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https://www.readbyqxmd.com/read/29778558/successful-kidney-transplant-with-eculizumab-thymoglobulin-and-belatacept-therapy-in-a-highly-sensitised-patient-with-atypical-haemolytic-uraemic-syndrome-due-to-factor-h-mutation
#1
John Fredy Nieto-Ríos, Mónica Zuluaga-Quintero, Diana Carolina Bello-Márquez, Arbey Aristizabal-Alzate, Catalina Ocampo-Kohn, Lina María Serna-Higuita, Lina Arias, Gustavo Zuluaga-Valencia
Atypical haemolytic uremic syndrome is a disease caused by complement regulation abnormalities that generally progresses to chronic end-stage renal disease with a high rate of recurrence in kidney transplantation and a high risk of graft loss. Anti-complement therapy has improved the prognosis of these patients, achieving disease remission in most cases, increasing the likelihood of a successful kidney transplant and increasing patient and graft survival. Drugs with low risk of induction of thrombotic microangiopathies such as belatacept and mycophenolate have also been used with satisfactory results...
May 16, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29765543/igg4-related-kidney-disease-the-effects-of-a-rituximab-based-immunosuppressive-therapy
#2
Giacomo Quattrocchio, Antonella Barreca, Andrea Demarchi, Laura Solfietti, Giulietta Beltrame, Roberta Fenoglio, Michela Ferro, Paola Mesiano, Stefano Murgia, Giulio Del Vecchio, Carlo Massara, Cristiana Rollino, Dario Roccatello
IgG4-related disease (IgG4-RD) is a recently recognized disorder, characterized by elevated serum IgG4 concentrations, dense tissue infiltration of IgG4-positive plasma cells and storiform fibrosis. Treatment is usually based on steroids, however, relapses and long-term adverse effects are frequent. We prospectively studied 5 consecutive patients with histologically-proven IgG4-RD and renal involvement, treated with an extended Rituximab protocol combined with steroids. Two doses of intravenous cyclophosphamide were added in 4 patients...
April 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#3
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29751781/full-normalization-of-severe-hypertension-after-parathryoidectomy-a-case-report-and-systematic-review
#4
Andreea Corina Sofronie, Isabelle Kooij, Claude Bursot, Giulia Santagati, Jean-Philippe Coindre, Giorgina Barbara Piccoli
BACKGROUND: Although the relationship between hyperparathyroidism and hypertension has been described for decades, the role of hyperparathyroidism in hypertension in dialysis is still unclear. Following the case of a severely hypertensive dialysis patient, in which parathyroidectomy (PTX) corrected the metabolic imbalance and normalized blood pressure (BP), we tried to contextualize our observation with a systematic review of the recent literature on the effect of PTX on BP. CASE PRESENTATION: A dialysis patient, aged 19 years at the time of this report, with chronic kidney disease (CKD) from childhood; he was an early-preterm baby with very low birth weight (910 g), and is affected by a so-far unidentified familial nephropathy...
May 11, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29740436/understanding-the-cellular-origin-of-the-mononuclear-phagocyte-system-sheds-light-on-the-myeloid-postulate-of-immune-paralysis-in-sepsis
#5
REVIEW
Lionel Franz Poulin, Corentin Lasseaux, Mathias Chamaillard
Sepsis, in essence, is a serious clinical condition that can subsequently result in death as a consequence of a systemic inflammatory response syndrome including febrile leukopenia, hypotension, and multiple organ failures. To date, such life-threatening organ dysfunction remains one of the leading causes of death in intensive care units, with an increasing incidence rate worldwide and particularly within the rapidly growing senior population. While most of the clinical trials are aimed at dampening the overwhelming immune response to infection that spreads through the bloodstream, based on several human immunological investigations, it is now widely accepted that susceptibility to nosocomial infections and long-term sepsis mortality involves an immunosuppressive phase that is characterized by a decrease in some subsets of dendritic cells (DCs)...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29735033/pancreas-transplantation-for-patients-with-type-1-and-type-2-diabetes-mellitus-in-the-united-states-a-registry-report
#6
REVIEW
Angelika C Gruessner, Rainer W G Gruessner
Successful pancreas transplantation is still the only method to restore short-term and long-term insulin independence and good metabolic control for patients with diabetes. Since the first transplant in 1966, tremendous progress in outcome was made; however, transplant numbers have declined since 2004. This article describes the development and risk factors of pancreas transplantation with or without a kidney graft between 2001 and 2016. Patient survival and graft function improved significantly owing to careful recipient and donor selection, which reduced technical failure and immunologic graft loss rates...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29734149/recent-advances-in-treatment-strategies-for-lupus-nephritis
#7
Kazunori Karasawa, Keiko Uchida, Tomo Takabe, Takahito Moriyama, Kosaku Nitta
Systemic lupus erythematosus (SLE) is an autoimmune chronic inflammatory disease that affects multiple organs and tissues. Lupus nephritis (LN) is a serious complication of SLE, which occurs at a high rate. Conventional treatment strategies of LN have been widely accepted by two concepts such as induction therapy and maintenance therapy. In LN induction therapy until recently, cyclophosphamide in combination with prednisone (PSL) has been the standard method of treatment for proliferative forms of LN. In the latest review, the combination of mycophenolate mofetil (MMF) is also considered a standard treatment option...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29731924/the-spectrum-of-histopathological-changes-in-the-renal-allograft-a-12-months-protocol-biopsy-study
#8
Galina Severova-Andreevska, Ladislava Grcevska, Gordana Petrushevska, Koco Cakalaroski, Aleksandar Sikole, Olivera Stojceva-Taneva, Ilina Danilovska, Ninoslav Ivanovski
INTRODUCTION: Renal transplantation became a routine and successful medical treatment for Chronic Kidney Disease in the last 30 years all over the world. Introduction of Luminex based Single Antigen Beads (SAB) and recent BANFF consensus of histopathological phenotypes of different forms of rejection enables more precise diagnosis and changes the therapeutic approach. The graft biopsies, protocol or cause, indicated, remain a golden diagnostic tool for clinical follow up of kidney transplant recipients (KTR)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29731096/causes-of-ineligibility-for-recipients-in-living-kidney-transplantation
#9
N Masaki, K Iwadoh, A Kondo, I Koyama, I Nakajima, S Fuchinoue
BACKGROUND: Even if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. METHODS: We targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29729178/-primary-renal-amyloidosis-feautures-of-disease-course-and-the-possibilities-of-in-time-diagnosis-clinical-case-report
#10
Ivan P Katerenchuk, Lidia A Tkachenko, Tetiana Yarmola, Oleksandr I Katerenchuk
The article presents a clinical case of primary renal amyloidosis that was diagnosed in female patient. Typically, the spectrum of clinical signs of primary amyloidosis is wide: from moderate symptoms in some patients having localized amyloidosis, to life-threatening conditions that require rapid diagnosis determination and aggressive treatment. Finding a diagnosis of primary renal amyloidosis is enough difficult as for family doctors as for well-skilled nephrologists. In some cases, the primary renal amyloidosis starts with atypical symptoms, and so, only doctor's sufficient clinical experience combined with the in-time usage of highly informative diagnostic methods (morphological and immunological evaluation of the renal biopsy), allows to make an in-time diagnosis of the disease and to prescribe specific therapy that can slow down the disease progression and delay the time of severe complications development...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29725650/effect-of-frequent-dialysis-on-renal-recovery-results-from-the-acute-renal-failure-trial-network-study
#11
Anitha Vijayan, Rowena B Delos Santos, Tingting Li, Charles W Goss, Paul M Palevsky
Introduction: The optimal frequency of intermittent hemodialysis (IHD) in the treatment of acute kidney injury (AKI) remains unclear. Increasing the frequency of IHD, while offering the possible advantage of reduced ultrafiltration requirement and less hemodynamic instability per session, amplifies patient contact with an extracorporeal circuit with possible deleterious cardiovascular and immunological consequences. A recent study suggested that intensive renal replacement therapy (RRT) is associated with a decrease in urine output during AKI...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29707870/polypeptide-with-high-zwitterion-density-for-safe-and-effective-therapeutics
#12
Peng Zhang, Priyesh Jain, Caroline Tsao, Zhefan Yuan, Wenchen Li, Bowen Li, Kan Wu, Hsiang-Chieh Hung, Xiaojie Lin, Shaoyi Jiang
Stealth materials are widely used in nano-formulations to improve the performance of therapeutics. As the current "gold standard", poly(ethylene glycol) (PEG) polymer effectively promotes the pharmacokinetics of veiled therapeutic cargos while reducing their immune responses. However, recent studies suggested that the usage of PEG could induce adverse reactions, including the emergence of anti-PEG antibodies and PEG-induced tissue histologic changes, therefore casting a shadow over its future therapeutic applications...
April 29, 2018: Angewandte Chemie
https://www.readbyqxmd.com/read/29707619/differences-in-proinflammatory-cytokines-and-monocyte-subtypes-in-older-as-compared-with-younger-kidney-transplant-recipients
#13
Emily C Liang, Maura Rossetti, Tiffany Sidwell, Victoria Groysberg, Gema Sunga, Yael Korin, Sitaram Vangala, Basmah Abdalla, Erik Lum, Suphamai Bunnapradist, Phuong-Thu Pham, Gabriel Danovitch, Elaine F Reed, Joanna Schaenman
Background: The number of elderly patients with end-stage kidney disease requiring kidney transplantation continues to grow. Evaluation of healthy older adults has revealed proinflammatory changes in the immune system, which are posited to contribute to age-associated illnesses via "inflamm-aging." Immunologic dysfunction is also associated with impaired control of infections. Whether these immunologic changes are found in older kidney transplant recipients is not currently known, but may have important implications for risk for adverse clinical outcomes...
March 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29697013/long-term-survival-of-kidney-grafts-in-lupus-nephritis-a-mexican-cohort
#14
J C Ramirez-Sandoval, H Chavez-Chavez, M Wagner, O Vega-Vega, L E Morales-Buenrostro, R Correa-Rotter
Kidney transplant for patients with lupus nephritis (LN) has satisfactory outcomes in studies with short-term or mid-term follow up. Nevertheless, information about long-term outcomes is scarce. We performed a retrospective matched-pair cohort study in 74 LN recipients compared with 148 non-LN controls matched by age, sex, immunosuppressive treatment, human leukocyte antigen (HLA) matches, and transplant period in order to evaluate long-term outcomes of kidney transplant in LN recipients. Matched pairs were predominantly females (83%), median age at transplant surgery of 32 years (interquartile range 23-38 years), and 66% received a graft from a living related donor...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29696565/emerging-role-of-semaphorin-3a-in-autoimmune-diseases
#15
REVIEW
Li-Na Liu, Xiao-Mei Li, Dong-Qing Ye, Hai-Feng Pan
Autoimmune diseases (ADs) are featured by the body's immune responses being directed against its own tissues, resulting in prolonged inflammation and subsequent tissue damage. Currently, the exact pathogenesis of ADs remains not fully elucidated. Semaphorin-3A (Sema3A), a secreted member of semaphorin family, is a potent immunoregulator during all immune response stages. Sema3A has wide expression, such as in bone, connective tissue, kidney, neurons, and cartilage. Sema3A can downregulate ADs by suppressing the over-activity of both T-cell and B-cell autoimmunity...
April 25, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29696081/proteomic-analysis-reveals-different-composition-of-extracellular-vesicles-released-by-two-trypanosoma-cruzi-strains-associated-with-their-distinct-interaction-with-host-cells
#16
Kleber Silva Ribeiro, Camilla Ioshida Vasconcellos, Rodrigo Pedro Soares, Maria Tays Mendes, Cameron C Ellis, Marcela Aguilera-Flores, Igor Correia de Almeida, Sergio Schenkman, Leo Kei Iwai, Ana Claudia Torrecilhas
Trypanosoma cruzi , the aetiologic agent of Chagas disease, releases vesicles containing a wide range of surface molecules known to affect the host immunological responses and the cellular infectivity. Here, we compared the secretome of two distinct strains (Y and YuYu) of T. cruzi , which were previously shown to differentially modulate host innate and acquired immune responses. Tissue culture-derived trypomastigotes of both strains secreted extracellular vesicles (EVs), as demonstrated by electron scanning microscopy...
2018: Journal of Extracellular Vesicles
https://www.readbyqxmd.com/read/29673068/molecular-definition-of-the-transplantation-antigens
#17
REVIEW
Peter Parham
In the first half of the twentieth century, the Major Histocompatibility Complex (MHC) of the laboratory mouse, the H-2 complex, was defined by a combination of serology and genetics. In the second half of the twentieth century, its human counterpart, the Human Leukocyte Antigen (HLA) complex was similarly defined and shown to mediate rejection of allogeneic kidney grafts. The clinical relevance of the transplantation antigens created the field of transplant immunology, which aimed to reduce graft rejection by HLA matching of transplant donors and recipients, and to use immunosuppressive drugs to prevent and treat rejection...
April 19, 2018: FEBS Journal
https://www.readbyqxmd.com/read/29670389/fgf23-modulates-the-effects-of-erythropoietin-on-gene-expression-in-renal-epithelial-cells
#18
Mitsuru Yashiro, Masaki Ohya, Toru Mima, Yumi Ueda, Yuri Nakashima, Kazuki Kawakami, Yohei Ishizawa, Shuto Yamamoto, Sou Kobayashi, Takurou Yano, Yusuke Tanaka, Kouji Okuda, Tomohiro Sonou, Tomohiro Shoshihara, Yuko Iwashita, Yu Iwashita, Kouichi Tatsuta, Ryo Matoba, Shigeo Negi, Takashi Shigematsu
Background: FGF23 plays an important role in calcium-phosphorus metabolism. Other roles of FGF23 have recently been reported, such as commitment to myocardium enlargement and immunological roles in the spleen. In this study, we aimed to identify the roles of FGF23 in the kidneys other than calcium-phosphorus metabolism. Methods: DNA microarrays and bioinformatics tools were used to analyze gene expression in mIMCD3 mouse renal tubule cells following treatment with FGF23, erythropoietin and/or an inhibitor of ERK...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29667907/direct-peritoneal-resuscitation-reduces-leukocyte-infiltration-in-the-kidney-after-acute-brain-death
#19
Jessica Lee Weaver, Paul J Matheson, Amy Matheson, Victoria S Graham, Cynthia Downard, Richard Neal Garrison, Jason W Smith
Brain death is associated with significant inflammation within the kidneys, which may contribute to reduced graft survival. Direct peritoneal resuscitation (DPR) has been shown to reduce systemic inflammation after brain death. To determine its effects, brain dead rats were resuscitated with normal saline (targeted intravenous fluid, TIVF) to maintain a mean arterial pressure of 80 mmHg and DPR animals also received 30cc of intraperitoneal peritoneal dialysis solution. Rats were euthanized at zero, two, four, and six hours after brain death...
April 18, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29663071/cyclosporine-a-responsive-congenital-nephrotic-syndrome-with-single-heterozygous-variants-in-nphs1-nphs2-and-plce1
#20
Anna Eichinger, Sabine Ponsel, Carsten Bergmann, Roman Günthner, Julia Hoefele, Kerstin Amann, Bärbel Lange-Sperandio
BACKGROUND: Congenital nephrotic syndrome (CNS) is primarily a monogenetic disease, with the majority of cases due to changes in five different genes: the nephrin (NPHS1), podocin (NPHS2), Wilms tumor 1 (WT1), laminin ß2 (LAMB2), and phospholipase C epsilon 1 (PLCE1, NPHS3) gene. Usually CNS is not responsive to immunosuppressive therapy, but treatment with ACE inhibitors, AT1 receptor blockade and/or indomethacin can reduce proteinuria. If the disease progresses to end-stage renal disease, kidney transplantation is the therapy of choice...
April 16, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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