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nephritis,kidney disease,kidney transplant

R J Turner, M Eikmans, I M Bajema, J A Bruijn, H J Baelde
Vascular endothelial growth factor A (VEGF-A) is essential for maintaining the glomerular filtration barrier. Absolute renal levels of VEGF-A change in patients with diabetic nephropathy and inflammatory kidney diseases, but whether changes in the renal splicing patterns of VEGF-A play a role remains unclear. In this study, we investigated mRNA splicing patterns of pro-angiogenic isoforms of VEGF-A in glomeruli and whole kidney samples from human patients with kidney disease and from mouse models of kidney disease...
2016: PloS One
Terry King-Wing Ma, Stephen P McAdoo, Frederick Wai-Keung Tam
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN)...
2016: Nephron
Nicola Wearne, Ikechi G Okpechi
The cause of the human immunodeficiency virus (HIV) epidemic in South Africa (SA) was worsened by the denial by key political players that HIV causes acquired immunodeficiency syndrome (AIDS). South Africa continues to have the highest rate of HIV world-wide, which has had a huge impact on the development of both chronic kidney disease and acute kidney injury. Fortunately, there is now an effective antiretroviral therapy (ART) roll-out program. SA is also dealing with a collision of epidemics of HIV, tuberculosis, and non-communicable disease, particularly hypertension and diabetes...
July 29, 2016: Clinical Nephrology
Mary Lynn Davis-Ajami, Jeffery C Fink, Jun Wu
BACKGROUND: Nephrotoxic medication exposure increases risks for acute kidney injury, permanent renal function loss, and costly preventable adverse drug events. Exposure to medications associated with inducing acute tubular nephritis or tubular toxicity versus nonexposure among those with predialysis renal disease-a population vulnerable to increased risk of kidney injury-may affect health services utilization and cost outcomes. Few studies quantify nephrotoxic medication exposure in chronic kidney disease (CKD) and associated costs...
August 2016: Journal of Managed Care & Specialty Pharmacy
Michelle M O'Shaughnessy, Sai Liu, Maria E Montez-Rath, Colin R Lenihan, Richard A Lafayette, Wolfgang C Winkelmayer
Differences in kidney transplantation outcomes across GN subtypes have rarely been studied. From the US Renal Data System, we identified all adult (≥18 years) first kidney transplant recipients (1996-2011) with ESRD attributed to one of six GN subtypes or two comparator kidney diseases. We computed hazard ratios (HRs) for death, all-cause allograft failure, and allograft failure excluding death as a cause (competing risks framework) using Cox proportional hazards regression. Among the 32,131 patients with GN studied, patients with IgA nephropathy (IgAN) had the lowest mortality rates and patients with IgAN or vasculitis had the lowest allograft failure rates...
July 18, 2016: Journal of the American Society of Nephrology: JASN
Eve M D Smith, Michael W Beresford
Juvenile-onset systemic lupus erythematosus (JSLE) is a rare, severe multisystem autoimmune disease affecting the kidney (Lupus Nephritis, LN) in up to 80% of children. LN is more severe in children than adults, with potential for irreversible kidney damage requiring dialysis or transplant. Renal biopsy is currently the gold standard for diagnosing and monitoring LN, however, it is invasive and associated with complications. Urine biomarkers have been shown to be better than serum biomarkers in differentiating renal disease from other organ manifestations...
June 29, 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
J Teranishi, Y Hattori, T Mochizuki, T Kawahara, K Makiyama, H Uemura
BACKGROUND: Granulomatous interstitial nephritis (GIN) is a rare renal disease, and its etiology remains unknown. We report recurrent GIN in renal allograft successfully treated with everolimus (EVR). CASE REPORT: A 22-year-old man with GIN received a kidney from his mother. On follow-up 8 months later, his serum creatinine level was increased, from 1.3 mg/dL to 1.7 mg/dL, and he had microhematuria and proteinuria. A protocol graft biopsy at 1 year after transplantation showed epithelioid granuloma with multinucleated giant cells...
April 2016: Transplantation Proceedings
John Fredy Nieto-Ríos, Lina María Serna-Higuita, Sheila Alexandra Builes-Rodriguez, Ricardo Cesar Restrepo-Correa, Arbey Aristizabal-Alzate, Catalina Ocampo-Kohn, Angélica Serna-Campuzano, Natalia Cardona-Díaz, Nelson Darío Giraldo-Ramirez, Gustavo Adolfo Zuluaga-Valencia
BACKGROUND: Patients with lupus nephritis could progress to end-stage renal disease (10-22%); hence, kidney transplants should be considered as the treatment of choice for these patients. OBJECTIVE: To evaluate the clinical outcomes after kidney transplants in patients with chronic kidney diseases secondary to lupus nephritis, polycystic kidney disease and diabetes nephropathy at Pablo Tobon Uribe Hospital. METHODS: A descriptive and retrospective study performed at one kidney transplant center between 2005 and 2013...
2016: Colombia Médica: CM
Lei Zhang, Gavin Lee, Xusheng Liu, Elaine M Pascoe, Sunil V Badve, Neil C Boudville, Philip A Clayton, Carmel M Hawley, John Kanellis, Stephen P McDonald, Chen Au Peh, Kevan R Polkinghorne, David W Johnson
Patient outcomes in end-stage kidney disease (ESKD) secondary to lupus nephritis have not been well described. To help define this we compared dialysis and transplant outcomes of patients with ESKD due to lupus nephritis to all other causes. All patients diagnosed with ESKD who commenced renal replacement therapy in Australia and New Zealand (1963-2012) were included. Clinical outcomes were evaluated in both a contemporary cohort (1998-2012) and the entire 50-year cohort. Of 64,160 included patients, 744 had lupus nephritis as the primary renal disease...
June 2016: Kidney International
Rachel Gwertzman, Howard Corey, Isabel Roberti
BACKGROUND: Autoimmune polyglandular syndrome type 1 (APS 1) is an autosomal recessive disorder characterized by immune injury of multiple organ systems (primarily endocrine) secondary to a mutation in the autoimmune regulator (AIRE) gene. In some cases, patients develop tubulointerstitial nephritis (TIN) and progress to end-stage renal failure (ESRD). CASE DIAGNOSIS/TREATMENT: We describe two patients with APS 1 and TIN. In both cases, TIN was clinically silent and the diagnosis was confirmed by renal biopsy...
June 2016: Clinical Nephrology
Sarat Kuppachi, Deepkamal Kaur, Danniele G Holanda, Christie P Thomas
BK virus (BKV) is a non-enveloped DNA virus of the polyomaviridae family that causes an interstitial nephritis in immunosuppressed patients. BKV nephropathy is now a leading cause of chronic kidney disease and early allograft failure following kidney transplantation. It is also known to cause renal disease with a progressive decline in kidney function in non-renal solid organ transplant (NRSOT) recipients, although the disease may not be recognized nor its impact appreciated in this patient population. In this report, we review the existing literature to highlight our current understanding of its incidence in NRSOT populations, the approaches to diagnosis and the potential treatment options...
April 2016: Clinical Kidney Journal
I G Okpechi, O I Ameh
Lupus nephritis (LN) is a significant cause of morbidity and mortality in patients with systemic lupus erythematosus. Delayed recognition and diagnosis of LN may be a common cause of chronic kidney disease among South Africans. Renal biopsy is the gold standard of diagnosing LN; however, this service is not available in many centres and the use of urinalysis, urine microscopic examination and other serological tests can be useful in identifying patients with proliferative LN. Proliferative types of LN (class III, class IV and mixed class V)comprise the larger proportion of patients with this condition...
December 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Ayub Akbari, Michelle Hladunewich, Kevin Burns, Felipe Moretti, Rima Abou Arkoub, Pierre Brown, Swapnil Hiremath
BACKGROUND: Pregnancy in patients on chronic hemodialysis therapy, though unlikely, does happen rarely. Intensive hemodialysis is thought to offer a better survival advantage to the unborn child. Circulating angiogenic factors are helpful for prognostication of pregnant patients with chronic kidney disease who are not on dialysis. Data on their utilization in dialysis patients, however, are limited. CASE PRESENTATION: We report the case of a patient with a history of interstitial nephritis who had a kidney transplant that failed after 8 years due to membranous nephropathy...
2016: Canadian Journal of Kidney Health and Disease
Michelle M O'Shaughnessy, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD), while peritoneal dialysis affords certain benefits over hemodialysis. Distributions and determinants of first ESRD treatment modality have not been compared across glomerulonephritis (GN) subtypes. METHODS: We identified all adult (18-75 years) patients with ESRD attributed to any of six GN subtypes [focal segmental glomerulosclerosis (FSGS), IgA nephropathy (IgAN), membranous nephropathy (MN), membranoproliferative GN (MPGN), lupus nephritis (LN) and vasculitis] who were first registered in the US Renal Data System (USRDS) between 1996 and 2011...
February 2016: Nephrology, Dialysis, Transplantation
Samir Mallat, Maroun Moukarzel, David Atallah, Rima Abou Arkoub, Chebl Mourani
Cytomegalovirus (CMV) remains one of the most important pathogen responsible for the morbidity and mortality of transplantation patients. The impact on recipients depends on the form of CMV infection knowing that 10% to 50% develop symptomatic disease while solid organ involvement if presumed (e.g. CMV nephritis) may have deleterious outcome and requires histopathology testing. Treatment with antivirals IV ganciclovir and valganciclovir is managed according to early diagnostic tools with quantitative nucleic acid testing (QNAT) and antigenemia that will indicate the extent of disease and monitor response to treatment...
July 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
Alberto J Sabucedo, Gabriel Contreras
Kidney disease resulting from systemic lupus erythematosus accounts for 1.9% of the end-stage kidney disease (ESKD) population in the United States. Systemic lupus erythematosus patients with lupus nephritis (LN) who progress to ESKD in the United States are mostly female (81%) and of African ancestry (49%), with a mean age of 41 years at initiation of renal replacement therapy (RRT). The incidence of ESKD in patients with LN steadily increased between 1982 and 1998 because RRT was offered more readily to LN patients in the United States...
September 2015: Seminars in Nephrology
J Hashimoto, Y Hamasaki, T Yanagisawa, T Sekine, A Aikawa, S Shishido
An autosomal dominant hereditary disease, Epstein syndrome (ES) is characterized by sensorineural hearing impairment, macrothrombocytopenia, and hereditary nephritis, and can progress to end-stage kidney disease after puberty. Generally, kidney transplantation is difficult to perform in Epstein syndrome owing to the high risk of perioperative bleeding. Additionally, due to previous platelet transfusions, ES patients sometimes have antihuman leukocyte antigen (HLA) antibodies, including antiplatelet antibodies and donor-specific anti-HLA antibodies (DSA), which may result in refractoriness to platelet transfusion and antibody-mediated rejection (AMR)...
October 2015: Transplantation Proceedings
J Hasegawa, K Honda, S Wakai, H Shirakawa, K Omoto, M Okumi, H Ishida, K Tanabe
OBJECTIVE: We report a case of the clinical course and pathologic findings for a kidney transplant recipient with plasma cell-rich rejection (PCRR) accompanied by antibody-mediated rejection (ABMR). METHODS: A 29-year-old man with end-stage renal disease caused by lupus nephritis received an ABO-compatible living kidney transplant. RESULTS: Eighteen months after transplantation, the patient presented with proteinuria and increased serum creatinine...
October 2015: Transplantation Proceedings
Aygül Çeltİk, Saİt Şen, Abdülkerİm Furkan Tamer, Mümtaz Yılmaz, Banu Sarsık, Mehmet Özkahya, Alı Başçı, Hüseyİn Töz
AIM: Lupus nephritis (LN) is an important complication of systemic lupus erythematosus (SLE). The aim is to use indication and protocol biopsies to determine clinicopathological findings and outcomes of patients with LN undergoing kidney transplantation (KTx). METHODS: Patients who underwent KTx due to LN were retrospectively analyzed. Recurrent LN (RLN) was diagnosed by transplant kidney biopsy. RESULTS: Among 955 KTx patients, 12 patients with LN as the cause of end-stage renal disease were enrolled...
July 2016: Nephrology
Lei Zhang, Xusheng Liu, Elaine M Pascoe, Sunil V Badve, Neil C Boudville, Philip A Clayton, Janak De Zoysa, Carmel M Hawley, John Kanellis, Stephen P McDonald, Chen Au Peh, Kevan R Polkinghorne, David W Johnson
BACKGROUND: Clinical outcomes of patients with end-stage kidney disease (ESKD) receiving renal replacement therapy (RRT) secondary to IgA nephropathy (IgAN) have not been well described. AIM: To investigate the characteristics, treatments and outcomes of ESKD because of kidney-limited IgAN and Henoch-Schönlein purpura nephritis (HSPN) in the Australian and New Zealand RRT populations. METHODS: All ESKD patients who commenced RRT in Australia and New Zealand between 1971 and 2012 were included...
May 2016: Nephrology
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