scholarly journals Native kidney biopsies in Armenian and Swiss children: high prevalence of amyloidosis in Yerevan and of IgA nephropathy in Zurich

2014 ◽  
Vol 466 (1) ◽  
pp. 77-83
Author(s):  
Guido F. Laube ◽  
Ashot Sarkissian ◽  
Helen Nazaryan ◽  
Giuseppina Spartà ◽  
Armen Sanamyan ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Native Kidney ◽  
High Prevalence

scholarly journals IgA Nephropathy Secondary to Ipilimumab Use

2021 ◽  
pp. 327-333
Author(s):  
Sean C. Dougherty ◽  
Nisa Desai ◽  
Helen P. Cathro ◽  
Amanda Renaghan
Keyword(s):  
Iga Nephropathy ◽  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitor ◽  
Human Monoclonal Antibody ◽  
Kidney Injury ◽  
Stage Iv ◽  
Clinical History ◽  
High Prevalence ◽  
Initiation Of Therapy ◽  
Nephrotic Range Proteinuria

Ipilimumab is a human monoclonal antibody targeting cytotoxic T-lymphocyte-associated protein 4 approved for the treatment of non-small-cell lung cancer (NSCLC) and other malignancies. Despite a high prevalence of other immune-related adverse events (irAEs), checkpoint inhibitor (CPI)-related nephrotoxicity has been reported less frequently. In this clinical case report, we describe the evaluation of a 70-year-old female with stage IV NSCLC who presented with nephrotic range proteinuria 4 weeks after receiving her first cycle of ipilimumab. She underwent a renal biopsy and was found to have IgA nephropathy that was presumed to be secondary to ipilimumab use, given recent initiation of therapy and clinical history. Unfortunately, despite prompt initiation of corticosteroids, her acute kidney injury progressed and she required hemodialysis, later transitioning to hospice. To our knowledge, this is one of few reported cases of IgA nephropathy secondary to CPI use. With increasing use of CPIs, this case further emphasizes the need for continued surveillance for irAEs, which can occur at any point in a patient’s treatment course.

Posttransplant IgA nephropathy: A clinicopathological study in comparison with IgA nephropathy in native kidney

Nephrology ◽  
2000 ◽  
Vol 5 (s1) ◽  
pp. A13-A13
Author(s):  
K Oka ◽  
M Izumi ◽  
T Sugiura ◽  
Y Isaka ◽  
M Takenaka ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Native Kidney ◽  
Clinicopathological Study

C4d in Native Glomerular Diseases

2019 ◽  
Vol 49 (1) ◽  
pp. 81-92 ◽  
Author(s):  
Preeti Chandra
Keyword(s):  
Iga Nephropathy ◽  
Focal Segmental Glomerulosclerosis ◽  
Complement Activation ◽  
Immunoglobulin A ◽  
Future Research ◽  
Glomerular Diseases ◽  
Segmental Glomerulosclerosis ◽  
Native Kidney

Complement activation occurs in many glomerular diseases, the exact pathway(s) of activation has been studied in detail in some diseases but not in all. C4d is generated by the activation of classical and lectin pathways, and its presence can point to the activation of either of these pathways. This review aims to summarize the available data with regard to the deposition of glomerular C4d in native kidney biopsies in different glomerular pathologies that may be useful for future research into the role of complement activation in glomerular diseases. While there is more information on C4d in certain diseases (e.g., Immunoglobulin A (IgA) nephropathy), there is scant data in other diseases (such as focal segmental glomerulosclerosis).

scholarly journals Monoclonal and polyclonal immunoglobulin G deposits on tubular basement membranes of native and pretransplant kidneys: A retrospective study

2020 ◽  
Author(s):  
Anri Sawada ◽  
Masayoshi Okumi ◽  
Shigeru Horita ◽  
Tomomi Tamura ◽  
Sekiko Taneda ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Immunoglobulin G ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Basement Membranes ◽  
Native Kidney ◽  
Dense Deposits ◽  
Microscopic Evaluation ◽  
Renal Prognosis ◽  
Stable Renal Function ◽  
Hematological Investigation

Abstract BackgroundMonoclonal tubular basement membrane immune deposits (TBMID) are identified by renal biopsy and are associated with progression of interstitial injury in renal allograft. However, the significance of TBMID in the native kidney remains unclear.MethodWe retrospectively analyzed 3,126 native kidney biopsies and 1,724 zero-hour biopsies performed between 2008 and 2018 in our institution.ResultsThe rate of immunoglobulin G (IgG) TBMID was found to be 5.2 % among native kidney biopsies and 0.4 % among zero-hour biopsies. The rate of IgG TBMID was relatively common in the case of diabetic nephropathy (31.3%) and lupus nephritis (25.5%), but rare in IgA nephropathy (IgAN) (1.1%). Monoclonal IgG TBMID was identified in seven cases, including three zero-hour biopsies. The pathological diagnosis from native kidney biopsy was IgAN in two cases, antineutrophil cytoplasmic antibody-related vasculitis in one, and Focal segmental glomerulosclerosis in one. Zero-hour biopsy revealed IgAN in one case and mild atherosclerosis in two. The combination of IgG1κ was observed in two cases, IgG1λ in three, and IgG2κ in two. Interstitial injury is not severe in all cases. Electron microscopy revealed powdery electron-dense deposits. Monoclonal gammopathy of undetermined significance was diagnosed in one case with IgA nephropathy. Although One patient developed renal failure, all others exhibited stable renal function.ConclusionMonoclonal IgG TBMID in the native kidney is not associated with renal prognosis or interstitial injury. However, this could be a useful immunopathological parameter for early identification of cases requiring hematological investigation and microscopic evaluation.

scholarly journals P0474UTILITY OF NATIVE KIDNEY BIOPSY IN OLDER ADULTS: SAFETY AND DIAGNOSES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hui Zhuan Tan ◽  
Cynthia Lim ◽  
Marjorie Foo ◽  
Chieh Suai Tan ◽  
Jason Choo
Keyword(s):  
Older Adults ◽  
Diabetic Nephropathy ◽  
Iga Nephropathy ◽  
Major Bleeding ◽  
Older Patients ◽  
Kidney Biopsy ◽  
Bleeding Complications ◽  
Younger Adults ◽  
Native Kidney ◽  
Increased Risk

Abstract Background and Aims Population aging is an increasing phenomenon worldwide and consequently more are developing kidney diseases which may necessitate diagnostic kidney biopsy. However, older patients may be at increased risk for complications such as bleeding. We aimed to examine the utility and safety of native kidney biopsies among our older adults. Method This was a single-centre retrospective study of older adults (≥60 years) who had native kidney biopsies at the Singapore General Hospital between June 2011 and March 2015. Demographic data, co-morbid illnesses, clinical presentation at kidney biopsy, as well as laboratory results before and after kidney biopsy, were retrieved from electronic medical records. Patient outcomes were recorded until their last visit or death before 30th March 2017. End stage renal disease (ESRD) was defined as estimated glomerular filtration rate (eGFR) <15 ml/min/1.73 m2 or need for renal replacement therapy persisting >3 months. All post biopsy bleeding events were documented, with major bleeding defined as the need for transfusion and/or intervention; or if bleeding was either a direct or contributory cause of death. Results Older adults accounted for 153 of 545 (28.1%) native renal biopsies performed. The indications for biopsy in older adults included microscopic hematuria with proteinuria (51.0%), nephrotic syndrome (32.0%) and isolated proteinuria (17.0%). One hundred and ten patients (71.9%) had eGFR <60ml/min/1.72m2 at biopsy and a significantly higher proportion of older patients (85.5% vs 62.4%, p<0.001) had eGFR <30ml/min/1.72m2. Compared to the younger individuals <60 years old, older patients were more likely to be hypertensive (86.3% vs 58.4%, p<0.001) and diabetic (49.0% vs 28.1%, p<0.001). Post biopsy, major bleeding was more frequent among older adults compared with younger adults (13.3% vs 5.7% respectively; p=0.04), although overall bleeding episodes between older and younger adults were not significantly different (15.9% vs 22.9% respectively; p=0.18). Among older adults, minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS) was the most frequent diagnosis (23.5%), followed by membranous nephropathy (20.9%) and IgA nephropathy (9.8%), whereas MCD/FSGS (26.5%), lupus nephritis (24.5%) and IgA nephropathy (19.6%) were the top three diagnoses amongst younger adults. Co-existing glomerulonephritis (GN) with diabetic nephropathy and isolated diabetic nephropathy were seen in 12 (7.8%) and 20 (13.1%) elderly patients respectively. The majority (124 patients, 81.0%) of biopsies in older adults had histological diagnoses of glomerulonephritis that were potentially amendable to treatment although only 90 (58.8%) patients subsequently received immunosuppressants. Among older adults with biopsy-proven glomerulonephritis, median follow up was similar between those treated and not treated with immunosuppressants (30.4 [27.3, 53.7] months versus 38.8 [30.7, 51.9] months, p=0.12). Among older adults with GN, ESRD was less frequent among those treated with immunosuppressants, compared to those who did not receive immunosuppressants, although the difference did not reach statistical significance (10.3% versus 18.9%, p=0.24). However, the combined endpoint of ESRD or mortality were similar (24.1% vs 21.6%, p=0.76). Conclusion Our findings support the utility of renal biopsy for diagnosis and to guide clinical care. Older adults undergoing kidney biopsy should be counselled and monitored for bleeding complications.

scholarly journals Outcome of 313 Czech Patients With IgA Nephropathy After Renal Transplantation

2021 ◽  
Vol 12 ◽  
Author(s):  
Dita Maixnerova ◽  
Petra Hruba ◽  
Michaela Neprasova ◽  
Kamila Bednarova ◽  
Janka Slatinska ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Kidney Transplant ◽  
Graft Failure ◽  
Microscopic Hematuria ◽  
Histological Evaluation ◽  
Cox Regression Analysis ◽  
Antibody Mediated Rejection ◽  
Native Kidney

The recurrence of IgA nephropathy (IgAN) after kidney transplantation occurs in 20–35% of patients. The main aim of this study is to evaluate risk factors affecting the course of IgAN after renal biopsy of native kidney and kidney transplant. We evaluated clinical parameters and histological findings at the time of biopsy of native kidney and after kidney transplantation in 313 patients with IgAN with a follow-up of up to 36 years. Using hierarchical clustering method, patients with graft failure (n=50) were divided into two groups based on the mean time from kidney transplant to graft failure (11.2 versus 6.1 years). The time-to-graft failure corresponded well to the time from the renal biopsy of native kidney to end-stage renal disease (5.9 versus 0.4 years). Body mass index, proteinuria, microscopic hematuria, histological evaluation of fibrosis, and crescents at the time of renal biopsy of native kidney were the main variables for the differentiation of the two groups. Higher age of kidney-transplant donor, histological recurrence of IgAN, antibody-mediated rejection, and the onset of microscopic hematuria and proteinuria within 1 year after kidney transplant were also associated with worse graft survival in multivariate Cox regression analysis.

Bioelectronic Measurement of Nasality in Trainable Mentally Retarded Children

1977 ◽  
Vol 42 (3) ◽  
pp. 436-439 ◽  
Author(s):  
David A. Daly
Keyword(s):  
Mentally Retarded ◽  
High Prevalence ◽  
Mentally Retarded Children ◽  
Trainable Mentally Retarded

Fifty trainable mentally retarded children were evaluated with TONAR II, a bioelectronic instrument for detecting and quantitatively measuring voice parameters. Results indicated that one-half of the children tested were hypernasal. The strikingly high prevalence of excessive nasality was contrasted with results obtained from 64 nonretarded children and 50 educable retarded children tested with the same instrument. The study demonstrated the need of retarded persons for improved voice and resonance.

Multiple Perspectives on the Barriers to Identification and Management of Pediatric Voice Disorders

2017 ◽  
Vol 2 (3) ◽  
pp. 49-56
Author(s):  
Jana Childes ◽  
Alissa Acker ◽  
Dana Collins
Keyword(s):  
Academic Success ◽  
Voice Disorders ◽  
School Personnel ◽  
Voice Disorder ◽  
Multiple Perspectives ◽  
Vocal Qualities ◽  
High Prevalence ◽  
Pediatric Populations ◽  
Low Incidence ◽  
University Settings

Pediatric voice disorders are typically a low-incidence population in the average caseload of clinicians working within school and general clinic settings. This occurs despite evidence of a fairly high prevalence of childhood voice disorders and the multiple impacts the voice disorder may have on a child's social development, the perception of the child by others, and the child's academic success. There are multiple barriers that affect the identification of children with abnormal vocal qualities and their access to services. These include: the reliance on school personnel, the ability of parents and caretakers to identify abnormal vocal qualities and signs of misuse, the access to specialized medical services for appropriate diagnosis, and treatment planning and issues related to the Speech-Language Pathologists' perception of their skills and competence regarding voice management for pediatric populations. These barriers and possible solutions to them are discussed with perspectives from the school, clinic and university settings.

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
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