Lupus Nephritis and Kidney Transplantation: Where Are We Today?
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Tiffany Wong, Simin GoralLupus nephritis (LN) is the cause of end-stage kidney disease (ESKD) for 1.9% of the ESKD population in the United States. Although the incidence rates of ESKD from LN stopped rising in recent years, racial disparities in waiting time, pre-emptive kidney transplant, and transplant outcomes still exist. Patients with LN who progress to ESKD tend to be female, of African ancestry, and young. Kidney transplantation is safe in this population and associated with a substantial survival benefit, prima...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Classification of Lupus Nephritis; Time for a Change?
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Michael B. Stokes, Vivette D. D'AgatiRenal biopsy plays a critical role in the diagnosis and management of kidney disease in patients with systemic lupus erythematosus. The current pathologic classification of lupus nephritis is widely accepted but remains a work in progress. We discuss the key challenges in lupus nephritis classification and review new approaches to improve clinical utility and prognostic value. (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Pregnancy in Women With Systemic Lupus and Lupus Nephritis
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Sharon Maynard, Grace Guerrier, Margaret DuffyPregnancy is an altered immunologic state in which hormonal changes impact the immune system to enable maternal tolerance of the fetus. These hormonal and immunologic changes may affect disease activity in systemic lupus erythematosus. Conversely, lupus nephritis and its complications may adversely impact pregnancy. Systemic lupus erythematosus increases the risk of pre-eclampsia and its complications, including preterm birth and intrauterine growth restriction. Comorbiditie...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Moving Forward With Biologics in Lupus Nephritis
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Liliane Hobeika, Lauren Ng, Iris J. LeeThe majority of patients with systemic lupus erythematosus develop lupus nephritis (LN) which significantly contributes to increased risks of hospitalizations, ESRD, and death. Unfortunately, treatments for LN have not changed over the past 15 years. Despite continued efforts to elucidate the pathogenesis of LN, no new drugs have yet replaced the standard-of-care regimens of cyclophosphamide or mycophenolate mofetil plus high-dose corticosteroids. The significant limitations of st...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Utilization of Biomarkers in Lupus Nephritis
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Dawn J. Caster, David W. PowellLupus nephritis (LN) occurs in up to 60% of SLE patients, and is a leading cause of disability and death. Current treatment of LN consists of a combination of high dose corticosteroids that non-specifically decrease inflammation and cytotoxic medications that reduce auto-antibody production. That combination of therapy is associated with significant side effects while remission rates remain inadequate. Since the introduction of biologics into the pharmacological armamentarium, there has be...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
The Kidney Biopsy in Systemic Lupus Erythematosus: A View of the Past and a Vision of the Future
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Isabelle Ayoub, Clarissa Cassol, Salem Almaani, Brad Rovin, Samir V. ParikhThe kidney biopsy advanced our understanding of kidney disease in systemic lupus erythematosus. It allowed for better recognition and classification of lupus nephritis (LN). Several LN classifications have been devised in an effort to inform treatment decision and predict prognosis, and these are being further updated. In this review, we will examine the role of diagnostic as well as repeat kidney biopsy in the management of LN, including the pot...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Lupus Podocytopathy: An Overview
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Nestor Oliva-Damaso, Juan Payan, Elena Oliva-Damaso, Teresa Pereda, Andrew S. BombackIn systemic lupus erythematosus, nephrotic-range proteinuria typically signals the presence of a proliferative lupus nephritis (class III/IV) and/or membranous lupus nephritis (class V, with or without concomitant class III or IV lesions). However, in rare instances, systemic lupus erythematosus patients with nephrotic syndrome have kidney biopsy findings of normal glomeruli or focal segmental glomerulosclerosis lesions, with or without...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Antiphospholipid Syndrome Nephropathy and Other Thrombotic Microangiopathies Among Patients With Systemic Lupus Erythematosus
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Elizabeth S. Kotzen, Sanjeet Roy, Koyal JainAntiphospholipid syndrome (APS) and other causes of thrombotic microangiopathy (TMA) negatively impact the renal outcomes of patients with systemic lupus erythematosus (SLE) and lupus nephritis. Here we review the diagnosis and management of occlusive renal vascular lesions due to APS and other TMAs, with a focus on patients with SLE and lupus nephritis. The presence of a thrombotic event, unexplained hypertension, thrombocytopenia, or hemolytic anemia should prompt considerat...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Lupus Nephritis: Duration of Therapy and Possibility of Withdrawal
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Latisha Heinlen, Eliza F. ChakravartyLupus nephritis is the most common organ-threatening manifestation of systemic lupus erythematosus, affecting more than one-third of patients. Induction of remission and maintenance of relapse-free disease have been and continue to be a critical focus of investigation. Because the need for renal replacement therapy in those with an insufficient response to therapy is associated with significantly increased morbidity and mortality, providers and patients are willing to accept moderate...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Membranous Lupus Nephritis: A Clinical Review
Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Salem Almaani, Samir V. ParikhMembranous lupus nephritis (MLN) (Class V lupus nephritis [LN]) is a distinct form of LN defined by the presence of subepithelial immune complex deposits seen on kidney biopsy. MLN is often associated with the nephrotic syndrome. The histology of MLN closely resembles that of idiopathic (primary) membranous nephropathy (pMN). However, MLN typically has abundant mesangial deposits that are absent in primary membranous nephropathy. The clinical presentation, management, and prognosis of MLN d...
Source: Advances in Chronic Kidney Disease - November 14, 2019 Category: Urology & Nephrology Source Type: research
Masthead
Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - August 31, 2019 Category: Urology & Nephrology Source Type: research
Editorial Board
Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - August 31, 2019 Category: Urology & Nephrology Source Type: research
Table of Contents
Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - August 31, 2019 Category: Urology & Nephrology Source Type: research
Erythropoiesis-Stimulating Agents and Cancer: Myth or Truth
Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): Michael J. Choi, Jerry Yee (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - August 31, 2019 Category: Urology & Nephrology Source Type: research
Anemia Treatment After 30 Years of Erythropoietic Stimulating Agents: No Longer Business as Usual?
Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): Jay B. Wish (Source: Advances in Chronic Kidney Disease)
Source: Advances in Chronic Kidney Disease - August 31, 2019 Category: Urology & Nephrology Source Type: research
