scholarly journals New Insights into the Pathogenesis and Treatment Strategies in IgA Nephropathy

2021 ◽  
Author(s):  
Katrin Scionti ◽  
Karen Molyneux ◽  
Haresh Selvaskandan ◽  
Jonathan Barratt ◽  
Chee Kay Cheung
Keyword(s):  
Iga Nephropathy ◽  
Treatment Strategies

scholarly journals Single versus dual blockade of the renin-angiotensin system in patients with IgA nephropathy

2020 ◽  
Vol 33 (6) ◽  
pp. 1231-1239
Author(s):  
David Paul Lennartz ◽  
Claudia Seikrit ◽  
Stephanie Wied ◽  
Christina Fitzner ◽  
Frank Eitner ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Clinical Remission ◽  
Treatment Strategies ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Blocker Therapy ◽  
Renin Angiotensin ◽  
Renal Outcomes ◽  
Single Versus ◽  
Trial Phase

Abstract Background Inhibitors of the renin-angiotensin system (RAS) are cornerstones of supportive therapy in patients with IgA nephropathy (IgAN). We analyzed the effects of single versus dual RAS blockaQueryde during our randomized STOP-IgAN trial. Methods STOP-IgAN participants with available successive information on their RAS treatment regimen and renal outcomes during the randomized 3-year trial phase were stratified post hoc into two groups, i.e. patients under continuous single or dual RAS blocker therapy over the entire 3 years of the trial phase. Primary and secondary STOP-IgAN trial endpoints, i.e. frequencies of full clinical remission, eGFR-loss ≥ 15 and ≥ 30 ml/min/1.73 m2 and ESRD onset, were analyzed by logistic regression and linear mixed effects models. Results Among the 112 patients included in the present analysis, 82 (73%) were maintained on single and 30 (27%) on dual RAS inhibitor therapy throughout the trial. Neither RAS blocker strategy significantly affected full clinical remission, eGFR-loss rates, onset of ESRD. Proteinuria moderately increased in patients under dual RAS blockade by 0.1 g/g creatinine during the 3-year trial phase. This was particularly evident in patients without additional immunosuppression during the randomized trial phase, where proteinuria increased by 0.2 g/g creatinine in the dual RAS blockade group. In contrast, proteinuria decreased in patients under single RAS blocker therapy by 0.3 g/g creatinine. The course of eGFR remained stable and did not differ between the RAS treatment strategies. Conclusion In the STOP-IgAN cohort, neither RAS blocker regimen altered renal outcomes. Patients on dual RAS blockade even exhibited higher proteinuria over the 3-year trial phase.

scholarly journals Clinical and pathological findings of SARS-CoV-2 infection and concurrent IgA nephropathy: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Huang ◽  
Xiao-Juan Li ◽  
Yue-Qiang Li ◽  
Wei Dai ◽  
Tiffany Shao ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Renal Involvement ◽  
Treatment Strategies ◽  
Glomerular Disease ◽  
Angiotensin Ii Receptor Blocker ◽  
Limited Data ◽  
Angiotensin Ii Receptor ◽  
Renal Abnormalities

Abstract Background Since the Coronavirus Disease 2019 (COVID-19) outbreak, there is accumulating data on the clinical characteristics, treatment strategies and prognosis of COVID-19 in patients with concurrent renal disease. Postmortem investigations reveal renal involvement in COVID-19, and most recently, several biopsy researches reveal that acute tubular injury, as well as glomerular nephropathy such as collapsing glomerulopathy were common histological findings. However, to our best knowledge, there is limited data regarding IgA nephropathy in the setting of COVID-19. Case presentation In the present case, we report a 65-year old Chinese woman who presented with dark-colored urine, worsening proteinuria and decreased renal function after COVID-19 infection. She received a renal biopsy during COVID-19 infection. The renal biopsy revealed IgA nephropathy without any evidence for SARS-Cov-2. The findings suggest that the renal abnormalities were a consequence of exacerbation of this patient’s underlying glomerular disease after COVID-19 infection. After a regimen of 3-day course of glucocorticoid and angiotensin II receptor blocker therapy, the patient recovered and remained stable upon follow-up. Conclusions It is important to consider the underlying glomerular disease exacerbation as well as virus induced injury when dealing with renal abnormalities in patients with COVID-19. A kidney biopsy may be indicated to exclude a rapidly progressive glomerular disease.

scholarly journals The Contribution of Complement to the Pathogenesis of IgA Nephropathy: Are Complement-Targeted Therapies Moving from Rare Disorders to More Common Diseases?

2021 ◽  
Vol 10 (20) ◽  
pp. 4715
Author(s):  
Felix Poppelaars ◽  
Bernardo Faria ◽  
Wilhelm Schwaeble ◽  
Mohamed R. Daha
Keyword(s):  
Iga Nephropathy ◽  
Targeted Therapies ◽  
Alternative Pathway ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Lectin Pathway ◽  
Phase 2 Trial ◽  
Complement Inhibitors ◽  
Common Diseases

Primary IgA nephropathy (IgAN) is a leading cause of chronic kidney disease and kidney failure for which there is no disease-specific treatment. However, this could change, since novel therapeutic approaches are currently being assessed in clinical trials, including complement-targeting therapies. An improved understanding of the role of the lectin and the alternative pathway of complement in the pathophysiology of IgAN has led to the development of these treatment strategies. Recently, in a phase 2 trial, treatment with a blocking antibody against mannose-binding protein-associated serine protease 2 (MASP-2, a crucial enzyme of the lectin pathway) was suggested to have a potential benefit for IgAN. Now in a phase 3 study, this MASP-2 inhibitor for the treatment of IgAN could mark the start of a new era of complement therapeutics where common diseases can be treated with these drugs. The clinical development of complement inhibitors requires a better understanding by physicians of the biology of complement, the pathogenic role of complement in IgAN, and complement-targeted therapies. The purpose of this review is to provide an overview of the role of complement in IgAN, including the recent discovery of new mechanisms of complement activation and opportunities for complement inhibitors as the treatment of IgAN.

A Language Approach to Treatment of Phonological Process Problems

1983 ◽  
Vol 14 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Edna Carter Young
Keyword(s):  
Treatment Strategies ◽  
Phonological Process ◽  
Conceptual Skills

Treatment strategies and therapy materials for remediation of phonological process problems are described. This approach uses the child's language and conceptual skills to facilitate the use of the sound contrasts necessary to convey meaning to the listener.

Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

2008 ◽  
Vol 15 (3) ◽  
pp. 66-72 ◽  
Author(s):  
José G. Centeno
Keyword(s):  
Stroke Rehabilitation ◽  
Culturally Diverse ◽  
Treatment Strategies ◽  
The United States ◽  
Intervention Strategies ◽  
Steady Increase ◽  
Clinical Procedures ◽  
Bilingual Speakers ◽  
Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

2021 ◽  
pp. 1-8
Author(s):  
Connie K. Porcaro ◽  
Clare Singer ◽  
Boris Djokic ◽  
Ali A. Danesh ◽  
Ruth Tappen ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Social Engagement ◽  
Leisure Activities ◽  
Treatment Strategies ◽  
Voice Disorders ◽  
Community Dwelling ◽  
Vocal Performance ◽  
Older Individuals ◽  
Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

Interstitial inflammation and the expression of apoptotic modulators in iga nephropathy

Nephrology ◽  
2000 ◽  
Vol 5 (3) ◽  
pp. A114-A114
Author(s):  
Menahem Sa ◽  
Maguire Ja ◽  
Stein‐Oakley A ◽  
Bailey M ◽  
Dowling J ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Interstitial Inflammation

Surgical treatment strategies for secondary peritonitis: Outcome in 278 patients

2001 ◽  
Vol 120 (5) ◽  
pp. A401-A401
Author(s):  
M BOERMEESTER ◽  
E BELT ◽  
B LAMME ◽  
M LUBBERS ◽  
J KESECIOGLU ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Strategies ◽  
Secondary Peritonitis

Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Ernemann ◽  
Bender ◽  
Melms ◽  
Brechtel ◽  
Kobba ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Carotid Bifurcation ◽  
Current Treatment ◽  
Long Term Results ◽  
Clinical Indication ◽  
Interventional Treatment ◽  
Special Focus ◽  
Brachiocephalic Artery ◽  
Treatment Concepts ◽  
Angioplasty And Stenting

Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.

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