scholarly journals In Acute IgA Nephropathy, Proteinuria and Creatinine Are in the Spot, but Podocyturia Operates in Silence: Any Place for Amiloride?

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
H. Trimarchi ◽  
M. Paulero ◽  
R. Canzonieri ◽  
A. Schiel ◽  
A. Iotti ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Specific Treatment ◽  
Young Male ◽  
Normal Subjects ◽  
Response To Therapy ◽  
Long Term Prognosis ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

IgA nephropathy is the most frequent cause of primary glomerulonephritis, portends erratic patterns of clinical presentation, and lacks specific treatment. In general, it slowly progresses to end-stage renal disease. The clinical course and the response to therapy are usually assessed with proteinuria and serum creatinine. Validated biomarkers have not been identified yet. In this report, we present a case of acute renal injury with proteinuria and microscopic hematuria in a young male. A kidney biopsy disclosed IgA nephropathy. Podocyturia was significantly elevated compared to normal subjects. Proteinuria, renal function, and podocyturia improved promptly after steroids and these variables remained normal after one year of follow-up, when steroids had already been discontinued and patient continued on valsartan and amiloride. Our report demonstrates that podocyturia is critically elevated during an acute episode of IgA nephropathy, and its occurrence may explain the grim long-term prognosis of this entity. Whether podocyturia could be employed in IgA nephropathy as a trustable biomarker for treatment assessment or even for early diagnosis of IgA nephropathy relapses should be further investigated.

A histologic classification of IgA nephropathy for predicting long-term prognosis: emphasis on end-stage renal disease

2012 ◽  
Vol 26 (2) ◽  
pp. 350-357 ◽  
Author(s):  
Tetsuya Kawamura ◽  
Kensuke Joh ◽  
Hideo Okonogi ◽  
Kentaro Koike ◽  
Yasunori Utsunomiya ◽  
...  
Keyword(s):  
Renal Disease ◽  
Iga Nephropathy ◽  
End Stage Renal Disease ◽  
Histologic Classification ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage

The Ethics of Infant Dialysis

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 505-509 ◽  
Author(s):  
Timothy E. Bunchman
Keyword(s):  
Standard Of Care ◽  
Health Care Team ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Number Of Factors ◽  
Long Term Prognosis ◽  
Infant Dialysis ◽  
Stage Renal Disease ◽  
End Stage

The proper treatment of an infant with end-stage renal disease depends upon a number of factors including parental willingness to take on the task, experience of the health-care team, local and regional resources, and society's willingness to accept this support as a standard of care. Whereas the abilityto keep infants aliveon peritoneal dialysis (PD) is obtainable, it is not without physical, financial, as well as emotional cost. In order for a family to agree to take on such a task, an understanding of the risks and long-term prognosis should be offered. This “informed consent” is difficult to obtain in such a highly charged situation when emotions often dictate choice independently of logic. Long-term outcome of infants on PD has improved over time, yet is still fraught with complications. Options of treatment or nontreatment are explored.

scholarly journals Coronary Revascularization Improves Long-Term Prognosis in Diabetic and Nondiabetic End-Stage Renal Disease

2002 ◽  
Vol 66 (6) ◽  
pp. 595-595 ◽  
Author(s):  
Jiro Aoki ◽  
Yuji Ikari ◽  
Hiroyoshi Nakajima ◽  
Tokuichiro Sugimoto ◽  
Kazuhiro Hara
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Coronary Revascularization ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage

IgA nephropathy: common nephritis leading to end-stage renal failure

1994 ◽  
Vol 17 (9) ◽  
pp. 457-460 ◽  
Author(s):  
K.N. Lai ◽  
A.Y.M. Wang
Keyword(s):  
Renal Failure ◽  
Iga Nephropathy ◽  
Significant Proportion ◽  
Specific Treatment ◽  
Prognostic Indicators ◽  
Initial Report ◽  
End Stage Renal Failure ◽  
High Incidence ◽  
End Stage

IgA nephropathy (IgAN) characterized by mesangial proliferative glomerulonephritis with predominant mesangial IgA deposition is the commonest glomerulonephritis worldwide. In contrast to the initial report indicated a favorable prognosis, subsequent reports have shown a highly variable outcome leading to end-stage renal failure (ESRF) in a significant proportion of patients. Many centers report a high incidence (ranging from 10-22%) of patients with idiopathic IgAN amongst the total population of patients on maintenance dialysis. Most of these patients develop ESRF at their middle-age and hence, will pose a significant and important workload in the dialysis and transplantation programme. Because IgAN is a disease with a variable rate of progression leading to chronic renal failure amongst younger patients and with neither effective nor specific treatment, identification of the clinical and pathologic prognostic indicators for these patients is of paramount importance in planning the long-term renal replacement program.

scholarly journals Long-term prognosis in patients with end-stage renal disease after coronary artery bypass grafting

2020 ◽  
Vol 12 (11) ◽  
pp. 6722-6730
Author(s):  
Philip Y. K. Pang ◽  
Christopher K. J. Teow ◽  
Ming Jie Huang ◽  
Madhava J. Naik ◽  
See Lim Lim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage

MO272CLINICOPATHOLOGICAL CORRELATION OF APRIL AND BAFF IN IG A NEPHROPATHY- A SINGLE CENTER LONGITUDINAL OBSERVATIONAL STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anjana Gopal ◽  
Noble Gracious
Keyword(s):  
Iga Nephropathy ◽  
End Stage Renal Disease ◽  
Study Group ◽  
Single Center ◽  
Tubular Atrophy ◽  
Longitudinal Observational Study ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage ◽  
Time Of Presentation

Abstract Background and Aims Aberrantly glycosylated IgA1 molecules are important in the pathogenesis of IgA nephropathy. A proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) are cytokines involved in immunoglobulin class switching and production of galactose deficient IgA1(Gd IgA1). We aimed to study the association of serum levels of APRIL and BAFF with the clinical severity and pathological grading of IgA nephropathy (IgAN) and to assess the strength of the association by studying the clinicopathological correlation. Method The research study was conducted as a single-center longitudinal observational study. The study subjects were recruited based on the pathological diagnosis of primary IgA nephropathy. The plasma levels of APRIL, BAFF and Gd IgA1 were estimated using enzyme-linked immunosorbent assay (ELISA). All the study subjects were followed up for one year to study the renal outcome. Results In our study group of thirty-eight patients, the median estimated glomerular filtration rate(eGFR) was 33.9(15.9,79.4) ml/minute/1.73m2. The median levels of the cytokines APRIL and BAFF were 170.81(82.45, 550.61) ng/L and 6.66(3.39,16.33) ng/ml respectively. The baseline characteristics of the study group is given in table 1. APRIL levels had significant positive correlation with Gd IgA1 levels (correlation coefficient 0.556, p=0.003) in patients with IgAN. We also observed that patients with elevated APRIL levels had elevated BAFF levels also (correlation coefficient 0.657, p <0.001). Patients who had crescents, mesangial hypercellularity and endocapillary proliferation in biopsy had elevated APRIL and BAFF levels whereas patients with segmental sclerosis and tubular atrophy had low levels of APRIL(Table 2). However, the levels of APRIL and BAFF did not show any significant correlation with eGFR and proteinuria at time of presentation. At the end of one year, 12(31.5%) patients reached end stage renal disease (ESRD) and these patients had lower levels of APRIL, BAFF, and Gd IgA1. It was also seen that eighty-three percent of those who reached ESRD had chronic changes in biopsy like tubular atrophy and interstitial fibrosis(p=0.05). Hence the severity of tubulointerstitial fibrosis in histology correlated well with progression to end stage renal disease as seen in most glomerular diseases. But we did not find any association between APRIL, BAFF, and Gd IgA1 levels and the decline in eGFR over one year. Conclusion We conclude that levels of APRIL and BAFF are associated with elevated levels of Gd IgA1 in patients with IgAN and had a significant association with proliferative lesions in renal biopsy. But these cytokines levels did not have any association with the eGFR at time of presentation nor decline in eGFR over one year.

scholarly journals Recent advances in the understanding and management of IgA nephropathy

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 161 ◽  
Author(s):  
Kar Neng Lai ◽  
Joseph C.K. Leung ◽  
Sydney C.W. Tang
Keyword(s):  
Iga Nephropathy ◽  
Specific Treatment ◽  
Developed Countries ◽  
Current Data ◽  
Therapeutic Approaches ◽  
Clinical Progression ◽  
Primary Glomerulonephritis ◽  
New Therapeutic Approaches ◽  
Stage Renal Disease ◽  
End Stage

Since its first description in 1968, IgA nephropathy has remained the most common form of primary glomerulonephritis leading to chronic kidney disease in developed countries. The clinical progression varies, and consequent end-stage renal disease occurs in 30% to 40% of patients 20 to 30 years after the first clinical presentation. Current data implicate overproduction of aberrantly glycosylated IgA1 as being pivotal in the induction of renal injury. Effective and specific treatment is still lacking, and new therapeutic approaches will be developed after better understanding the disease pathogenesis.

Intestinal microbiome and metabolome analyses reveal metabolic disorders in the early stage of renal transplantation

2021 ◽  
Author(s):  
Chiyu Ma ◽  
Jingquan He ◽  
Liusheng Lai ◽  
Yumei Chen ◽  
Wen Xue ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Metabolic Disorders ◽  
Early Stage ◽  
Intestinal Microbiome ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage

Renal transplantation is the most effective treatment for end-stage renal disease, but the long-term prognosis of organs after transplantation is not ideal. In recent years, the value of gut microbes...

Quantifying rates of protein synthesis in humans by use of2H2O: application to patients with end-stage renal disease

2004 ◽  
Vol 286 (4) ◽  
pp. E665-E672 ◽  
Author(s):  
Stephen F. Previs ◽  
Richard Fatica ◽  
Visvanathan Chandramouli ◽  
James C. Alexander ◽  
Henri Brunengraber ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Normal Subjects ◽  
Body Water ◽  
Synthesis Rate ◽  
Plasma Albumin ◽  
Hydrogen Enrichment ◽  
Stage Renal Disease ◽  
End Stage

A method is introduced for quantitating protein synthetic rates in humans by use of2H2O. Its validity was tested in subjects with end-stage renal disease. Six clinically stable subjects, hemodialyzed three times weekly, ingested2H2O to a body water2H enrichment of ∼0.4%. On dialysis, body water enrichment declined to ∼0.1%. Enrichment of the α-hydrogen of plasma free alanine was also ∼0.4% before and ∼0.1% after dialysis. β-Hydrogen enrichment was ∼80-100% of α-hydrogen enrichment.2H2O was ingested to replace2H2O removed after each dialysis for 15-51 days, returning enrichment to ∼0.4%. Enrichment of alanine from plasma albumin gradually increased, with again ∼80-100% as much2H in β- as in α-hydrogens. With continued dialyses, without2H2O replacement, alanine from albumin enrichment gradually declined, whereas free alanine and water enrichments were negligible. The fractional albumin synthesis rate, calculated from the increase in enrichment in alanine from albumin, was 4.0 ± 0.5%/day, and from the decrease, 4.6 ± 0.2%/day. Thus body water enrichment in a subject given2H2O can be maintained constant long term. A rapid exchange, essentially complete, occurs between the hydrogens of alanine and body water. An integrated measure over a long period of albumin's synthetic rate can be estimated from both the rise in enrichment of alanine from the protein during2H2O ingestion and fall on2H2O withdrawal, while the subject's living routine is uninterrupted. Estimates are in subjects with renal disease, but the method should be applicable to estimates of protein synthetic rates in normal subjects and in other pathological states.

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