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https://www.readbyqxmd.com/read/29657202/outcomes-of-immunosuppression-in-iga-nephropathy-based-on-the-oxford-classification
#1
Dharmenaan Palamuthusingam, Clare Castledine, Sarah Lawman
Numerous studies have addressed the predictive value of pathology findings from the Oxford Classification. Whether this influences treatment choice has not been determined. We evaluated patients with IgA nephropathy who were immunosuppressed and correlated our findings with both clinical and histological features as per the Oxford Classification. This was a retrospective observational study of 45 patients who had biopsy-proven IgA nephropathy with a mean follow-up of 2.6 years. Primary outcomes were time to end-stage renal disease (ESRD) or a 50% rise in serum creatinine...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29578397/fibrillary-glomerulonephritis-in-an-hiv-patient-without-concurrent-hepatitis-c-infection-case-report-and-review-of-the-literature
#2
Lian Zhang, John M Carson, M Scott Lucia
The most common renal disease associated with human immunodeficiency virus infection (HIV) is HIV-associated nephropathy (HIVAN), especially in the African American patient population. However, various patterns of glomerulonephritis (GN) are not uncommon, collectively accounting for nearly half of the renal biopsies performed in HIV patients. Most GNs that occur in HIV patients are immune complex mediated, often with concurrent infections such as hepatitis B or C. Fibrillary glomerulonephritis (FGN), a rare primary glomerular disease, has only been reported in 2 HIV patients, and both patients had concurrent hepatitis C (HCV) infection...
March 26, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29574675/warfarin-related-nephropathy-with-acute-kidney-injury-in-a-patient-with-immunoglobulin-a-nephropathy
#3
Hiroki Ishii, Keiji Hirai, Katsunori Yanai, Taisuke Kitano, Mitsutoshi Shindo, Haruhisa Miyazawa, Kiyonori Ito, Yuichiro Ueda, Yoshio Kaku, Taro Hoshino, Honami Mori, Susumu Ookawara, Yoshihiko Ueda, Yoshiyuki Morishita
A 55-year-old man with Marfan syndrome taking warfarin for anticoagulant therapy after aortic valve replacement developed acute kidney injury (serum creatinine level of 9.01 mg/dL) and gross macrohematuria. Renal biopsy showed red cell casts in the renal tubules, glomerular crescent formation in the glomeruli with immunoglobulin A deposition, and global sclerosis. Based on these findings, the patient was diagnosed with warfarin-related nephropathy with acute kidney injury characterized by immunoglobulin A nephropathy with crescents...
March 24, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29564665/the-features-in-iga-dominant-infection-related-glomerulonephritis-distinct-from-iga-nephropathy-a-single-center-study
#4
Takaya Handa, Hiroko Kakita, Yu Tateishi, Tomomi Endo, Hiroyuki Suzuki, Toshiro Katayama, Tatsuo Tsukamoto, Eri Muso
BACKGROUND: IgA-dominant infection-related glomerulonephritis (IgA-IRGN) is a unique form of IRGN, which needs to be distinguished from IgA nephropathy (IgAN). METHODS: Thirteen patients with IgA-IRGN (IgA-IRGN group) and 122 with IgAN (IgAN group) were selected from 1788 patients who underwent kidney biopsy between 2000 and 2015 in Kitano Hospital. Data selected included clinical and serological parameters; light and electron microscope findings; immunofluorescence findings; and prognostic parameters like renal and overall survival and creatinine increase by > 50%...
March 21, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29456220/importance-of-renal-biopsy-in-patients-aged-60-years-and-older-experience-from-a-tertiary-care-hospital
#5
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/29456207/medical-renal-disease-in-tumor-nephrectomies-the-silent-killer
#6
Rohit Tewari, Rajat Bajaj, Reena Bharadwaj
In tumor nephrectomy specimens, the evaluation of the normal renal parenchyma is often overlooked. A patient with both end-stage renal diseases (ESRDs) with a renal cell carcinoma is more likely to die of the ESRD rather than cancer. At the time of nephrectomy, a pathologist has a large amount of tissue available to him to comment upon the presence of disease in the nonneoplastic kidney. Hence, this study was undertaken with the idea of characterizing disease in the nonneoplastic kidney at the time of tumor nephrectomy...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29432215/an-update-on-predicting-renal-progression-in-iga-nephropathy
#7
Sean Barbour, Heather Reich
PURPOSE OF REVIEW: Immunoglobulin A (IgA) nephropathy (IgAN) is a heterogeneous disease, and predicting individual patient risk of renal progression is challenging. Recent studies provide new evidence regarding the use of clinical, histologic, and biomarker predictors of renal outcome in IgAN. RECENT FINDINGS: A meta-analysis of clinical trials demonstrated that early change in proteinuria is a valid surrogate outcome measure for longer term decline in renal function, which supports the use of proteinuria to dynamically re-evaluate patient prognosis over time...
February 9, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29410298/renal-outcomes-in-primary-iga-nephropathy-patients-with-segmental-glomerular-necrosis-a-case-control-study
#8
Min Pan, Ji Zhang, Xiaohan You, Duo Li, Yinqiu Lv, Jianna Zhang, Xiaokai Ding, Zhanyuan Li, Feifei Xu, Chaosheng Chen
The renal prognosis and treatment of primary IgA nephropathy (IgAN) patients with segmental glomerular necrosis (SGN) remain controversial. Patients with primary IgAN confirmed by renal biopsy were enrolled. Patients with SGN on renal biopsy were selected as the necrosis group, and a propensity score matching method was used to match a control group according to age, gender, weight, height and follow-up time. A total of 825 IgAN patients were enrolled in the present study. Seventy-three (8.8%) patients with SGN were selected as the necrosis group, and 292 patients without SGN were matched as the control group...
February 1, 2018: Human Pathology
https://www.readbyqxmd.com/read/29407303/treatment-of-immunoglobulin-a-nephropathy-recurrence-post-renal-transplant
#9
P S Malhotra, T Jorna, S Bhandari
Immunoglobulin A nephropathy (IgAN) is the most commonly occurring glomerulonephritis. Recurrence of disease in the transplanted kidney can significantly reduce allograft survival rates. Currently, there is no definitive management plan for IgAN recurrence in a transplant that reduces the rate of decline of allograft function and prolongs time to dialysis or re-transplantation. Herein we present a 48-year-old man who had received a renal transplantation in 2006 following his diagnosis of IgAN. In 2015, the patient was noted to have an elevated blood pressure and proteinuria (urinary protein:creatinine ratio [uPCR] 170 mg/mmol)...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29285431/acute-kidney-injury-aggravated-by-treatment-initiation-with-apixaban-another-twist-of-anticoagulant-related-nephropathy
#10
Sergey V Brodsky, Nilesh S Mhaskar, Sampath Thiruveedi, Rajnish Dhingra, Sharon C Reuben, Edward Calomeni, Iouri Ivanov, Anjali Satoskar, Jessica Hemminger, Gyongyi Nadasdy, Lee Hebert, Brad Rovin, Tibor Nadasdy
Anticoagulant-related nephropathy (ARN) was initially described in patients on warfarin (as warfarin-related nephropathy) and recently in those using dabigatran. Herein, we report clinical history and kidney biopsy findings in a patient on apixaban (Eliquis). Initiation of treatment with apixaban resulted in aggravation of preexisting mild acute kidney injury (AKI). A few days after apixaban therapy, the patient became oligoanuric, and kidney biopsy showed severe acute tubular necrosis with numerous occlusive red blood cell casts...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29197971/comparison-of-long-term-follow-up-outcomes-between-multiple-drugs-combination-therapy-and-tonsillectomy-pulse-therapy-for-pediatric-iga-nephropathy
#11
Yukihiko Kawasaki, Ryo Maeda, Syuto Kanno, Yuichi Suzuki, Shinichiro Ohara, Kazuhide Suyama, Mitsuaki Hosoya
BACKGROUND: To clarify the long-term efficacy of multiple-drugs combination therapy (PWDM) and tonsillectomy pulse therapy (TPT) for pediatric IgA nephropathy (IgAN), we retrospectively evaluated the clinical and laboratory findings as well as the prognosis for IgAN patients treated with each treatment at long-term follow-up. METHODS: We collected data on 61 children who had been diagnosed with severe IgAN. The children were retrospectively divided into two groups...
December 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29185209/value-of-the-oxford-classification-of-iga-nephropathy-in-children-with-henoch-sch%C3%A3-nlein-purpura-nephritis
#12
Ke Xu, Lili Zhang, Jie Ding, Suxia Wang, Baige Su, Huijie Xiao, Fang Wang, Xuhui Zhong, Yanming Li
BACKGROUND: The widely used International Study of Kidney Disease in Children (ISKDC) classification for Henoch-Schönlein purpura nephritis (HSPN) does not completely correlate with the clinical presentation and long-term prognosis of this disease. Primary IgA nephropathy (IgAN) and HSPN share common features; thus, the Oxford classification of IgAN might be useful in predicting the long-term outcomes of HSPN. However, its value has not been confirmed in children with HSPN. METHODS: We selected children with HSPN diagnosed between 2003 and 2015, and reclassified their renal biopsies according to the Oxford classification scoring system...
April 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29178575/serum-iga-c3-and-glomerular-c3-staining-predict-severity-of-iga-nephropathy
#13
Yukihiko Kawasaki, Ryo Maeda, Shinichiro Ohara, Kazuhide Suyama, Mitsuaki Hosoya
BACKGROUND: The aim of this study was to determine whether serum immunoglobulin A/complement factor 3 (IgA/C3) ratio and glomerular C3 staining predict outcome in IgA nephropathy. METHODS: We collected data for 44 IgA nephropathy children treated with multi-drug combination therapy. The children were retrospectively divided into four groups based on serum IgA/C3 ratio and glomerular C3 staining: group A, IgA/C3 ratio >2.68 (median) and glomerular C3 staining ≥2...
February 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29170179/anca-positive-iga-nephropathy-without-necrotising-or-crescentic-glomerulonephritis-a-clinical-conundrum
#14
Abhilash Koratala, Xu Zeng, Amir Kazory
IgA nephropathy, the most prevalent form of primary glomerular disease, usually portends a favourable outcome. Antineutrophil cytoplasmic autoantibodies (ANCAs) have been reported in association with IgA nephropathy in a small subset of patients, mostly presenting with rapidly progressive glomerulonephritis and necrotising crescentic lesions. Herein, we describe a case of IgA nephropathy, positive serum cytoplasmic and perinuclear ANCAs with anti-myeloperoxidase antibody, and preserved renal function without any histological evidence of necrotising or crescentic glomerulonephritis...
November 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29115212/endemic-influences-of-political-regimes-healthcare-systems-and-preferences-on-the-frequencies-and-incidences-of-nephropathies-in-eastern-saxony-germany%C3%A2
#15
Sam Sedaghat, Eleène Sahmila Heshmati, Thomas Frese, Wilma Gertrud Rasche, Filip Barinka, Florian Fahr, Joachim Beige, Stephan Schiekofer, Franz Maximilian Rasche
INTRODUCTION: The possible confounding influence of investigator-related preferences, available histological techniques, and healthcare systems on the frequencies and incidences of primary and secondary nephropathies was evaluated in this long-term observation. MATERIALS AND METHODS: The observation time from 1983 to 2010 was divided in regard to the political regimes: a) prior to and after German reunification: German Democratic Republic (GDR, period 1 from 1983 to 1990)/Federal Republic of Germany (FRG, period 2 from 1990 to 2010); and the two heads of the division of nephrology, b) conductor 1 (1983 - 2006) and conductor 2 (2006 - 2010)...
December 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29101552/long-term-renal-outcome-in-pediatric-glomerulonephritis-associated-with-crescent-formation
#16
Pornpimol Rianthavorn, Manunya Chacranon
BACKGROUND: Information on long-term renal outcome of pediatric glomerulonephritis associated with crescent formation is limited. A single center retrospective study was conducted to assess long-term renal survival and to determine whether the 2010 classification for antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis can predict renal outcome in pediatric glomerulonephritis associated with crescent formation. METHODS: Biopsy and clinical data of children, aged ≤ 18 years with ≥ 10 glomeruli and ≥ 10% crescentic glomeruli during January 1998 to December 2015, were reviewed...
November 3, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29054943/non-infectious-aortitis-in-an-immunosuppressed-renal-transplant-recipient-with-iga-nephropathy
#17
Charlotte M Snead, Stephen C Crockett, Phillippa K Bailey
A 54-year-old woman presented with atypical chest pain, fever and malaise. She was immunosuppressed with three agents following a living-donor kidney transplant 1 year previously. Her native kidney failure was secondary to biopsy-demonstrated crescentic IgA nephropathy, with systemic involvement. A CT pulmonary angiogram revealed an inflammatory cuff of soft tissue around the descending thoracic aorta suggesting aortitis. Inflammatory markers were elevated. Given her immunosuppression, the patient was screened extensively for infective causes and was empirically commenced on intravenous meropenem...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29018146/anca-and-iga-glomerulonephritis-all-in-one-prognosis-and-complications
#18
Pitchaphon Nissaisorakarn, Vivette D'Agati, Kisra Anis, Belinda Jim
We present the case of a 75-year-old Hispanic woman with known stage 3 chronic kidney disease, long-standing hypertension and type 2 diabetes mellitus who presented with right-sided abdominal pain and acute kidney injury, nephrotic range proteinuria with positive antimyeloperoxidase antibody. A renal biopsy revealed IgA nephropathy with superimposed pauci-immune antineutrophilic cytoplasmic antibody (ANCA)-associated crescentic glomerulonephritis. The patient was treated with pulse intravenous methylprednisolone, cyclophosphamide and plasmapheresis...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28992348/location-of-glomerular-immune-deposits-not-codeposition-of-immunoglobulin-g-influences-definitive-renal-outcomes-in-immunoglobulin-a-nephropathy
#19
Anthony S Alvarado, Nicole K Andeen, Sergey Brodsky, Alice Hinton, Tibor Nadasdy, Charles E Alpers, Christopher Blosser, Behzad Najafian, Brad H Rovin
Background: It has been suggested that the prognosis of immunoglobulin (IgA) nephropathy (IgAN) is adversely affected if there is codeposition of IgG in the glomeruli or if immune deposits are present in the glomerular capillary walls. We sought to understand how these variables affect clinical outcome. Methods: A total of 80 IgAN biopsies were retrospectively divided into groups: (i) IgA without IgG deposition versus IgA + IgG and (ii) immune deposits restricted to the mesangium versus mesangium and peripheral capillary walls (PCWs)...
August 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28984299/medical-renal-diseases-are-frequent-but-often-unrecognized-in-adult-autopsies
#20
Marie E Perrone, Anthony Chang, Kammi J Henriksen
Kidney diseases affect many hospitalized patients and contribute to morbidity and mortality. Therefore, kidney disease should be prevalent, but the frequency and spectrum of medical renal pathology in autopsy specimens has not been well documented. We sought to determine the spectrum of medical renal pathology in adult autopsy specimens and the frequency of overlooked diagnoses. We reviewed the hematoxylin- and eosin-stained kidney sections from 140 adult autopsies performed at a large teaching hospital over a 2-year period...
October 6, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
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