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https://www.readbyqxmd.com/read/29525605/treatment-and-clinical-outcomes-of-elderly-idiopathic-membranous-nephropathy-a-multicenter-cohort-study-in-korea
#1
Eunjin Bae, Sung Woo Lee, Seokwoo Park, Dong Ki Kim, Hajeong Lee, Hyuk Huh, Ho Jun Chin, Shina Lee, Dong-Ryeol Ryu, Ji In Park, Sejoong Kim, Dong Jun Park, Shin-Wook Kang, Yon Su Kim, Yun Kuy Oh, Yong Chul Kim, Chun Soo Lim, Jung Tak Park, Jung Pyo Lee
Idiopathic membranous nephropathy (MN) is the most common glomerulonephritis in elderly patients showing nephrotic syndrome. However, little is known about its treatment options and outcomes in elderly MN patients at long term follow-up. We retrospectively enrolled patients with biopsy-proven MN between April 1990 and December 2015 from eight tertiary hospitals in Korea. Among them, we excluded patients who had secondary causes of MN and subnephrotic-range proteinuria. We evaluated the presenting features and clinical outcomes and analyzed the all-cause mortality, renal outcomes, infection, and remission with respect to age...
March 3, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29456220/importance-of-renal-biopsy-in-patients-aged-60-years-and-older-experience-from-a-tertiary-care-hospital
#2
Pallav Gupta, Devinder Singh Rana
As the life expectancy is increasing, there is a rise in elderly population and consequent increase in the patients with renal disease. There is an inconsistency between clinical and histopathological diagnosis in elderly, and so renal biopsy is important in these patients to decide appropriate clinical management and prognosis. This study outlines the importance of renal biopsy in elderly and describes the clinical and pathologic spectrum of renal diseases in patient ≥60 years. All patients (age ≥60 years) undergoing renal biopsies from January 2011 to December 2014 were included in this retrospective study...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29441190/nephrotic-syndrome-in-very-elderly-should-we-treat-aggressively
#3
Abhilash Koratala, Jogiraju Tantravahi
Chronic kidney disease and acute kidney injury are being increasingly recognized in very elderly patients, aged 80 or more. In cases of suspected glomerulonephritis with or without nephrotic syndrome, the clinical decision-making of whether to obtain a renal biopsy and treat with immunosuppressive therapy should not be based on advanced age alone but take into consideration the patient's functional status and overall prognosis. Herein, we report a case of an elderly patient with minimal change disease who benefitted from a timely renal biopsy and aggressive immunosuppressive therapy...
January 8, 2018: Clinics and Practice
https://www.readbyqxmd.com/read/29403303/the-clinicopathological-features-of-patients-with-membranous-nephropathy
#4
Hanyu Zhu, Qiuxia Han, Dong Zhang, Yong Wang, Jing Gao, Xiaoli Yang, Wenjia Geng, Xiangmei Chen
Background: Membranous nephropathy (MN) represents a distinct glomerular disease which has been considered as a major cause of nephrotic syndrome (NS) in adults. Evidences show that the clinicopathological features of MN are various among MN cases. This study aimed to summarize and analyze the clinicopathological features of patients with MN. Methods: A total of 231 MN patients were recruited in this study. Their clinical and pathological features were collected and analyzed according to their age, gender, pathological stages, and anti-phospholipase A2 receptor (anti-PLA2R) antibodies tests...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29395322/thymoma-associated-myasthenia-gravis-and-lgi1-encephalitis-with-nephrotic-syndrome-post-thymectomy
#5
Jyh Yung Hor, Thien Thien Lim, Mei Chih Cheng, Yuen Kang Chia, Chee Keong Wong, Su Min Lim, Chun Fai Cheah, Kenny Tan, P E Samuel Easaw, M Isabel Leite
Thymoma is associated with a wide spectrum of autoimmune paraneoplastic syndromes, though it is uncommon for multiple paraneoplastic syndromes to be present in a single individual. We report a rare case of an elderly gentleman who was found to have thymoma-associated myasthenia gravis and LGI1-encephalitis with myokymia, who presented with nephrotic syndrome (minimal change glomerulopathy) after thymectomy. The latter two paraneoplastic syndromes had manifested when prednisolone was tapered down to low dose...
January 30, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29259860/steroid-resistant-nephrotic-syndrome-caused-by-co-inheritance-of-mutations-at-nphs1-and-adck4-genes-in-two-chinese-siblings
#6
Hongwen Zhang, Fang Wang, Xiaoyu Liu, Xuhui Zhong, Yong Yao, Huijie Xiao
Hereditary nephrotic syndrome often presents with steroid-resistance and onset within the first year of life. Mutations in genes highly expressed in podocytes have been found in two thirds of these patients, especially NPHS1 and NPHS2 among at least 29 genetic causes that have been discovered. We reported two siblings with steroid-resistant nephrotic syndrome caused by co-inheritance of mutations at NPHS1 (c.1339G>A, p.E447K) and ACDK4 (c.748G>C, p.D250H) genes. The siblings presented with steroid-resistant nephrotic syndrome and pathological lesions of focal segmental glomerulosclerosis (FSGS), while the elder sister also developed hypertension, renal failure and cardiac dysfunction...
November 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/29214407/clinical-features-and-pathogenesis-of-membranoproliferative-glomerulonephritis-a-nationwide-analysis-of-the-japan-renal-biopsy-registry-from-2007-to-2015
#7
Naoki Nakagawa, Naoyuki Hasebe, Motoshi Hattori, Michio Nagata, Hitoshi Yokoyama, Hiroshi Sato, Hitoshi Sugiyama, Akira Shimizu, Yoshitaka Isaka, Shoichi Maruyama, Ichiei Narita
BACKGROUND: The incidence and age distribution of membranoproliferative glomerulonephritis (MPGN) vary throughout the world by race and ethnicity. We sought to evaluate the clinical features, pathogenesis, and age distribution of MPGN among a large nationwide data from the Japan Renal Biopsy Registry (J-RBR). METHODS: A cross-sectional survey of 593 patients with MPGN (types I and III) registered in the J-RBR between 2007 and 2015 was conducted. Clinical parameters, and laboratory findings at diagnosis were compared between children (< 20 years), adults (20-64 years), and elderly patients (≥ 65 years)...
December 6, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28954579/an-exceptional-cause-of-hemoptysis-in-the-elderly-patient-iga-vasculitis
#8
Aline Pourcelet, Marine Georgery, Frederic Vandergheynst, Jean-Michel Hougardy, Sandra De Breucker
We describe here the case of a 73-year-old woman who presented a recurrent macular rash, acute respiratory distress, and hemoptysis. Chest CT scan showed diffuse ground-glass opacities that were suggestive of alveolar hemorrhage. With the development of severe acute kidney injury and nephrotic-range proteinuria (creatininemia 2.6 from 1.9 mg/dL with overt proteinuria 34 from 2.1 g/g creat), a kidney-lung syndrome was evoked. Skin biopsy revealed leukocytoclastic vasculitis with IgA deposits. Blood tests showed an increased IgA level...
September 28, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28859624/living-kidney-transplantation-between-brothers-with-unrecognized-renal-amyloidosis-as-the-first-manifestation-of-familial-mediterranean-fever-a-case-report
#9
Ramón Peces, Sara Afonso, Carlos Peces, Julián Nevado, Rafael Selgas
BACKGROUND: Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever and polyserositis and by the onset of reactive amyloid-associated amyloidosis. Amyloidosis due to familial Mediterranean fever can lead to end-stage renal disease, culminating in kidney transplantation for some patients. In this study, we report the clinical outcome of two brothers with familial Mediterranean fever who were the inadvertent donor and recipient, respectively, of a kidney...
August 31, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28503551/a-case-of-fibrillary-glomerulonephritis-with-fibril-deposition-in-the-arteriolar-wall-and-a-family-history-of-renal-disease
#10
Kentaro Watanabe, Kentaro Nakai, Nozomi Hosokawa, Shuhei Watanabe, Keiji Kono, Shunsuke Goto, Hideki Fujii, Shigeo Hara, Shinichi Nishi
Herein, we report a case of fibrillary glomerulonephritis (FGN). FGN usually shows non-amyloidal fibrils in the mesangium and glomerular capillary walls on electron microscopy. Inherited cases of FGN have been reported in only 3 families, and the suspected genetic form was autosomal dominant. In the present case, the deposition of microfibrils in the arteriolar wall as well as the glomerulus is unique. Our patient's father died of nephrotic syndrome, and his elder brother had a biopsy-proven glomerulopathy...
January 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28425160/causes-of-nephrotic-syndrome-and-nephrotic-range-proteinuria-are-different-in-adult-chinese-patients-a-single-centre-study-over-33%C3%A2-years
#11
Jack Kit-Chung Ng, Terry King-Wing Ma, Fernand Mac-Moune Lai, Kai Ming Chow, Bonnie Ching-Ha Kwan, Chi Bon Leung, Philip Kam-To Li, Cheuk Chun Szeto
BACKGROUND: The reported causes of nephrotic syndrome (NS) varied between different countries. Less is known about the causes of nephrotic-range proteinuria (NPU). METHODS: In this single-centre, retrospective study of adult patients who underwent renal biopsy between 1983-2015 in a tertiary referral hospital in Hong Kong, we aimed to evaluate the underlying causes of NS and NPU. We also determined the distribution of histopathological diagnoses with regard to the age subgroups and time periods RESULTS: Among 7,456 patients who underwent renal biopsy, 982 and 838 patients had NS and NPU, respectively...
April 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28384915/paraneoplastic-glomerulopathy-in-a-case-of-collecting-duct-renal-cell-carcinoma
#12
Srikanth Prasad Devarsetty, Dharshan Rangaswamy, Shailaja Bhat, Shankar Prasad Nagaraju, Ravindra Prabhu Attur
Paraneoplastic glomerulopathy has been described in established cases of the solid tumors of lung, gastrointestinal system, breast, etc., and rarely in patients with Renal Cell Carcinoma (RCC). Studies on secondary glomerular diseases have described a higher incidence of IgA nephropathy in patients with RCC compared to membranous glomerulopathy, which are commonly reported in malignancies of the lung and gastrointestinal tract. Collecting Duct Carcinoma (CDC), a rare high grade adenocarcinoma accounts for <1% of all renal malignancies...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28339709/clinicopathologic-correlations-of-renal-pathology-in-the-adult-population-of-poland
#13
Agnieszka Perkowska-Ptasinska, Artur Bartczak, Malgorzata Wagrowska-Danilewicz, Agnieszka Halon, Krzysztof Okon, Aldona Wozniak, Marian Danilewicz, Henryk Karkoszka, Andrzej Marszalek, Jolanta Kowalewska, Andrzej Mroz, Agnieszka Korolczuk, Andrzej Oko, Alicja Debska-Slizien, Beata Naumnik, Zbigniew Hruby, Marian Klinger, Kazimierz Ciechanowski, Marek Myslak, Wladyslaw Sulowicz, Andrzej Rydzewski, Andrzej Wiecek, Jacek Manitius, Tadeusz Gregorczyk, Stanislaw Niemczyk, Michal Nowicki, Ryszard Gellert, Tomasz Stompor, Monika Wieliczko, Krzysztof Marczewski, Leszek Paczek, Olga Rostkowska, Dominika Deborska-Materkowska, Grazyna Bogdanowicz, Andrzej Milkowski, Magdalena Durlik
Background: This is the first report on the epidemiology of biopsy-proven kidney diseases in Poland. Methods: The Polish Registry of Renal Biopsies has collected information on all (n = 9394) native renal biopsies performed in Poland from 2009 to 2014. Patients' clinical data collected at the time of biopsy, and histopathological diagnoses were used for epidemiological and clinicopathologic analysis. Results: There was a gradual increase in the number of native renal biopsies performed per million people (PMP) per year in Poland in 2009-14, starting from 36 PMP in 2009 to 44 PMP in 2014...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27855638/alteration-of-histone-h3k4-methylation-in-glomerular-podocytes-associated-with-proteinuria-in-patients-with-membranous-nephropathy
#14
Takayuki Fujino, Naoyuki Hasebe
BACKGROUND: Histone H3K4 trimethylation (H3K4 me3) is found in active euchromatic regions and plays an important role in podocyte function in which actin filaments are abundant in the foot processes. The pathogenesis of membranous nephropathy (MN), the most prevalent cause of primary nephrotic syndrome in the middle-aged and elderly, is podocyte dysfunction. METHODS: We investigated the role of H3K4 me3 in podocyte dysfunction in nephrotic syndrome using cultured podocytes and a mouse proteinuria model induced by LPS...
November 17, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27596627/biopsy-proven-kidney-diseases-in-the-elderly-clinical-characteristics-renal-histopathological-spectrum-and-prognostic-factors
#15
Yue Chen, Ping Li, Chunli Cui, Aihong Yuan, Kun Zhang, Chen Yu
Objective To explore the clinical characteristics, renal histopathological spectrum and prognostic factors of biopsy-proven kidney diseases in the elderly. Methods A retrospective observational study was conducted in elderly patients who had received renal biopsies. Demographic, clinical and pathological data at the time of the biopsy were collected from the medical records. Follow-up records and prognostic factors were studied. Results The elderly (≥60 years) accounted for 74 of 434 (17.1%) native renal biopsies that were performed in a 9-year period...
October 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27536673/management-of-membranous-nephropathy-in-western-countries
#16
REVIEW
Talal Alfaadhel, Daniel Cattran
BACKGROUND: Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults in Western countries. In 2012, the KDIGO (Kidney Disease: Improving Global Outcomes) working group published guidelines for the management of glomerulonephritis, thus providing a template for the treatment of this condition. While being aware of the impact of the clinicians' acumen and that patients may choose a different therapeutic option due to the risks of specific drugs and also of the evolving guidelines, this review details our approach to the management of patients with IMN in a Western center (Toronto)...
September 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27536672/management-of-membranous-nephropathy-in-asia
#17
REVIEW
Jing Xu, Xiaofan Hu, Jingyuan Xie, Nan Chen
BACKGROUND: Membranous nephropathy (MN) is the most common cause of nephrotic syndrome (NS) in adults, accounting for about 20.0% of all NS cases. With an increasing prevalence, especially in the elderly, it has received great attention in Asia. SUMMARY: Recently, the prevalence of idiopathic MN (IMN) has significantly increased among the elderly people in Asia and other places in the world. Although the exact mechanism of IMN remains unveiled, the identification of new antigens such as PLA2R and THSD7A has greatly enhanced our understanding of its pathogenesis...
September 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27297947/novel-type-of-renal-amyloidosis-derived-from-apolipoprotein-cii
#18
Samih H Nasr, Surendra Dasari, Linda Hasadsri, Jason D Theis, Julie A Vrana, Morie A Gertz, Prasuna Muppa, Michael T Zimmermann, Karen L Grogg, Angela Dispenzieri, Sanjeev Sethi, W Edward Highsmith, Giampaolo Merlini, Nelson Leung, Paul J Kurtin
Amyloidosis is characterized by extracellular deposition of misfolded proteins as insoluble fibrils. Most renal amyloidosis cases are Ig light chain, AA, or leukocyte chemotactic factor 2 amyloidosis, but rare hereditary forms can also involve the kidneys. Here, we describe the case of a 61-year-old woman who presented with nephrotic syndrome and renal impairment. Examination of the renal biopsy specimen revealed amyloidosis with predominant involvement of glomeruli and medullary interstitium. Proteomic analysis of Congo red-positive deposits detected large amounts of the Apo-CII protein...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27241076/-giant-cell-aortitis-complicated-by-aa-amyloidosis-diagnosed-with-imaging-techniques-report-of-a-case
#19
J-P Hammelin, G Cardon, M Reberolle, F Moulonguet, Y Neugebauer, G Raybaud, V Gnemmi, E Hachulla
INTRODUCTION: AA amyloidosis is a common but severe complication of many chronic inflammatory processes of infectious, autoimmune, or neoplastic origin. It frequently leads to renal damage, often presenting as a nephrotic syndrome. Giant cell arteritis is a common inflammatory arteritis in elderly people, but rarely complicated by AA amyloidosis. CASE REPORT: We report an 87-year-old female who presented with a nephrotic syndrome and a chronic inflammation, in whom the kidney biopsy showed secondary amyloidosis...
February 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/26844777/renal-biopsy-in-2015-from-epidemiology-to-evidence-based-indications
#20
REVIEW
Marco Fiorentino, Davide Bolignano, Vladimir Tesar, Anna Pisano, Wim Van Biesen, Graziella D'Arrigo, Giovanni Tripepi, Loreto Gesualdo
BACKGROUND: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. SUMMARY: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications...
2016: American Journal of Nephrology
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