg/kg body weight) and were identified as diabetic mice when the level of blood glucose was ≥ 11.1 mmol/L...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28115289/profibrotic-ihg-1-complexes-with-renal-disease-associated-hspa5-and-trap1-in-mitochondria
#7
Una Bhreathnach, Brenda Griffin, Eoin Brennan, Leah Ewart, Debra Higgins, Madeline Murphy
The highly conserved mitochondrial protein induced in high glucose-1 (IHG-1) functions to maintain mitochondrial quality and is associated with the development of fibrosis in diabetic nephropathy. Towards identifying novel approaches to treating diabetic kidney disease, IHG-1-protein-protein interactions were investigated using epitope-tagged immunoprecipitation analyses followed by mass spectrometry. Here we show that IHG-1 is solely expressed in mitochondria and localised to the inner mitochondrial membrane, the region where mitochondrial reactive oxygen species are generated...
January 20, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28110970/-plasma-exchange-in-nephrology-indications-and-technique
#8
Christophe Ridel, Sébastien Kissling, Laurent Mesnard, Alexandre Hertig, Éric Rondeau
Plasma exchange is a non-selective apheresis technique that can be performed by filtration or centrifugation allowing rapid purification of high molecular weight pathogens. An immunosuppressive treatment is generally associated to reduce the rebound effect of the purified substance. Substitution solutes such as human albumin and macromolecules are needed to compensate for plasma extraction. Compensation by viro-attenuated plasma is reserved solely for the treatment of thrombotic microangiopathies or when there is a risk of bleeding, because this product is very allergenic and expensive...
January 16, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28102816/clinicopathological-features-diagnosis-and-treatment-of-iga-nephropathy-with-minimal-change-disease-related-to-exposure-to-mercury-containing-cosmetics-a-case-report%C3%A2
#9
Hong-Xin Niu, Shen-Heng Li, Hong-Ying Li, Yi-Hua Chen, Wei-Wei Liu, Pei-Lin Li, Hai-Bo Long
AIM: Membranous nephropathy and minimal change disease (MCD) have been involved in mercury-induced nephrotic syndrome. IgA nephropathy is not known to be a common pathological type. In the present article, we report a case of IgA nephropathy with MCD following exposure to mercury-containing skin lightening cream. MATERIAL AND METHODS: The patient was a 39-year-old woman who presented with nephrotic syndrome. She had a 6-month history of using as many as 8 kinds of skin-lightening creams, and urinary mercury excretion was high...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28090051/different-effects-of-tolvaptan-in-patients-with-idiopathic-membranous-nephropathy-with-nephrotic-syndrome
#10
Atsushi Tanaka, Tsukasa Nakamura, Eiichi Sato, Yoshihiko Ueda, Koichi Node
This case report discusses the clinical indication for immunosuppressants in patients with idiopathic membranous nephropathy (IMN). Because this disease occasionally shows spontaneous remission, it is necessary to determine the predictive values for a therapeutic effect in order to provide appropriate treatment. Two distinct cases described herein illustrate the different effects of tolvaptan in responders and non-responders, according to the pre-treatment levels of AQP-2 immunostaining in the samples from renal biopsy and urinary levels of AQP-2 and osmolality, suggesting that these values may be useful predictors of response to tolvaptan in patients with nephrotic IMN...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28065518/membranous-nephropathy-integrating-basic-science-into-improved-clinical-management
#11
REVIEW
Daniel C Cattran, Paul E Brenchley
Idiopathic membranous nephropathy (INM) remains a common cause of the nephrotic syndrome in adults. The autoimmune nature of IMN was clearly delineated in 2009 with the identification of the glomerular-deposited IgG to be a podocyte receptor, phospholipase A2 receptor (PLA2R) in 70% to 75% of cases. This anti-PLA2R autoantibody, predominantly the IgG4 subclass, has been quantitated in serum using an enzyme-linked immunosorbent assay and has been used to aid diagnosis and monitor response to immunosuppressive therapy...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28056860/evaluating-tacrolimus-treatment-in-idiopathic-membranous-nephropathy-in-a-cohort-of-408-patients
#12
Hua-Zhang Qin, Lei Liu, Shao-Shan Liang, Jing-Song Shi, Chun-Xia Zheng, Qing Hou, Ying-Hui Lu, Wei-Bo Le
BACKGROUND: The KDIGO Clinical Practice Guidelines for Glomerulonephritis recommended tacrolimus as an alternative regimen for the initial therapy for Idiopathic membranous nephropathy (IMN), however, large observational studies evaluating tacrolimus treatment in IMN remains rare. METHODS: A total of 408 consecutive IMN patients with nephrotic syndrome who were treated with tacrolimus in Jinling Hospital were included. The effectiveness and safety of tacrolimus treatment in IMN were analyzed in this study...
January 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28029267/the-pathological-spectrum-associated-with-the-ultrastructural-finding-of-thin-glomerular-basement-membrane-a-tertiary-medical-city-experience-and-review-of-the-literature
#13
Hala Kfoury, Maria Arafah
BACKGROUND: Thin glomerular basement membrane (GBM) has been noted in several glomerular diseases including IgA nephropathy, focal segmental glomerulosclerosis (FSGS), Fabry's disease, and Alport's syndrome. We conducted this study to investigate the pathological ultrastructural spectrum of thin GBMs, to identify associated diseases, and to measure the GBM thickness in thin GBMs in our adult population. MATERIALS AND METHODS: All renal biopsies with thin GBM, diagnosed between 2010 and 2016, were retrieved and reviewed...
December 28, 2016: Ultrastructural Pathology
https://www.readbyqxmd.com/read/28004272/rice-bran-protein-hydrolysates-attenuate-diabetic-nephropathy-in-diabetic-animal-model
#14
Kampeebhorn Boonloh, Eun Soo Lee, Hong Min Kim, Mi Hye Kwon, You Mi Kim, Patchareewan Pannangpetch, Bunkerd Kongyingyoes, Upa Kukongviriyapan, Supawan Thawornchinsombut, Eun Young Lee, Veerapol Kukongviriyapan, Choon Hee Chung
INTRODUCTION: Diabetic nephropathy (DN) is an important microvascular complication of uncontrolled diabetes. The features of DN include albuminuria, extracellular matrix alterations, and progressive renal insufficiency. Rice bran protein hydrolysates (RBPs) have been reported to have antihyperglycemic, lipid-lowering, and anti-inflammatory effects in diabetic rats. Our study was to investigate the renoprotective effects of RBP in diabetic animals and mesangial cultured cells. METHODS: Eight-week-old male db/m and db/db mice were orally treated with tap water or RBP (100 or 500 mg/kg/day) for 8 weeks...
December 21, 2016: European Journal of Nutrition
https://www.readbyqxmd.com/read/27999961/long-term-outcomes-of-initial-therapy-for-idiopathic-membranous-nephropathy
#15
Masayo Sato, Takashi Takei, Takahito Moriyama, Mitsuyo Itabashi, Kosaku Nitta
BACKGROUND: The objective of this study is to determine whether initial steroid therapy is actually effective for the treatment of iMN, and we examined a 40% reduction in estimated glomerular filtration rate (eGFR) and remission rates. METHODS: This was a retrospective study between 1993 and 2013. First, we divided patients with iMN having a urinary protein level of ≥1 g/gCre into two groups: those who had received steroid therapy (Group S1; n = 52) within 6 months of diagnosis and those who had received supportive therapy (Group H1; n = 31)...
December 20, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27994855/treatment-with-rituximab-in-idiopathic-membranous-nephropathy
#16
Marco Fiorentino, Francesco Tondolo, Francesca Bruno, Barbara Infante, Giuseppe Grandaliano, Loreto Gesualdo, Carlo Manno
BACKGROUND: Rituximab represents a valid therapeutic option to induce remission in patients with primary glomerulonephritis. Despite several studies proving its efficacy in improving outcomes in patients with membranous nephropathy (MN), its role in therapeutic protocols is not yet defined. METHODS: We studied 38 patients with idiopathic MN treated with rituximab (in 13 patients as first-line therapy, in the remaining 25 after conventional immunosuppressive therapy)...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27988429/calcineurin-inhibitors-versus-cyclophosphamide-for-idiopathic-membranous-nephropathy-a-systematic-review-and-meta-analysis-of-21-clinical-trials
#17
REVIEW
Ting Ting Qiu, Chao Zhang, Hong Wei Zhao, Jun Wen Zhou
OBJECTIVE: To compare the efficacy and safety of calcineurin inhibitors (CNIs) with cyclophosphamide (CTX) in the treatment of idiopathic membranous nephropathy (IMN). METHODS: A literature search was carried out using PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and three Chinese databases (WanFang Data, Chongqing VIP and China National Knowledge Infrastructure) from inception through June 2016. Randomized controlled trials (RCTs) comparing the efficacy and safety of CNIs with CTX in IMN patients were included...
February 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27974710/clinical-predictors-of-response-to-prednisone-plus-cyclophosphamide-in-patients-with-idiopathic-membranous-nephropathy
#18
Shu Li, Ling Wang, Minfang Zhang, Wenyan Zhou, Wei Fang, Qin Wang, Chaojun Qi, Shan Mou, Xinghua Shao, Zhaohui Ni
BACKGROUND: Complete remission (CR) and partial remission (PR) are beneficial to the long-term outcome of patients with idiopathic membranous nephropathy (iMN). However, we are lacking in studies that evaluate the clinical predictors of response to treatment with prednisone plus cyclophosphamide (CP). The objectives of the study are to identify clinical factors that could predict clinical remission or relapse in patients with iMN who were treated with prednisone plus i.v. CP therapy. METHODS: This retrospective study recruited a total of 102 eligible patients diagnosed with biopsy-proven iMN between January 2010 and December 2013 in our center...
2017: Nephron
https://www.readbyqxmd.com/read/27942609/membranous-nephropathy-pilot-study-of-a-novel-regimen-combining-cyclosporine-and-rituximab
#19
Meryl Waldman, Laurence H Beck, Michelle Braun, Kenneth Wilkins, James E Balow, Howard A Austin
INTRODUCTION: There is broad consensus that high grade basal proteinuria and failure to achieve remission of proteinuria are key determinants of adverse renal prognosis in patients with primary membranous nephropathy. Based on the fact that current regimens are not ideal due to short and long-term toxicity and propensity to relapse after treatment withdrawal, we developed a treatment protocol based on a novel combination of rituximab and cyclosporine which targets both the B and T cell limbs of the immune system...
July 2016: KI Reports
https://www.readbyqxmd.com/read/27836988/sphingomyelinase-like-phosphodiesterase-3b-mediates-radiation-induced-damage-of-renal-podocytes
#20
Anis Ahmad, Alla Mitrofanova, Jacek Bielawski, Yidong Yang, Brian Marples, Alessia Fornoni, Youssef H Zeidan
The molecular mechanisms responsible for the development of proteinuria and glomerulosclerosis in radiation nephropathy remain largely unknown. Podocytes are increasingly recognized as key players in the pathogenesis of proteinuria in primary and secondary glomerular disorders. The lipid-modulating enzyme sphingomyelin phosphodiesterase acid-like 3B (SMPDL3b) is a key determinant of podocyte injury and a known off target of the anti-CD20 antibody rituximab (RTX). The current study investigates the role of sphingolipids in radiation-induced podocytopathy...
November 11, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
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