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By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
https://www.readbyqxmd.com/read/29359118/immunoglobulin-g4-related-kidney-diseases-an-updated-review
#1
REVIEW
Maurizio Salvadori, Aris Tsalouchos
This review will encompass definition, pathogenesis, renal clinical manifestations and treatment of immunoglobulin G4-related diseases (IgG4-RDs). IgG4-RD is a recently recognized clinical entity that often involves multiple organs and is characterized by high levels of serum immunoglobulins G4, dense infiltration of IgG4+ cells and storiform fibrosis. Cellular immunity, particularly T-cell mediated immunity, has been implicated in the pathogenesis of IgG4-RDs. The most frequent renal manifestations of IgG4-RD are IgG4-related tubulointerstitial nephritis, membranous glomerulopathy and obstructive nephropathy secondary to urinary tract obstruction due to IgG4-related retroperitoneal fibrosis...
January 6, 2018: World Journal of Nephrology
https://www.readbyqxmd.com/read/29736379/antineutrophil-cytoplasmic-antibody-associated-vasculitides-with-renal-involvement-open-challenges-in-the-remission-induction-therapy
#2
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Renal involvement with rapidly progressive glomerulonephritis is a common manifestation of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides, which is characterized by end-stage renal disease and high mortality rates in untreated and/or late referral patients. The long-term renal survival has improved dramatically since the addition of cyclophosphamide (CYC) and recently of rituximab (RTX) in association with corticosteroids in the remission induction therapeutic regimens. However, renal prognosis remains unfavorable for many patients and the mortality rate is still significantly high...
May 6, 2018: World Journal of Nephrology
https://www.readbyqxmd.com/read/29716794/proliferative-glomerulonephritis-with-monoclonal-immunoglobulin-g-deposits-is-associated-with-high-rate-of-early-recurrence-in-the-allograft
#3
Samar M Said, Fernando G Cosio, Anthony M Valeri, Nelson Leung, Sanjeev Sethi, Hassan Salameh, Lynn D Cornell, Mary E Fidler, Mariam P Alexander, Fernando C Fervenza, Maria Eleni Drosou, Da Zhang, Vivette D D'Agati, Samih H Nasr
The characteristics of allograft proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID) are not well defined. To better characterize this disease we retrospectively identified 26 patients with allograft PGNMID, including 16 followed with early protocol biopsies. PGNMID was found to be a recurrent disease in most (89%) patients. A diagnostic biopsy was done for proteinuria and/or increased creatinine in most patients. Median time from transplant to diagnostic biopsy was 5.5 months, with detection within three to four months post-transplant in 86% of patients...
April 28, 2018: Kidney International
https://www.readbyqxmd.com/read/29548021/the-utility-of-trough-mycophenolic-acid-levels-for-the-management-of-lupus-nephritis
#4
Negiin Pourafshar, Ashkan Karimi, Xuerong Wen, Eric Sobel, Shirin Pourafshar, Nikhil Agrawal, Emma Segal, Rajesh Mohandas, Mark S Segal
Background: Monitoring of mycophenolic acid (MPA) levels may be useful for effective mycophenolate mofetil (MMF) dosing. However, whether commonly obtained trough levels are an acceptable method of surveillance remains debatable. We hypothesized that trough levels of MPA would be a poor predictor of area under the curve (AUC) for MPA. Methods: A total of 51 patients with lupus nephritis who were on MMF 1500 mg twice a day and had a 4-h AUC done were included in this study...
March 13, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29398134/kidney-disease-in-the-setting-of-hiv-infection-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#5
Charles R Swanepoel, Mohamed G Atta, Vivette D D'Agati, Michelle M Estrella, Agnes B Fogo, Saraladevi Naicker, Frank A Post, Nicola Wearne, Cheryl A Winkler, Michael Cheung, David C Wheeler, Wolfgang C Winkelmayer, Christina M Wyatt
HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population...
March 2018: Kidney International
https://www.readbyqxmd.com/read/28832357/recurrent-glomerular-disease-after-kidney-transplantation
#6
REVIEW
Christopher D Blosser, Roy D Bloom
PURPOSE OF REVIEW: With improving short-term kidney transplant outcomes, recurrent glomerular disease is being increasingly recognized as an important cause of chronic allograft failure. Further understanding of the risks and pathogenesis of recurrent glomerular disease enable informed transplant decisions, along with the development of preventive and treatment strategies. RECENT FINDINGS: Multiple observational studies have highlighted differences in rates and outcomes for various recurrent glomerular diseases, although these rates have not markedly improved over the last decade...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29449955/prospects-for-precision-medicine-in-glomerulonephritis-treatment
#7
REVIEW
Yulu Cherry Liu, Justin Chun
Background: Glomerulonephritis (GN) consists of a group of kidney diseases that are categorized based on shared histopathological features. The current classifications for GN make it difficult to distinguish the individual variability in presentation, disease progression, and response to treatment. GN is a significant cause of end-stage renal disease (ESRD), and improved therapies are desperately needed because current immunosuppressive therapies sometimes lack efficacy and can lead to significant toxicities...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29462348/long-term-follow-up-of-a-combined-rituximab-and-cyclophosphamide-regimen-in-renal-anti-neutrophil-cytoplasm-antibody-associated-vasculitis
#8
Stephen P McAdoo, Nicholas Medjeral-Thomas, Seerapani Gopaluni, Anisha Tanna, Nicholas Mansfield, Jack Galliford, Megan Griffith, Jeremy Levy, Thomas D Cairns, David Jayne, Alan D Salama, Charles D Pusey
Background: Current guidelines advise that rituximab or cyclophosphamide should be used for the treatment of organ-threatening disease in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV), although few studies have examined the efficacy and safety of these agents in combination. Methods: We conducted a single-centre cohort study of 66 patients treated with a combination of oral corticosteroids, rituximab and low-dose pulsed intravenous cyclophosphamide followed by a maintenance regimen of azathioprine and tapered steroid for the treatment of biopsy-proven renal involvement in AAV...
February 14, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29459092/revision-of-the-international-society-of-nephrology-renal-pathology-society-classification-for-lupus-nephritis-clarification-of-definitions-and-modified-national-institutes-of-health-activity-and-chronicity-indices
#9
Ingeborg M Bajema, Suzanne Wilhelmus, Charles E Alpers, Jan A Bruijn, Robert B Colvin, H Terence Cook, Vivette D D'Agati, Franco Ferrario, Mark Haas, J Charles Jennette, Kensuke Joh, Cynthia C Nast, Laure-Hélène Noël, Emilie C Rijnink, Ian S D Roberts, Surya V Seshan, Sanjeev Sethi, Agnes B Fogo
We present a consensus report pertaining to the improved clarity of definitions and classification of glomerular lesions in lupus nephritis that derived from a meeting of 18 members of an international nephropathology working group in Leiden, Netherlands, in 2016. Here we report detailed recommendations on issues for which we can propose adjustments based on existing evidence and current consensus opinion (phase 1). New definitions are provided for mesangial hypercellularity and for cellular, fibrocellular, and fibrous crescents...
April 2018: Kidney International
https://www.readbyqxmd.com/read/29401359/anti-phospholipase-a2-receptor-antibodies-in-primary-membranous-nephropathy-10-key-points
#10
Emily P McQuarrie
No abstract text is available yet for this article.
February 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29378770/management-of-membranous-nephropathy-in-the-pla-2-r-era
#11
Andrew S Bomback
No abstract text is available yet for this article.
May 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28905856/position-paper-revised-2017-international-consensus-on-testing-of-ancas-in-granulomatosis-with-polyangiitis-and-microscopic-polyangiitis
#12
REVIEW
Xavier Bossuyt, Jan-Willem Cohen Tervaert, Yoshihiro Arimura, Daniel Blockmans, Luis Felipe Flores-Suárez, Loïc Guillevin, Bernhard Hellmich, David Jayne, J Charles Jennette, Cees G M Kallenberg, Sergey Moiseev, Pavel Novikov, Antonella Radice, Judith Anne Savige, Renato Alberto Sinico, Ulrich Specks, Pieter van Paassen, Ming-Hui Zhao, Niels Rasmussen, Jan Damoiseaux, Elena Csernok
Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications...
November 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/27837947/recent-advances-in-our-understanding-of-recurrent-primary-glomerulonephritis-after-kidney-transplantation
#13
REVIEW
Fernando G Cosio, Daniel C Cattran
Recurrent glomerulonephritis (GN) is an important cause of kidney allograft failure, particularly in younger recipients. Approximately 15% of death-censored graft failures are due to recurrent GN, but this incidence is likely an underestimation of the magnitude of the problem. Overall, 18% to 22% of kidney allografts are lost due to GN, either recurrent or presumed de novo. The impact of recurrent GN on allograft survival was recognized from the earliest times in kidney transplantation. However, progress in this area has been slow, and our understanding of GN recurrence remains limited, in large part due to incomplete understanding of the pathogenesis of these diseases...
February 2017: Kidney International
https://www.readbyqxmd.com/read/27821390/update-on-lupus-nephritis
#14
REVIEW
Salem Almaani, Alexa Meara, Brad H Rovin
SLE is a chronic inflammatory disease that affects the kidneys in about 50% of patients. Lupus nephritis is a major risk factor for overall morbidity and mortality in SLE, and despite potent anti-inflammatory and immunosuppressive therapies still ends in CKD or ESRD for too many patients. This review highlights recent updates in our understanding of disease epidemiology, genetics, pathogenesis, and treatment in an effort to establish a framework for lupus nephritis management that is patient-specific and oriented toward maintaining long-term kidney function in patients with lupus...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27528553/the-relatively-poor-correlation-between-random-and-24-hour-urine-protein-excretion-in-patients-with-biopsy-proven-glomerular-diseases
#15
Marie C Hogan, Heather N Reich, Peter J Nelson, Sharon G Adler, Daniel C Cattran, Gerald B Appel, Debbie S Gipson, Matthias Kretzler, Jonathan P Troost, John C Lieske
Random urine protein creatinine ratios are used to estimate 24-hour urine protein excretion, which is considered a diagnostic gold standard. However, few studies are available of the sensitivity and specificity of this estimation in patients with glomerular proteinuria. To clarify this, we measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease...
November 2016: Kidney International
https://www.readbyqxmd.com/read/27481040/the-clinical-presentation-and-therapy-of-diseases-related-to-anti-neutrophil-cytoplasmic-antibodies-anca
#16
REVIEW
Maria Weiner, Mårten Segelmark
Anti-neutrophil cytoplasmic antibodies (ANCA) are a family of autoantibodies that react with proteins predominantly expressed in cytoplasmic granules of polymorphonuclear neutrophil granulocytes (PMNs). ANCA was initially detected using indirect immunofluorescence, allowing for different patterns such as p-ANCA (perinuclear) and c-ANCA (cytoplasmic) to be distinguished. Today it is common to detect the antibodies by immunochemical assays such as ELISA using purified proteins as antigens. The strongest association with ANCA is found in the pauci-immune small vessel vasculitides granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)...
October 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27498206/plasmapheresis-for-the-treatment-of-kidney-diseases
#17
REVIEW
William F Clark, Shih-Han S Huang, Michael W Walsh, Myriam Farah, Ainslie M Hildebrand, Jessica M Sontrop
The purpose of this review is to examine the evidence supporting the application of plasma exchange in renal disease. Our review focuses on the following 6 most common renal indications for plasma exchange based on 2014 registry data from the Canadian Apheresis Group: (i) thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome; (ii) renal transplantation, (iii) anti-neutrophil cytoplasm antibodies-associated vasculitis, (iv) cryoglobulinemia, (v) focal segmental glomerulosclerosis, and (vi) Goodpasture syndrome...
November 2016: Kidney International
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/27324941/2015-homer-w-smith-award-the-podocyte-from-periphery-to-center-stage
#19
REVIEW
Dontscho Kerjaschki
This overview summarizes selected major developments over the last 40 years in understanding podocyte biology and its involvement in glomerular disease subjectively from my perspective. Serendipity has played a major role in my contributions to investigative nephrology that range from basic mechanisms of immune deposit formation in experimental membranous nephropathy to the role of a microRNA in FSGS. This review emphasizes the importance of continuous reality checks of experimental results obtained in vitro or with genetically modified animals with human disease...
November 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27432742/kidney-transplantation-outcomes-across-gn-subtypes-in-the-united-states
#20
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...
February 2017: Journal of the American Society of Nephrology: JASN
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