Acute kidney injury associated with glomerular diseases

Purpose of review This review focuses on acute kidney injury (AKI) associated with glomerular diseases and specifically the mechanisms of development of AKI in the wide spectrum of glomerulopathies. Recent findings The immune system and the kidneys are closely linked. In healthy individuals, the kidneys contribute to immune homeostasis, whereas components of the immune system mediate many acute forms of kidney disease. Both crescentic and noncrescentic forms of acute glomerulonephritis can present as AKI. The diagnosis of glomerular diseases underlying AKI requires a high degree of suspicion coupled with an algorithmic approach to laboratory investigations. Renal biopsy represents the gold standard for the diagnosis of medical conditions of the kidney. The main clinical–biological presentations of glomerular diseases are acute nephritic syndrome, nephrotic syndrome and rapidly progressive glomerulonephritis (RPGN). All these presentations can be worsened by AKI both in the onset and in the clinical course. Heavy proteinuria and macroscopic hematuria can be directly involved in the development of AKI. Summary AKI associated with glomerular diseases is not uncommon. Sometimes it represents an emergency case. The understanding of the various mechanisms underlying kidney diseases is improving, and may aid in their prevention and treatment.
Source: Current Opinion in Critical Care - Category: Nursing Tags: RENAL SYSTEM: Edited by Mitchell H. Rosner Source Type: research

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Rationale: Bevacizumab—an inhibitor of vascular endothelial growth factor—is effective against various advanced cancers. However, it is associated with the development of hypertension and high-grade proteinuria during thrombotic microangiopathy of the kidney. In addition, there are several reports of immunoglobulin A deposition in the glomeruli, but the etiology is unclear. Patient concerns: A 67-year-old Japanese man with metastatic rectal cancer underwent low anterior rectal resection, followed by treatment with bevacizumab and SOX (S-1 plus oxaliplatin). Six months later, the patient developed hematuria...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSIONS: Ser interfered with albumin internalization through the caveolae into GEnCs and podocytes and reduced albuminuria. Dynamin inhibitors may serve as a novel therapeutic option for reducing albuminuria in glomerulonephritis. PMID: 31655808 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
Authors: special issue: “Focus on pediatric nephrology”, Colavita L, Salpietro C, Cuppari C, Sallemi A, Di Benedetto V, Concolino D, Marseglia L, D'Angelo G, Gitto E, Betta P, Fede C, Conti G, Chimenz R Abstract Nephrotic Syndrome (NS) is a rare diseases (around 2-7 cases per 100.000 children per year) characterized by proteinuria ≥50 mg/kg/day (or ≥40 mg/m2/h) or a proteinuria/creatininuria ratio>2 (mg/mg); hypoalbuminaemia less than 25 g/l and edema. The protein leakage, with the consequent hypoalbunaemia and edema, due to podocyte alterations may be caused by genetic diseases, immunological ...
Source: Journal of Biological Regulators and Homeostatic Agents - Category: Biomedical Science Tags: J Biol Regul Homeost Agents Source Type: research
Authors: Higashihara T, Okada A, Nakamura Y, Saigusa H, Homma S, Matsumura M, Kusano T, Shimizu A, Takano H Abstract We performed a renal biopsy for nephrotic syndrome in a patient with squamous cell lung carcinoma, which can worsen the prognosis. Chemoradiation therapy was effective for the cancer and proteinuria; we thus inferred that the nephrotic syndrome had been closely associated with the carcinoma. A pathological analysis of the kidney showed monoclonality for λ chain, satisfying the diagnostic criteria of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID); however, con...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractIgA nephropathy (IgAN) is the most common glomerulonephritis worldwide. The classic manifestation of IgAN is episodic hematuria and proteinuria. Nephrotic syndrome (NS) is not very common in IgAN, reported to occur in only 5 –10% of IgAN patients. However, the clinical and pathological characteristics and long-term outcomes of patients with NS-IgAN at onset remain unknown. A retrospective study was conducted, enrolling 1165 patients with biopsy-proven IgAN from West China Hospital in 2008–2015. Patients with renal b iopsy of minimal change disease with mesangial IgA deposits were excluded. The renal end...
Source: Clinical and Experimental Medicine - Category: Research Source Type: research
Publication date: Available online 19 July 2019Source: American Journal of Kidney DiseasesAuthor(s): Jonathan J. Hogan, Miriam Priya Alexander, Nelson LeungDysproteinemic kidney diseases occur when B- or plasma cell clones produce pathogenic monoclonal immunoglobulins or light chains that cause kidney damage. The clinical presentation of these disorders ranges from sub–nephrotic-range proteinuria or microscopic hematuria with preserved kidney function to severe nephrotic syndrome to severe acute kidney injury or rapidly progressive glomerulonephritis. These monoclonal immunoglobulins can cause a variety of histologic...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Abstract Rheumatoid arthritis (RA) is accompanied by a variety of nephropathies. It is often difficult to distinguish between disease-associated and drug-associated renal diseases. Three hundred and seventy-six RA patients with renal involvement were included in our study; they were subjected to full history and clinical examination, kidney function, 24-h urinary protein, and kidney biopsy. All our patients were on methotrexate, low dose steroids, and nonsteroidal anti-inflammatory drugs, in addition to the previous medications. About 79.3%, 20.7%, 6.9%, and 5.9% of our patients were on leflunomide, hydroxychloroq...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Rationale: Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown. Patient concerns: A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction. Diagnoses: Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level. Interventions: The patient received plasma exchange and rituximab besides corticosteroids. O...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Therapeutic Targeting of Fibrotic Epithelial-Mesenchymal Transition–An Outstanding Challenge Attila Fintha1, Ákos Gasparics2, László Rosivall3 and Attila Sebe3,4* 12nd Department of Pathology, Semmelweis University, Budapest, Hungary 21st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary 3Department of Pathophysiology, International Nephrology Research and Training Center, Semmelweis University, Budapest, Hungary 4Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany Back in 1995, a landmark paper was published, which shaped the fi...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionsEculizumab blunted terminal complement activation in all patients with immune complex–mediated MPGN or C3 glomerulonephritis and nephrotic syndrome, but persistently reduced proteinuria in just a subgroup.Trial RegistrationRegistered in the EU Clinical Trials Register with study no. 2013-003826-10.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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