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REVIEW
Priyanshu R Verma, Praful Patil
Nephrotic syndrome (NS) is characterized by hypoalbuminemia, severe proteinuria, and peripheral edema, frequently in conjunction with hyperlipidemia. Individuals usually show symptoms of weariness and swelling, but no signs of serious liver damage or cardiac failure. With characteristic medical symptoms and evidence of hypoalbuminemia and severe proteinuria, NS can be diagnosed. The majority of NS episodes are classified as unexplained or primary; the most prevalent histopathological subgroups of primary NS in people are focal segmental glomerulosclerosis and membraneous nephropathy...
February 2024: Curēus
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JOURNAL ARTICLE
Yuanyuan Zhang, Jingjing Yang, Jianzhong Li, Jiani Sun, Ling Zhou, Deyu Xu, Wengang Sha, Lan Dai, Lei Shen
BACKGROUND: The aim of this study was to investigate the effects and significance of rituximab (RTX) on the levels of T lymphocyte subsets in patients diagnosed with primary membranous nephropathy (PMN). METHODS: A total of 58 PMN patients and 25 healthy donors were chosen as the subjects. Among the PMN patients, 40 individuals received RTX treatment and completed at least 6 months of follow-up. All subjects underwent flow cytometry analysis to determine the peripheral blood lymphocyte subsets...
March 6, 2024: BMC Nephrology
#23
JOURNAL ARTICLE
Zhixia Song, Yao Xia, Lang Shi, Hongchu Zha, Jing Huang, Xiaohong Xiang, Huiming Li, Hua Huang, Ruchi Yue, Hongtao Wang, Jiefu Zhu
BACKGROUND: Acute kidney injury (AKI) is a common clinical disorder with complex etiology and poor prognosis, and currently lacks specific and effective treatment options. Mitochondrial dynamics dysfunction is a prominent feature in AKI, and modulation of mitochondrial morphology may serve as a potential therapeutic approach for AKI. METHODS: We induced ischemia-reperfusion injury (IRI) in mice (bilateral) and Bama pigs (unilateral) by occluding the renal arteries...
March 4, 2024: Cellular & Molecular Biology Letters
#24
JOURNAL ARTICLE
Kalpa Jayanatha, Ashutosh Kumar, Mark Sapsford, Mark Simpson
Membranous nephropathy has been associated with demyelinating polyneuropathies and antiglomerular membrane disease; however, an association with vasculitic neuropathy has not been described. This case describes a patient with biopsy-proven idiopathic membranous nephropathy and synchronous mononeuritis multiplex secondary to idiopathic small vessel vasculitis, who presented with lower limb microvascular ischaemia, peripheral neuropathy and active urinary sediment. Her extensive non-invasive screening for immunological disease and radiological investigations for occult malignancy were unremarkable...
February 29, 2024: BMJ Case Reports
#25
JOURNAL ARTICLE
Hui-Lin Xing, Dong-Hong Ma, Jin Li, Qing-Yu Xu, Li-Ke Ji, Qiong-Jie Zhu, Yu-Qing Luo, Ming-Hao Guo
Objective: To compare the efficacy of a steroid-free regimen with steroid-based treatment in managing primary membranous nephropathy (PMN) and investigate the potential benefits of steroid-free regimens in PMN therapy. Methods: This was a single-centre prospective cohort study. A total of 81 patients were divided into two groups according to their medication regimen: a rituximab (RTX)/tacrolimus (TAC) group (low-dose RTX combined with low-dose TAC group, without steroids, n = 31) and a prednisone (P)/TAC group (P combined with TAC group, n = 61)...
2024: Frontiers in Pharmacology
#26
JOURNAL ARTICLE
Prabhjot Kaur, Arun Prabhahar, Deeksha Pal, Ritambhra Nada, Harbir Singh Kohli, Vinod Kumar, Raja Ramachandran
Primary membranous nephropathy (PMN), an autoimmune disease, is the most common cause of nephrotic syndrome in middle-aged non-diabetic adults. PMN pathophysiology includes Th1/Th2 paradigm. The IL-23/IL-17 pathway is implicated in autoimmune kidney disorders, but no study has examined its relationship with PMN. In several unrelated studies, PMN patients reported to have paradoxical IL-17 levels. This manuscript describes the best possible association of IL-23/IL-17 axis with PMN. Biopsy-proven PMN patients and age, gender-matched healthy controls were enrolled...
February 23, 2024: Inflammation
#27
JOURNAL ARTICLE
Xiaobin Liu, Jing Xue, Ting Li, Qingqing Wu, Huiming Sheng, Xue Yang, Bo Lin, Xiumei Zhou, Yuan Qin, Zijian Huang, Leting Zhou, Liang Wang, Zhigang Hu, Biao Huang
BACKGROUND: M-type phospholipase A2 receptor (PLA2R) is the major autoantigen in adult idiopathic membranous nephropathy (IMN). Although reactive epitopes in the PLA2R domains have been identified, the clinical value of these domains recognized by anti-PLA2R antibodies remains controversial. Accordingly, this study aimed to quantitatively detect changes in the concentrations of different antibodies against epitopes of PLA2R in patients with IMN before and after treatment to evaluate the clinical value of epitope spreading...
2024: PloS One
#28
JOURNAL ARTICLE
Fei Liu, Sarah T Ryan, Kelly C Fahnoe, Jennifer G Morgan, Anne E Cheung, Michael J Storek, Alejandro Best, Hui A Chen, Monica Locatelli, Shuyun Xu, Enno Schmidt, Leon F Schmidt-Jiménez, Katja Bieber, Joel M Henderson, Christine G Lian, Admar Verschoor, Ralf J Ludwig, Ariela Benigni, Giuseppe Remuzzi, David J Salant, Susan L Kalled, Joshua M Thurman, V Michael Holers, Shelia M Violette, Stefan Wawersik
Complement-mediated diseases can be treated using systemic inhibitors. However, complement components are abundant in circulation, affecting systemic inhibitors' exposure and efficacy. Furthermore, because of complement's essential role in immunity, systemic treatments raise infection risk in patients. To address these challenges, we developed antibody fusion proteins combining the alternative-pathway complement inhibitor factor H (fH1-5 ) with an anti-C3d monoclonal antibody (C3d-mAb-2fH). Because C3d is deposited at sites of complement activity, this molecule localizes to tissue complement while minimizing circulating complement engagement...
February 19, 2024: Molecular Therapy
#29
JOURNAL ARTICLE
Peng Yan, Xiangdong Fang, Ben Ke
BACKGROUND: Rituximab (RTX) has become the first-line treatment for idiopathic membranous nephropathy (IMN). Compared with conventional therapy, rituximab therapy has a more favorable safety profile. However, the recommended RTX dose as a flux may have its limitations. The aim of this study was to investigate the clinical efficacy and safety of three regimens, including a cyclic corticosteroid-cyclophosphamide regimen and two different doses of RTX regimens, for the treatment of IMN. METHODS: We recruited 58 patients with IMN confirmed by renal biopsy...
February 19, 2024: International Immunopharmacology
#30
JOURNAL ARTICLE
Yuan-Zhang Zhu, Zhi-Zhi Dou, Wen-Ying Wang, Qing-Yue Ma, Wen-Dan Yi, Ning-Ning Yao, Yi-Chong Liu, Xiao-Di Gao, Qian Zhang, Wen-Juan Luo
AIM: To observe the therapeutic effect of conbercept on diabetic macular edema (DME) complicated with diabetic nephropathy (DN). METHODS: In this retrospective study, 54 patients (54 eyes) that diagnosed as DME from January 2017 to October 2021 were collected. The patients were divided into two groups: DME patients with DN (25 eyes), and DME patients without DN (29 eyes). General conditions were collected before treatment, laboratory tests include fasting blood glucose, HbA1c, microalbumin/creatinine, serum creatinine...
2024: International Journal of Ophthalmology
#31
JOURNAL ARTICLE
Fumiyuki Morioka, Shinya Nakatani, Katsuhito Mori, Toshihide Naganuma, Takeshi Yamasaki, Hideki Uedono, Akihiro Tsuda, Eiji Ishimura, Junji Uchida, Masanori Emoto
Thirteen years after kidney donation, a 70-year-old man was referred to a nephrologist because of proteinuria. The serum creatinine, albumin, and urinary protein levels were 2.39 mg/dL, 3.0 g/dL, and 6.72 g/gCr, respectively. A kidney biopsy revealed thickening of the glomerular basement membrane with sub-epithelial deposits, suggesting membranous nephropathy. Considering the apparent interstitial fibrosis and diffuse glomerulosclerosis, supportive treatment was chosen. However, 11 months after the kidney biopsy, hemodialysis was required...
February 12, 2024: Internal Medicine
#32
JOURNAL ARTICLE
Joel D Murphy, Tiffany N Caza, Clarissa A Cassol, Aaron Storey, Josephine M Ambruzs, Christie Boils, Patrick D Walker, Shree Sharma, Nidia Messias, Randolph Hennigar, Nicole K Andeen, Christine VanBeek, Matthew Palmer, Lakshna Sankar, Pooja Sanghi, Kumar Dinesh, Lance Dicker, Anatoly Urisman, Christopher P Larsen
INTRODUCTION: Antibrush border antibody disease (ABBA) is an autoimmune tubulointerstitial kidney disease that primarily affects older individuals and results in progressive kidney failure. It is rare with only 20 reported cases. Here, we describe a case series to further define the clinicopathologic spectrum and natural history, and to inform management. METHODS: We identified 67 patients with ABBA who underwent kidney biopsy, including 65 native and 2 transplants...
February 2024: KI Reports
#33
Yao Zhang, Jing Sun, Jie Gao, Weiyan Sun, Liang Xu, Chunjuan Zhai, WenYan Su, Haiping Wang
Rituximab (RTX) is a monoclonal antibody commonly used to treat PLA2R-associated membranous nephropathy (MN). This report presents a case of refractory MN in a patient who experienced severe hypokalemia, a rare but clinically significant condition, after the 5th RTX infusion. Clinicians should be aware of the potential for hypokalemia and its management during or after RTX infusion. After the onset of hypokalemia, the patient received treatment with obinutuzumab and achieved partial remission of renal disease without experiencing further hypokalemia...
2024: Frontiers in Pharmacology
#34
JOURNAL ARTICLE
Frank Hullekes, Audrey Uffing, Rucháma Verhoeff, Harald Seeger, Seraina von Moos, Juliana Mansur, Gianna Mastroianni-Kirsztajn, Helio Tedesco Silva, Anna Buxeda, María José Pérez-Sáez, Carlos Arias-Cabrales, A Bernard Collins, Christie Swett, Leela Morená, Marina Loucaidou, Andreas Kousios, Paolo Malvezzi, Mathilde Bugnazet, Luis Sanchez Russo, Saif A Muhsin, Nikhil Agrawal, Pitchaphon Nissaisorakarn, Het Patel, Ayman Al Jurdi, Enver Akalin, Elias David Neto, Fabiana Agena, Carlucci Ventura, Roberto C Manfro, Andrea Carla Bauer, Marilda Mazzali, Marcos Vinicius de Sousa, Gaetano La Manna, Claudia Bini, Giorgia Comai, Roman Reindl-Schwaighofer, Stefan Berger, Paolo Cravedi, Leonardo V Riella
Membranous nephropathy (MN) is a leading cause of kidney failure worldwide, and frequently recurs after transplant. Available data originated from small retrospective cohort studies or registry analyses. Therefore, uncertainties remain on risk factors for MN recurrence and response to therapy. Within the Post-Transplant Glomerular Disease (TANGO) Consortium, we conducted a retrospective multicenter cohort study examining the MN recurrence rate, risk factors, and response to treatment. This study screened 22,921 patients across three continents and included 194 patients who underwent a kidney transplant due to biopsy-proven MN...
February 8, 2024: American Journal of Transplantation
#35
JOURNAL ARTICLE
Hassane Moussa Diongolé, Zeinabou Maiga Moussa Tondi, Abdoulazize Garba, Kabirou Ganiou, Laouali Chaibou, Djibrilla Bonkano, Illiassou Aboubacar, Abdoul Aziz Seribah, Abdoul Madjid Abdoulaye Idrissa, Akinfenwa Atanda, Lionel Rostaing
Kidney biopsy (KB) has become essential in the nephrologist's approach to kidney diseases, both for diagnosis, treatment, and prognosis. Our objective is to describe the preliminary results of KBs in Niger, one of the poorest countries in the world. This is a descriptive cross-sectional study that took place over 36 months in the nephrology/dialysis department of the Zinder National Hospital. Biopsy results were obtained in less than 5 working days. Patients were responsible for covering the cost of the kidney biopsy...
January 24, 2024: Journal of Clinical Medicine
#36
JOURNAL ARTICLE
Congcong Qin, Zhijuan Hu, Yanan Shi, Hui Cui, Jiejie Li
BACKGROUND: Pregnancy in patients with nephrotic syndrome presents enormous challenges to both the mother and fetus, and there are no treatment guidelines for these patients. METHODS: We show a case of a woman with anti-PLA2R antibody-positive membranous nephropathy who did not have a kidney biopsy. Her clinical course during both pregnancies was closely followed and her medications were guided. RESULTS: She gave birth to 2 healthy babies and her condition was very well controlled with the help of medication...
February 9, 2024: Medicine (Baltimore)
#37
JOURNAL ARTICLE
Mijie Guan, Liling Wu, Yuan Cheng, Dongli Qi, Jia Chen, Haiying Song, Haofei Hu, Qijun Wan
BACKGROUND: Hyperlipidemia is common in primary membranous nephropathy (PMN) patients, and tubular atrophy (TA) is an unfavorable prognostic factor. However, the correlation between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and TA is controversial. Therefore, our study aimed to investigate the association between the TG/HDL-C ratio and TA in PMN patients. METHODS: We conducted a cross-sectional study and collected data from 363 PMN patients at Shenzhen Second People's Hospital from January 2008 to April 2023...
2024: Frontiers in Endocrinology
#38
JOURNAL ARTICLE
Qiyan Zheng, Xueqin Zhang, Jing Guo, Yahui Wang, Yuhua Jiang, Shunmin Li, Yu Ning Liu, Wei Jing Liu
ETHNOPHARMACOLOGICAL RELEVANCE: The JinChan YiShen TongLuo (JCYSTL) formula, a traditional Chinese medicine (TCM), has been used clinically for decades to treat diabetic neuropathy (DN). TCM believes that the core pathogenesis of DN is "kidney deficiency and collateral obstruction," and JCYSTL has the effect of "tonifying kidney and clearing collateral," thus alleviating the damage to kidney structure and function caused by diabetes. From the perspective of modern medicine, mitochondrial damage is an important factor in DN pathogenesis...
February 5, 2024: Journal of Ethnopharmacology
#39
JOURNAL ARTICLE
Yuanbing Xiang, Min Sun, Yuxi Wu, Yao Hu
INTRODUCTION: Membrane-associated guanylate kinase with an inverted domain structure-1 (MAGI1) is dysregulated in diabetes; however, its role in diabetic nephropathy (DN) remains unclear. In this study, we determined the function and associated mechanisms of MAGI1 in DN. METHODS: Serum samples from 28 patients with DN and 28 normal volunteers were collected. High-glucose (HG)-treated human renal mesangial cells (HRMCs) and streptozotocin-treated rats were used as cell and animal models of DN, respectively...
February 7, 2024: Pharmacology
#40
JOURNAL ARTICLE
Alexandre Destere, Maxime Teisseyre, Diane Merino, Marion Cremoni, Alexandre O Gérard, Thomas Crepin, Noémie Jourde-Chiche, Daisy Graça, Kévin Zorzi, Céline Fernandez, Vesna Brglez, Sylvia Benzaken, Vincent L M Esnault, Sylvain Benito, Milou-Daniel Drici, Barbara Seitz-Polski
INTRODUCTION: Rituximab is a first-line treatment for membranous nephropathy. Nephrotic syndrome limits rituximab exposure due to urinary drug loss. Rituximab underdosing (serum level <2 μg/ml at month-3) is a risk factor for treatment failure. We developed a machine learning algorithm to predict the risk of underdosing based on patients' characteristics at rituximab infusion. We investigated the relationship between the predicted risk of underdosing and the cumulative dose of rituximab required to achieve remission...
January 2024: KI Reports
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