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general nephrology, immunosuppression,

Pei-Mei Zou, Hang Li, Jian-Fang Cai, Zhen-Jie Chen, Chao Li, Xue-Wang Li
Objective To investigate the efficacy and safety of rituximab (RTX) in the treatment of idiopathic membranous nephropathy (IMN) with nephrotic syndrome with a systematic review and meta-analysis. Methods PubMed, Embase, Cochrane Library and Clinical Trials (December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission (CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated...
March 30, 2018: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Arunkumar Subbiah, Soumita Bagchi, Dipankar Bhowmik, Sandeep Mahajan, Raj K Yadav, Yogesh Chhabra, Sanjay Agarwal
BACKGROUND: There are annual outbreaks of dengue infection in tropical and subtropical countries. This retrospective study aimed to assess the clinical manifestation of dengue and outcome in renal transplant recipients. METHODS: Renal transplant recipients diagnosed with dengue in the nephrology department during the outbreak from August 2015 to December 2015 were included in the study. RESULTS: Twenty patients developed dengue presenting during the outbreak...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Loredana Colla, Davide Diena, Maura Rossetti, Ana Maria Manzione, Luca Marozio, Chiara Benedetto, Luigi Biancone
Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects...
June 2018: Journal of Nephrology
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...
February 2017: Néphrologie & Thérapeutique
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Rossella Attini, Martina Gerbino, Paola Todeschini, Maria Luisa Perrino, Ana Maria Manzione, Gian Benedetto Piredda, Elisa Gnappi, Flavia Caputo, Giuseppe Montagnino, Vincenzo Bellizzi, Pierluigi Di Loreto, Francesca Martino, Domenico Montanaro, Michele Rossini, Santina Castellino, Marilisa Biolcati, Federica Fassio, Valentina Loi, Silvia Parisi, Elisabetta Versino, Antonello Pani, Tullia Todros
BACKGROUND: Kidney transplantation is the treatment of choice to restore fertility to women on renal replacement therapy. Over time, immunosuppressive, support therapies and approaches towards high-risk pregnancies have changed. The aim of this study was to analyse maternal-foetal outcomes in two cohorts of transplanted women who delivered a live-born baby in Italy in 1978-2013, dichotomized into delivery before and after January 2000. METHODS: A survey involving all the Italian transplant centres was carried out, gathering data on all pregnancies recorded since the start of activity at each centre; the estimated nationwide coverage was 75%...
November 2016: Nephrology, Dialysis, Transplantation
A Mathian, L Arnaud, D Adoue, C Agard, B Bader-Meunier, V Baudouin, C Belizna, B Bonnotte, F Boumedine, A Chaib, M Chauchard, L Chiche, E Daugas, A Ghali, P Gobert, G Gondran, G Guettrot-Imbert, E Hachulla, M Hamidou, J Haroche, B Hervier, A Hummel, N Jourde-Chiche, A-S Korganow, T Kwon, V Le Guern, A Le Quellec, N Limal, N Magy-Bertrand, P Marianetti-Guingel, T Martin, N Martin Silva, O Meyer, M Miyara, S Morell-Dubois, J Ninet, J-L Pennaforte, K Polomat, J Pourrat, V Queyrel, I Raymond, P Remy, K Sacre, J Sibilia, J-F Viallard, A Viau Brabant, T Hanslik, Z Amoura
PURPOSE: To develop French recommendations about the management of vaccinations, the screening of cervical cancer and the prevention of pneumocystis pneumonia in systemic lupus erythematosus (SLE). METHODS: Thirty-seven experts qualified in internal medicine, rheumatology, dermatology, nephrology and pediatrics have selected recommendations from a list of proposition based on available data from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified...
May 2016: La Revue de Médecine Interne
Nikolina Bašić-Jukić, Sanjin Rački, Mladen Knotek, Ljubica Bubić-Filipi, Ivan Bubić, Lada Zibar, Petar Kes
The use of generic immunosuppressive drugs may decrease the cost of immunosuppressive medication, although total cost sav- ings are still a matter of debate since patients need close monitoring after conversion from original to the generic formulation. A working group of the Croatian Society of Transplantation was established to develop recommendations on the use of generic immunosuppression in renal transplant recipients based on a review of the available data. Immunosuppressive drugs belong to the 'narrow therapeutic index' drugs, with huge pharmacokinetic variations secondary to the impact of food, other drugs, as well as of kidney and liver function...
April 2014: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
Mohamed H Abbas, Mabrouk I Ismail, Salem A El Deeb, Ayman M Nagib, Nabil M Hassan, Ayman F Refaie, Hanzada M El Maghrabi, Ahmed A Denewar, Mohamed A Bakr
OBJECTIVES: New-onset diabetes mellitus after transplant is a common complication in renal allograft recipients. Recently, a high prevalence of diabetes mellitus has been reported in patients with chronic hepatitis C virus. The association between hepatitis C and diabetes mellitus is well demonstrated in the general population, but some controversy still exists. This work aimed to study the effect of pretransplant hepatitis C virus on the development of new-onset diabetes mellitus after transplant in Egyptian living-donor renal allotransplant recipients...
February 2015: Experimental and Clinical Transplantation
A Zickert, B Sundelin, E Svenungsson, I Gunnarsson
OBJECTIVES: A renal biopsy is generally recommended for diagnosis and is necessary for classification of lupus nephritis (LN), but second biopsies after immunosuppressive therapy are seldom a routine procedure. We investigated how repeat biopsies contribute to the evaluation of treatment response and long-term outcome in LN. METHODS: Sixty-seven patients with active LN were included. Renal biopsies were performed at diagnosis and after standard induction immunosuppressive therapy in all patients (median 8 months), regardless of clinical outcome...
2014: Lupus Science & Medicine
Nuria Montero, Angela C Webster, Ana Royuela, Javier Zamora, Marta Crespo Barrio, Julio Pascual
BACKGROUND: Pancreas or kidney-pancreas transplantation improves survival and quality of life for people with type 1 diabetes mellitus and kidney failure. Immunosuppression after transplantation is associated with complications. Steroids have adverse effects on cardiovascular risk factors such as hypertension, hyperglycaemia or hyperlipidaemia, increase risk of infection, obesity, cataracts, myopathy, bone metabolism alterations, dermatologic problems and cushingoid appearance. Whether avoiding steroids changes outcomes is unclear...
2014: Cochrane Database of Systematic Reviews
(no author information available yet)
OBJECTIVE: Data of general status of clinical presentation and therapy of IgA nephropathy in children in China are lacking. This study aimed to investigate the clinical presentations and treatment status of children with IgA nephropathy in China. METHOD: The investigation was organized by Chinese Society of Pediatric Nephrology. Thirty five centers from 23 provinces/municipalities of China participated in the study. Children no more than 18 years old who were diagnosed by renal biopsy as IgA nephropathy from July 1, 2008 to June 20, 2011 were included...
July 2013: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Martin Kumnig, Gerhard Rumpold, Stefan Höfer, Paul König, Bernhard Holzner, Johannes Giesinger, Eva-Maria Gamper, August Zabernigg, Andrea Hoflehner
BACKGROUND: Patient-reported outcomes (PROs) are important in managing kidney transplant patients. Although, there are many instruments available to assess PROs, such as health-related quality of life (HRQOL), they are rarely collected in routine nephrology practices. Therefore, the aim of this study was the determination of reference values for physical and psychosocial symptom burden in kidney transplant patients. METHODS: Patients with a history of kidney transplantation being in aftercare at a nephrological outpatient unit (n = 120) were consecutively recruited, and a computer-based PRO assessment was used to assess their HRQOL reference values...
January 2014: Wiener Klinische Wochenschrift
Gianfranco Ferraccioli, Elisa Gremese
Nephritis in systemic lupus erythematosus is one of the manifestations of organ damage in this autoimmune disease. Class IV is the most ominous among the classes of nephritides and there are conflicting reports on whether class IV-G lupus nephritis differs from class IV-S as defined by the International Society of Nephrology and the Renal Pathology Society (ISN/RPS) in terms of kidney and patient survival. There is, however, general agreement that 15-30% of patients with class IV nephritis do not reach remission and that a similar percentage (15-30%) of those reaching remission relapses...
November 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Walter Seeling, Max Plischke, Christian Schuh
Immunosuppressive therapy is necessary when patients with chronic kidney disease receive a kidney transplant. Certain immunosuppressive agents need therapeutic drug monitoring. The goal of this paper was to identify adaptation rules for Tacrolimus therapy from a clinical data set. For knowledge acquisition, patient data from 1995 to 2008 from the Department of Nephrology and Dialysis of the Vienna General Hospital were used, including patient demographics, laboratory parameters, time since kidney transplantation and other immuno-suppressive drugs administered...
2012: Studies in Health Technology and Informatics
Luiz Carlos Ferreira da Silva, Roseana de Almeida Freitas, Manoel Pacheco de Andrade, Marta Rabello Piva, Paulo Ricardo Saquete Martins-Filho, Thiago de Santana Santos
To prevent rejection of kidney transplants, patients must be kept in immunosuppressive therapy for a long time, which includes the use of drugs such as cyclosporine, azathioprine, cyclophosphamide, and prednisone. The action of these drugs reduces the general immune response of transplant patients and thus increases their susceptibility to infections. Moreover, these drugs increase the potential of developing lesions. Therefore, oral hygiene in kidney transplant recipients contributes to maintenance of the transplanted organ and its function...
May 2012: Journal of Craniofacial Surgery
Wei Chen, Qinghua Liu, Yunhua Liao, Zhenhua Yang, Jian Chen, Junzhou Fu, Jinli Zhang, Yaozhong Kong, Ping Fu, Tanqi Lou, Zhengrong Liu, Yulian Ji, Zhibin Li, Xueqing Yu
INTRODUCTION: The treatment of adult refractory idiopathic membranous nephropathy with steroid and other immunosuppressant-resistant nephrotic syndrome can be a significant challenge. The authors investigated the efficacy and safety of tacrolimus (TAC) as a promising regimen. METHODS: A prospective, multicenter trial was conducted in 9 nephrology centers from 2006 to 2008. Fourteen patients were enrolled. In conjunction with prednisone, TAC was started at 0.05 mg/kg/d, titrated to achieve a trough blood level of 5 to 10 ng/mL for the first 6 months, then reduced to 4 to 6 ng/mL for the subsequent 6 months...
February 2013: American Journal of the Medical Sciences
Danilo D'Ettorre, Lorenzo Di Liberato, Vittorio Sirolli, Paolo Cappelli, Mario Bonomini
The current treatment of chronic inflammatory bowel diseases involves the administration of different immunosuppressive drugs, whose use is associated with several side effects. Among the treatment alternatives, clinicians are attracted by leukapheresis, a method able to selectively remove from the circulation molecules involved in the onset and maintenance of inflammation. From 2007 to 2008, six patients were recruited from our clinics; four patients were affected by ulcerative colitis and two by Crohn's disease...
January 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Seyyal Rota, Kibriya Fidan, Gülendam Bozdayı, Aydın Dalgıç, Işıl Fidan, Gülsan Sucak, Tuba Müderris
Human polyomaviruses, namely BK (BKV) and JC (JCV) viruses are small DNA viruses that cause latent infections worldwide. Primary infections are usually acquired in the early periods of life and are generally asymptomatic. However BKV/JCV infections may cause severe clinical conditions in immunosuppressive patients such as bone marrow and solid organ transplantation or cancer patients. The aim of this retrospective study was to investigate the presence of BKV and JCV nucleic acids by real-time polymerase chain reaction (RT-PCR) in the clinical samples of patients with high risk...
April 2011: Mikrobiyoloji Bülteni
Hans-Peter Tony, Gerd Burmester, Hendrik Schulze-Koops, Mathias Grunke, Joerg Henes, Ina Kötter, Judith Haas, Leonore Unger, Svjetlana Lovric, Marion Haubitz, Rebecca Fischer-Betz, Gamal Chehab, Andrea Rubbert-Roth, Christof Specker, Jutta Weinerth, Julia Holle, Ulf Müller-Ladner, Ramona König, Christoph Fiehn, Philip Burgwinkel, Klemens Budde, Helmut Sörensen, Michael Meurer, Martin Aringer, Bernd Kieseier, Cornelia Erfurt-Berge, Michael Sticherling, Roland Veelken, Ulf Ziemann, Frank Strutz, Praxis von Wussow, Florian M P Meier, Nico Hunzelmann, Enno Schmidt, Raoul Bergner, Andreas Schwarting, Rüdiger Eming, Michael Hertl, Rudolf Stadler, Michael Schwarz-Eywill, Siegfried Wassenberg, Martin Fleck, Claudia Metzler, Uwe Zettl, Jens Westphal, Stefan Heitmann, Anna L Herzog, Heinz Wiendl, Waltraud Jakob, Elvira Schmidt, Klaus Freivogel, Thomas Dörner
INTRODUCTION: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting. METHODS: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases...
May 13, 2011: Arthritis Research & Therapy
Muhammad Ziad Souqiyyeh, Faisal A M Shaheen
To survey the attitude of the physicians in Saudi Arabia toward the evaluation and treatment of glomerulonephritis (GN) patients, a questionnaire was sent to the medical directors of 175 dialysis centers in the KSA. The study was performed from July to November 2010. A total of 171 (97.7%) medical directors of dialysis centers answered the questionnaire. There were 131 (77%) respondents who followed up hospitalized or out-patients with nephrological problems other than dialysis at their corresponding hospitals...
March 2011: Saudi Journal of Kidney Diseases and Transplantation
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