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Kidney360 2022 Mar 9;3(3):534-545. Epub 2021 Dec 9.

Image Analysis in Medicine Lab (IAMLAB), Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, Canada.

Pathologists use multiple microscopy modalities to assess renal biopsy specimens. Besides usual diagnostic features, some changes are too subtle to be properly defined. Computational approaches have the potential to systematically quantitate subvisual clues, provide pathogenetic insight, and link to clinical outcomes. Read More

Sci Rep 2022 May 17;12(1):8234. Epub 2022 May 17.

University of Melbourne Department of Medicine (Melbourne Health), Parkville, VIC, 3076, Australia.

Retinal drusen are characteristic of macular degeneration and complement activation, but also occur in C3, lupus and IgA nephropathy. This cross-sectional observational study compared drusen counts in different forms of glomerulonephritis. Consecutive individuals with glomerulonephritis attending a general renal or transplant clinic underwent retinal imaging with a non-mydriatic camera. Read More

J Bras Nefrol 2022 May 13. Epub 2022 May 13.

Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, Departamento de Nefrologia, Lisboa, Portugal.

Background: Kidney disease is a rare manifestation of ankylosing spondylitis (AS) and its pathological alterations remain poorly described. The aim of this study was to investigate the clinical presentation and pathological alterations on kidney biopsy of AS patients and review and discuss the current literature on the issue.

Methods: We retrospectively studied the clinical presentation and kidney pathological alterations of 15 Caucasian AS patients submitted to kidney biopsy between October 1985 and March 2021. Read More

Case Rep Nephrol 2022 6;2022:8110940. Epub 2022 May 6.

Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo 162-0054, Japan.

Renal involvement in eosinophilic granulomatosis with polyangiitis (EGPA) typically occurs in anti-neutrophil cytoplasmic autoantibody (ANCA)-positive cases presenting with rapidly progressive renal insufficiency and urinary abnormalities induced by primarily necrotizing crescentic glomerulonephritis (NCGN). Recently, ANCA-negative EGPA has also been reported to manifest with renal involvement, such as NCGN or non-NCGN, including membranous nephropathy (MN). Herein, we report a 70-year-old female who presented with purpura on the lower legs, upper limb numbness, renal dysfunction (eGFR, 20. Read More

Kidney Int Rep 2022 May 14;7(5):1027-1036. Epub 2022 Feb 14.

Division of Nephrology, Hôpital du Sacré-Coeur de Montréal, Quebec, Canada.

Introduction: Studies on complement activation have implicated a combination of the classical pathway (CP), lectin pathway (LP), and alternative pathway (AP) in triggering the terminal pathway (TP) for each common autoimmune glomerulonephritis (GN). Evaluating different pathways simultaneously may help identify whether one is preferentially activated and, consequently, which is best to target for each disease.

Methods: We followed 112 patients with focal segmental glomerular sclerosis (FSGS), membranous nephropathy (MN), IgA nephropathy (IgAN), lupus nephritis (LN), and antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) for a median duration of 22 (12-52) months. Read More

J Transl Med 2022 05 14;20(1):224. Epub 2022 May 14.

Division of Nephrology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Youngsan-gu, Seoul, 04401, Republic of Korea.

Background: Extracellular vesicle (EV)-microRNAs (miRNAs) are potential biomarkers for various renal diseases. This study attempted to identify the circulating EV-miRNA signature not only for discriminating idiopathic membranous nephropathy (IMN) from idiopathic nephrotic syndrome (INS), but also to predict the treatment response of patients with IMN.

Methods: We prospectively enrolled 60 participants, including those with IMN (n = 19) and INS (n = 21) and healthy volunteers (HVs; n = 20) in this study. Read More

Int J Environ Res Public Health 2022 Apr 27;19(9). Epub 2022 Apr 27.

Chair and Department of Medical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland.

Primary membranous nephropathy (PMN) is considered a major cause of nephrotic syndrome. The discovery of circulating autoantibodies directed against glomerular podocytes helped to classify them as autoimmune diseases. Over the past years, there has been an increasing significance of anti-Phospholipase A2 Receptor (anti-PLAR), which has been detected in 70-80% of PMN cases, and relevance of anti-Thrombospondin type I domain-containing 7A (anti-THSD7A) even though they are present in 2-5% of patients. Read More

Int J Mol Sci 2022 Apr 23;23(9). Epub 2022 Apr 23.

Clinical Proteomics and Metabolomics Unit, School of Medicine and Surgery, University of Milano-Bicocca, 20854 Vedano al Lambro, Italy.

The podocyte injury, and consequent proteinuria, that characterize the pathology of idiopathic membranous nephropathy (IMN) is mediated by an autoimmune reaction against podocyte antigens. In particular, the activation of pathways leading to abundant renal deposits of complement is likely to involve the binding of mannose-binding lectin (MBL) to aberrant glycans on immunoglobulins. To obtain a landscape of circulatory IgG Fc glycosylation characterizing this disease, we conducted a systematic N-glycan profiling study of IgG1, 2, and 4 by mass spectrometry. Read More

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1388-1396

Department of Nephrology, Dialysis and Transplantation, Charles Nicolle Hospital; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

The elderly population has significantly increased in the world. Nephrotic syndrome (NS) is one manifestation of glomerular nephropathy in the elderly. The objective of our study is to determine NS particularities in the elderly and to identify the factors predicting progression to chronic end-stage renal disease (ESRD). Read More

Front Immunol 2022 22;13:845767. Epub 2022 Apr 22.

Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China.

Membranous nephropathy (MN) is the main cause of adult nephrotic syndrome (NS). The pathogenesis of MN is complex and involves subepithelial immune complex deposition. Approximately one-third of patients with MN develop end-stage renal disease (ESRD). Read More

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221086451

Kaweah Delta Health Care District, Visalia, CA, USA.

Kidney involvement with hepatitis B virus is varied and mostly limited to nephrotic syndrome with membranous nephropathy and nephritic syndrome with membranous proliferative glomerulonephritis. Lupus nephritis is associated with nephritic or nephrotic range proteinuria with most common finding of sub-endothelial electron-dense deposits and immunological stain demonstrating full-house picture with all immunological marker staining. Our case discusses a young male patient presenting with rapidly worsening renal function along with proteinuria, found to be positive for both hepatitis B core antibody along with hepatitis B surface antibody plus positive anti-neutrophilic antibody but negative anti-double-stranded DNA. Read More

J Cell Mol Med 2022 Apr 29. Epub 2022 Apr 29.

Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Transcriptome profiling of tubulointerstitial tissue in glomerulonephritis may reveal a potential tubulointerstitial injury-related biomarker. We profiled manually microdissected tubulointerstitial tissue from biopsy cores of 65 glomerulonephritis cases, including 43 patients with IgA nephropathy, 3 with diabetes mellitus nephropathy, 3 with focal segmental glomerulosclerosis, 3 with lupus nephritis, 4 with membranous nephropathy and 9 with minimal change disease, and additional 22 nephrectomy controls by RNA sequencing. A potential biomarker was selected based on the false discovery rate, and experiments were performed in TNF-α-stimulated primary cultured human tubular epithelial cells (hTECs). Read More

BMC Nephrol 2022 04 30;23(1):164. Epub 2022 Apr 30.

Department of Nephrology, the Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Ave, Harbin, Heilongjiang, 150086, China.

Background: The prevalence of idiopathic membranous nephropathy (IMN) is increasing worldwide and the gut microbiota is recognized to play a role in its pathology. The aim of this study was to understand the involvement of the gut-kidney axis in IMN by analyzing the composition of the gut microbiota of biopsy-proven IMN patients compared with healthy controls (HC).

Methods: Fecal samples from 30 patients with IMN diagnosed by renal biopsy and 30 healthy co-residents (control group) were collected for analysis in the Nephrology Department of the Second Affiliated Hospital of Harbin Medical University. Read More

Ren Fail 2022 Dec;44(1):731-740

Department of Nephrology, Kidney Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Objective: To verify glomerular PLA2R antigen and serum PLA2R antibody expression in membranous nephropathy as well as to explore glomerular PLA2R efficacy in evaluating the prognosis of idiopathic membranous nephropathy (IMN) in the background of different serum anti-PLA2R levels.

Methods: We retrospectively analyzed 155 patients who were diagnosed with IMN by kidney biopsy. Patients were divided into six groups according to their serum PLA2R antibody or glomerular PLA2R antigen positiveness and the level of serum anti-PLA2R titer. Read More

Front Immunol 2022 11;13:854749. Epub 2022 Apr 11.

Unitá Operativa (UO) of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Introduction: The Forkhead box protein P3 (FOXP3) is a transcription factor central to the function of regulatory T cells (Treg). Mutations in the gene lead to a systemic disease called immune dysregulation, polyendocrinopathy, and enteropathy, an X-linked syndrome (IPEX) characterized by the triad of early-onset intractable diarrhea, type 1 diabetes, and eczema. An atypical presentation of IPEX has been reported. Read More

Comput Math Methods Med 2022 14;2022:9337088. Epub 2022 Apr 14.

Shandong University of Traditional Chinese Medicine, Jinan, China.

Objective: To explore medications that have a therapeutic effect on idiopathic membranous nephropathy (IMN) using the Gene Expression Omnibus (GEO), the Connectivity Map (CMap) database, and bioinformatics approaches.

Methods: IMN patients' glomerular whole-genome sequencing data were retrieved and screened in the GEO database, differentially expressed genes were identified using GEO2R analysis, a PPI network was built in the STRING database, node degree values were calculated, and topological analysis was performed using the degree value to identify core genes. The WebGestalt database was used to perform GO enrichment and KEGG pathway analyses on the core genes. Read More

Can J Kidney Health Dis 2022 8;9:20543581221089094. Epub 2022 Apr 8.

Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, ON, Canada.

Background: Glomerulonephritis (GN) is a leading cause of kidney failure and accounts for 20% of incident cases of end-stage kidney disease (ESKD) in Canada annually. Reversal of kidney injury and prevention of progression to kidney failure is possible; however, limited knowledge of underlying disease mechanisms and lack of noninvasive biomarkers and therapeutic targets are major barriers to successful therapeutic intervention. Multicenter approaches that link longitudinal clinical and outcomes data with serial biologic specimen collection would help bridge this gap. Read More

J Assoc Physicians India 2022 Apr;70(4):11-12

Sms Medical College and Hospital, Jaipur.

Diabetes mellitus (DM) is the leading cause of chronic kidney disease worldwide chiefly attributable to diabetic nephropathy (DN). In these patients, non diabetic kidney disease (NDKD) can also occur either alone or superimposed on diabetic nephropathy. This study aimed to identify the prevalence and the etiology of NDKD in our center and also the clinical and laboratory parameters to help distinguish these two entities. Read More

J Assoc Physicians India 2022 Apr;70(4):11-12

Sms Medical College, Jaipur.

Resistant nephrotic syndrome is a group of disorders with diverse histological findings, which are by definition resistant to corticosteroids given in adequate dose for adequate duration and many are resistant to other therapy as well. In many patients progression to end-stage renal disease is the ultimate outcome. The role of B cells has not been fully explained in man, agents that specifically interfere with B cells would ideally represent the first step toward selective therapy. Read More

J Assoc Physicians India 2022 Mar;70(3):11-12

Assistant Professor, Madras Medical College, Chennai, Tamil Nadu.

Introduction: Idiopathic Membranous nephropathy (IMN) is one of the most common causes of adult onset nephrotic syndrome worldwide. About 50% will slowly progress to renal failure if untreated.

Methods: We did a retrospective study in patients with Idiopathic membranous nephropathy who were on follow-up between 2016-2018 at Madras medical college, Chennai. Read More

Mol Genet Genomic Med 2022 Apr 18:e1945. Epub 2022 Apr 18.

Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China.

Background: Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a monogenic immunodeficiency disease caused by forkhead box protein3 (FOXP3) mutation. The kidney is commonly involved in IPEX syndrome, but there were few studies focusing on renal involvement.

Methods: Whole-exome sequencing was used to identify the novel FOXP3 mutation. Read More

Korean J Intern Med 2022 Apr 15. Epub 2022 Apr 15.

Division of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

Background/aims: Membranous nephropathy (MN) is a major cause of nephrotic syndrome in adults. This study aimed to evaluate the effect of rituximab (RTX) in patients with idiopathic MN (iMN) who have a high risk of progression.

Methods: We retrospectively analyzed data of 13 patients with iMN, who received RTX treatments from January 2014 to July 2020. Read More

BMC Nephrol 2022 04 13;23(1):144. Epub 2022 Apr 13.

Guangzhou KingMed Center for Clinical Laboratory Co.,Ltd, Guangzhou, 510005, China.

Backgrounds: Systemic amyloidosis is classified according to the deposited amyloid fibril protein (AFP), which determines its best therapeutic scheme. The most common type of AFP found are immunoglobulin light chains. The laser microdissection combined with mass spectrometry (LMD-MS) technique is a promising approach for precise typing of amyloidosis, however, the major difficulty in interpreting the MS data is how to accurately identify the precipitated AFP from background. Read More

Isr Med Assoc J 2022 04;24(4):268-270

Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.

Int J Mol Sci 2022 Mar 24;23(7). Epub 2022 Mar 24.

Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan.

Treatment for glomerular diseases has been extrapolated from the experience of other autoimmune disorders while the underlying pathogenic mechanisms were still not well understood. As the classification of glomerular diseases was based on patterns of juries instead of mechanisms, treatments were typically the art of try and error. With the advancement of molecular biology, the role of the immune agent in glomerular diseases is becoming more evident. Read More

BMC Nephrol 2022 04 7;23(1):134. Epub 2022 Apr 7.

Kidney Health Service, Royal Brisbane and Women's Hospital, Level 9 Ned Hanlon Building, Butterfield Street, Herston, Queensland, 4029, Australia.

Background: Membranous Nephropathy (MN) is a common cause of nephrotic syndrome (NS) in adults. Recognition of MN as an antibody mediated autoimmune disease has enabled the introduction of anti-B-cell therapy. Rituximab, a type I anti-CD20 antibody has been used in the management of MN, but has a 35-45% failure rate. Read More

Front Pediatr 2022 21;10:854719. Epub 2022 Mar 21.

Medical Research Council, Fajara, Gambia.

In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Read More

Nephron 2022 Apr 5:1-14. Epub 2022 Apr 5.

Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Background: It has been widely recognized that exosomal miRNAs can participate in the pathogenesis of different renal disorders and serve as disease biomarkers. Although kidney biopsy is still the gold standard for diagnosing and monitoring immunoglobulin A nephropathy (IgAN), it is highly required to identify new and effective noninvasive biomarkers for IgAN, the most frequently detected primary glomerulonephritis worldwide.

Methods: Plasma and urinary exosomes were extracted by PEG precipitation. Read More

Ren Fail 2022 Dec;44(1):594-600

Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Background: Primary membranous nephropathy (PMN) is associated with the highest risk for developing venous thrombosis compared with other nephrotic diseases. The aim of the study was to assess the predictive value of the pathognomonic anti-phospholipase A2 receptor (PLA2R) antibody with regard to incidence of venous thrombosis in PMN.

Methods: A total of 365 in-hospital patients diagnosed with PMN were enrolled in the study. Read More

Kidney360 2021 Nov 19;2(11):1702-1705. Epub 2021 Apr 19.

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.