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Transplant glomerulopathy

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https://www.readbyqxmd.com/read/27848227/the-clinical-implications-of-the-unique-glomerular-complement-deposition-pattern-in-transplant-glomerulopathy
#1
Priya S Verghese, Robin C Reed, Bu Lihong, Arthur J Matas, Youngki Kim
The etiology and treatment of transplant glomerulopathy (TG) is not clear. TG is associated with donor-specific antibodies but the lack of C4d deposition in the peritubular capillaries (ptc-C4d) in some cases has caused the role of complement in the pathogenesis of TG to be debated. There is however, little information on C4d deposition in the glomerulus itself. We retrieved random frozen sections from 25 cases with well-established TG by light microscopy (LM) and 25 cases without TG as controls and reviewed the LM and immunofluorescence (nine biopsies were excluded due to inadequate samples)...
November 15, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27796697/characteristics-of-patients-diagnosed-with-renal-vein-thrombosis-and-glomerulopathy-a-case-series
#2
Oliver Ross, Andrew Pourmoussa, Michael Batech, John J Sim
BACKGROUND: Few contemporary studies have evaluated the clinical characteristics of patients with biopsy-proven glomerulopathy diagnosed with renal vein thrombosis (RVT). METHODS: Retrospective case series study within an integrated health system in a 12-year period (January 1, 2000 through December 31, 2011) investigating clinical characteristics of all adult patients who underwent native or transplant kidney biopsy and also had a diagnosis of RVT. Patient characteristics, diagnostic studies, and outcomes were evaluated...
October 28, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27753815/ssa-05-2-hypertension-and-kidney-complication-in-africa
#3
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751999/chronic-renal-allograft-dysfunction-in-egyptian-population-histopathological-and-immunohistochemical-study
#4
Wael M Hamza, Hanan H Ali, Samia M Gabal, Sawsan A Fadda
The chronic dysfunction stands as the most common cause of renal allograft loss. During the nineties of the past century, this condition was referred to as chronic allograft nephropathy (CAN). Since 2005, CAN has been assigned by the eighth Banff schema to four main categories via histopathological and immunohistochemical findings including chronic antibodymediated rejection (CAMR), chronic T-cell-mediated rejection (CTMR), chronic cyclosporine toxicity (CNITOX), and "interstitial fibrosis (IF)/tubular atrophy; not otherwise specified (NOS)" to eliminate the term CAN...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27742388/protocol-biopsies-utility-and-limitations
#5
Yihung Huang, Evan Farkash
As both T cell and antibody-mediated rejection can have a subclinical phase, protocol biopsies provide an early opportunity to intervene before the onset of clinical allograft dysfunction. Protocol biopsies are usually done after reperfusion to establish baseline, between 3 and 6 months to identify subclinical rejection, and at 6-12 months to assess chronicity and persistent inflammation that have prognostic implication. Treatment of both subclinical T cell and antibody-mediated rejection prevents progression of rejection and development of interstitial fibrosis/tubular atrophy or transplant glomerulopathy...
September 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/27682967/idiopathic-nephrotic-syndrome-the-ebv-hypothesis
#6
REVIEW
Claire Dossier, Agnès Jamin, Georges Deschênes
Steroid sensitive nephrotic syndrome is marked by a massive proteinuria and loss of podocytes foot processes. The mechanism of the disease remains debated but recent publications suggest a primary role of Epstein-Barr Virus (EBV). EBV replication in the peripheral blood is found in 50% of patients during the first flare of the disease. The genetic locus of steroid sensitive nephrotic syndrome was also identified as influencing antibodies directed against EBNA1. EBV is able to establish, latent benign infection in memory B cells that display phenotypes similar to antigen-selected memory B cells...
November 9, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27643378/ssa-05-2-hypertension-and-kidney-complication-in-africa
#7
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27605054/peritubular-capillary-basement-membrane-multilayering-in-early-and-advanced-transplant-glomerulopathy-quantitative-parameters-and-diagnostic-aspects
#8
Deján Dobi, Zsolt Bodó, Éva Kemény, László Bidiga, Zoltán Hódi, Pál Szenohradszky, Edit Szederkényi, Anikó Szilvási, Béla Iványi
The ultrastructural quantitative aspects of peritubular capillary basement membrane multilayering (PTCBML) were examined in 57 kidney transplant biopsies with transplant glomerulopathy (TG). The measurements included three cutoffs [permissive: 1 PTC with 5 basement membrane (BM) layers, intermediate: 3 PTCs with 5 layers or 1 PTC with 7 layers, strict: 1 PTC with 7 layers and 2 PTCs with 5 layers] and the mean number of BM layers (PTCcirc). Two groups were assigned, namely patients with mild TG (Banff cg1a and cg1b) and those with moderate-to-severe TG (cg2 and cg3)...
September 7, 2016: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27602081/plasmalemma-vesicle-associated-protein-a-crucial-component-of-vascular-homeostasis
#9
Ling Guo, Hongyan Zhang, Yinglong Hou, Tianshu Wei, Ju Liu
Endothelial subcellular structures, including caveolae, fenestrae and transendothelial channels, are crucial for regulating microvascular function. Plasmalemma vesicle-associated protein (PLVAP) is an endothelial cell-specific protein that forms the stomatal and fenestral diaphragms of blood vessels and regulates basal permeability, leukocyte migration and angiogenesis. Loss of PLVAP in mice leads to premature mortality due to disrupted homeostasis. Evidence from previous studies suggested that PLVAP is involved in cancer, traumatic spinal cord injury, acute ischemic brain disease, transplant glomerulopathy, Norrie disease and diabetic retinopathy...
September 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27536691/averting-the-legacy-of-kidney-disease-focus-on-childhood
#10
Julie R Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life...
April 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27495772/histological-and-extended-clinical-outcomes-following-abo-incompatible-renal-transplantation-without-splenectomy-or-rituximab
#11
Kevin V Chow, Shaun M Flint, Angeline Shen, Anthony Landgren, Moira Finlay, Anand Murugasu, Rosemary Masterson, Peter Hughes, Solomon J Cohney
BACKGROUND: Excellent short-term results have been reported in ABO-incompatible renal transplant recipients (ABOi) managed solely with antibody removal and conventional immunosuppression. However, long-term clinical outcomes with this regimen and predictive information from protocol biopsies is lacking. METHODS: We compared outcome data in ABOi and ABO compatible (ABOc) recipients receiving this regimen approximately 4 years posttransplant, and histology from biopsies approximately 12 month posttransplant...
August 5, 2016: Transplantation
https://www.readbyqxmd.com/read/27417242/averting-the-legacy-of-kidney-disease-focus-on-childhood
#12
EDITORIAL
Julie R Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer, On Behalf Of The World Kidney Day Steering Committee
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life...
2016: Children
https://www.readbyqxmd.com/read/27388502/hepatitis-c-therapy-in-renal-patients-who-how-when
#13
REVIEW
Corinne Isnard Bagnis, Patrice Cacoub
Renal patients are overexposed to hepatitis C virus (HCV) infection. Hepatitis C virus infection may induce renal disease, i.e., cryoglobulinemic membrano-proliferative glomerulopathy and non-cryoglobulinemic nephropathy. Hepatitis C virus impacts general outcomes in chronic kidney disease, dialysis or transplanted patients. Hepatitis C virus infection is now about to be only part of their medical history thanks to new direct acting antiviral drugs exhibiting as much as over 95% of sustained virological response...
September 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27274824/kidney-transplant-outcomes-in-familial-c3-glomerulopathy
#14
Limy Wong, Sarah Moran, Peter J Lavin, Anthony M Dorman, Peter J Conlon
C3 glomerulopathy, a newly designated entity, is characterized by glomerular disease associated with dysregulation of the alternative complement pathway and is a rare cause of end-stage kidney disease. Overall disease characteristics that include clinical presentation, laboratory assessment, histopathology and genetic background have only been unravelled in recent years and have led to the development of anti-complement therapies targeting different levels of the alternative pathway. We describe the long-term outcomes following kidney transplantation in an Irish family with familial C3 glomerulopathy due to a hybrid CFHR3-1 gene...
June 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27247150/averting-the-legacy-of-kidney-disease-focus-on-childhood
#15
Julie R Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group amongst children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertensionand CKD in later childhood or in adult life...
2016: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/27234747/outcomes-of-renal-allograft-recipients-with-hepatitis-c
#16
R Carpio, G E Pamugas, R Danguilan, E Que
BACKGROUND: Studies on the effect of hepatitis C virus (HCV) infection showed decreased graft survival compared to HCV-negative matched patients. It was also identified as an independent risk factor for graft loss and mortality in kidney transplantation patients. OBJECTIVE: This study was designed to evaluate the 10-year graft and patient outcomes of renal allograft recipients with HCV infection at the National Kidney and Transplant Institute. METHODS: This is a retrospective study of patients who underwent renal transplantation with HCV infection and a group who were HCV-negative in the same post-transplantation period...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27225518/early-subclinical-inflammation-correlates-with-outcomes-in-positive-crossmatch-kidney-allografts
#17
Patrick G Dean, Walter D Park, Lynn D Cornell, Carrie A Schinstock, Mark D Stegall
The aim of this study was to investigate correlations between early subclinical findings (10- and 90-day histology and gene expression data) and late outcomes (transplant glomerulopathy and graft loss) in positive crossmatch kidney transplants (+XMKTx). We compared 34 +XMKTx (19 receiving eculizumab and 15 receiving standard of care without eculizumab) to 13 -XMKTx (between August 2001 and August 2011). At 10 days, light microscopy identified subclinical inflammation in only 18% of +XMKTx, while intragraft gene expression identified inflammation in 79% (gene sets for activated macrophages, dendritic cells, NK cells or T cells)...
August 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27214874/splenic-irradiation-for-the-treatment-of-severe-antibody-mediated-rejection
#18
B J Orandi, B E Lonze, A Jackson, S Terezakis, E S Kraus, N Alachkar, S M Bagnasco, D L Segev, J B Orens, R A Montgomery
Patients requiring desensitization prior to renal transplantation are at risk for developing severe antibody-mediated rejection (AMR) refractory to treatment with plasmapheresis and intravenous immunoglobulin (PP/IVIg). We have previously reported success at graft salvage, long-term graft survival and protection against transplant glomerulopathy with the use of eculizumab and splenectomy in addition to PP/IVIg. Splenectomy may be an important component of this combination therapy and is itself associated with a marked reduction in donor-specific antibody (DSA) production...
May 23, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27188932/a-high-intrapatient-variability-in-tacrolimus-exposure-is-associated-with-poor-long-term-outcome-of-kidney-transplantation
#19
Nauras Shuker, Lamis Shuker, Joost van Rosmalen, Joke I Roodnat, Lennaert C P Borra, Willem Weimar, Dennis A Hesselink, Teun van Gelder
Tacrolimus is a critical dose drug with a considerable intrapatient variability (IPV) in its pharmacokinetics. We investigated whether a high IPV in tacrolimus exposure is associated with adverse long-term renal transplantation outcomes. Tacrolimus IPV was calculated from predose concentrations measured between 6 and 12 months post-transplantation of 808 renal transplant recipients (RTRs) transplanted between 2000 and 2010. One hundred and eighty-eight (23.3%) patients reached the composite end point consisting of graft loss, late biopsy-proven rejection, transplant glomerulopathy, or doubling of serum creatinine concentration between month 12 and the last follow-up...
May 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27184779/plasma-derived-c1-esterase-inhibitor-for-acute-antibody-mediated-rejection-following-kidney-transplantation-results-of-a-randomized-double-blind-placebo-controlled-pilot-study
#20
R A Montgomery, B J Orandi, L Racusen, A M Jackson, J M Garonzik-Wang, T Shah, E S Woodle, C Sommerer, D Fitts, K Rockich, P Zhang, M E Uknis
Antibody-mediated rejection (AMR) is typically treated with plasmapheresis (PP) and intravenous immunoglobulin (standard of care; SOC); however, there is an unmet need for more effective therapy. We report a phase 2b, multicenter double-blind randomized placebo-controlled pilot study to evaluate the use of human plasma-derived C1 esterase inhibitor (C1 INH) as add-on therapy to SOC for AMR. Eighteen patients received 20 000 units of C1 INH or placebo (C1 INH n = 9, placebo n = 9) in divided doses every other day for 2 weeks...
May 16, 2016: American Journal of Transplantation
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