Recurrent renal disease

2015 ◽  
Author(s):  
Philip Clayton ◽  
Steven Chadban
Keyword(s):  
Renal Disease ◽  
Renal Allograft ◽  
Systemic Disease ◽  
Immunoglobulin A ◽  
Specific Information ◽  
Graft Dysfunction ◽  
Immunoglobulin A Nephropathy ◽  
Focal And Segmental Glomerulosclerosis ◽  
Goodpasture Disease ◽  
Disease Specific

Although kidney transplantation restores kidney function, it does not cure the cause of kidney failure when it is glomerulonephritis or a systemic disease. These can recur in the allograft, causing graft dysfunction and ultimately graft failure. This is a challenge in the pre-transplant phase, perioperatively, and in a patient with renal allograft dysfunction. This chapter discusses the prophylaxis, diagnosis, and management of recurrent renal disease, including disease-specific information on focal and segmental glomerulosclerosis, membranous nephropathy, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, lupus nephritis, haemolytic uraemic syndrome, oxalosis, Goodpasture disease, oxalosis, and vasculitis, amongst others.

scholarly journals Integrated Fecal Microbiome and Serum Metabolomics Analysis Reveals Abnormal Changes in Rats with Immunoglobulin A Nephropathy and the Intervention Effect of Zhen Wu Tang

2021 ◽  
Vol 11 ◽  
Author(s):  
Jicheng Li ◽  
Yiwen Cao ◽  
Ruirui Lu ◽  
Honglian Li ◽  
Yu Pang ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Renal Disease ◽  
Intestinal Microbiota ◽  
Renal Damage ◽  
Immunoglobulin A ◽  
Metabolic Phenotype ◽  
Immunoglobulin A Nephropathy ◽  
Metabolic Phenotypes ◽  
Potential Relationship ◽  
Rdna Sequencing

Immunoglobulin A nephropathy (IgAN), an autoimmune renal disease with complicated pathogenesis, is one of the principal reasons for end-stage renal disease in the clinic. Evidence has linked apparent alterations in the components of the microbiome and metabolome to renal disease in rats. However, thus far, there is insufficient evidence that supports the potential relationship between gut microbiome, circulating metabolites, and IgAN. This study was designed to probe the effects of IgAN on intestinal microecology and metabolic phenotypes and to understand the possible underlying mechanisms. Fecal and serum samples were collected from IgAN rats. Composition of the gut microbiota and biochemical changes in the metabolites was analyzed using 16S rDNA sequencing and untargeted metabolomics. The IgAN rats exhibited renal insufficiency and increased concentration of 24-h urine protein, in addition to deposition of IgA and IgG immune complexes in the kidney tissues. There was a disturbance in the balance of gut microbiota in IgAN rats, which was remarkably associated with renal damage. Marked changes in microbial structure and function were accompanied by apparent alterations in 1,403 serum metabolites, associated with the disorder of energy, carbohydrate, and nucleotide metabolisms. Administration of Zhen Wu Tang ameliorated microbial dysbiosis and attenuated the renal damage. Besides, treatment with Zhen Wu Tang modulated the metabolic phenotype perturbation in case of gut microbiota dysbiosis in IgAN rats. In conclusion, these findings provided a comprehensive understanding of the potential relationship between the intestinal microbiota and metabolic phenotypes in rats with IgAN. Elucidation of the intestinal microbiota composition and metabolic signature alterations could identify predictive biomarkers for disease diagnosis and progression, which might contribute to providing therapeutic strategies for IgAN.

Autoimmune-mediated renal disease and hypertension

2021 ◽  
Vol 135 (17) ◽  
pp. 2165-2196
Author(s):  
Erika I. Boesen ◽  
Rahul M. Kakalij
Keyword(s):  
Renal Disease ◽  
Lupus Erythematosus ◽  
Functional Decline ◽  
Immunoglobulin A ◽  
Renal Diseases ◽  
Therapeutic Approaches ◽  
The Past ◽  
Current State ◽  
Underlying Mechanisms ◽  
Disease Specific

Abstract Hypertension is a major risk factor for cardiovascular disease, chronic kidney disease (CKD), and mortality. Troublingly, hypertension is highly prevalent in patients with autoimmune renal disease and hastens renal functional decline. Although progress has been made over the past two decades in understanding the inflammatory contributions to essential hypertension more broadly, the mechanisms active in autoimmune-mediated renal diseases remain grossly understudied. This Review provides an overview of the pathogenesis of each of the major autoimmune diseases affecting the kidney that are associated with hypertension, and describes the current state of knowledge regarding hypertension in these diseases and their management. Specifically, discussion focuses on Systemic Lupus Erythematosus (SLE) and Lupus Nephritis (LN), Immunoglobulin A (IgA) Nephropathy, Idiopathic Membranous Nephropathy (IMN), Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated glomerulonephritis, and Thrombotic Thrombocytopenic Purpura (TTP). A summary of disease-specific animal models found to exhibit hypertension is also included to highlight opportunities for much needed further investigation of underlying mechanisms and novel therapeutic approaches.

scholarly journals Secular trends in the incidence of end-stage renal disease and its risk factors in Japanese patients with immunoglobulin A nephropathy

2017 ◽  
Vol 33 (6) ◽  
pp. 963-971 ◽  
Author(s):  
Shigeru Tanaka ◽  
Toshiharu Ninomiya ◽  
Ritsuko Katafuchi ◽  
Kosuke Masutani ◽  
Akihiro Tsuchimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Immunoglobulin A ◽  
Japanese Patients ◽  
Secular Trends ◽  
Immunoglobulin A Nephropathy ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Recurrence of immunoglobulin A nephropathy after kidney transplantation: a narrative review of the incidence, risk factors, pathophysiology and management of immunosuppressive therapy

2020 ◽  
Vol 13 (5) ◽  
pp. 758-767
Author(s):  
Barbara Infante ◽  
Michele Rossini ◽  
Adelaide Di Lorenzo ◽  
Nicola Coviello ◽  
Castellano Giuseppe ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Immunosuppressive Treatment ◽  
Graft Loss ◽  
Immunoglobulin A ◽  
Supportive Therapy ◽  
Kidney Graft ◽  
Immunoglobulin A Nephropathy ◽  
Kidney Transplant Recipients ◽  
End Stage

Abstract Glomerulonephritis (GN) is the underlying cause of end-stage renal failure in 30–50% of kidney transplant recipients. It represents the primary cause of end-stage renal disease for 25% of the dialysis population and 45% of the transplant population. For patients with GN requiring renal replacement therapy, kidney transplantation is associated with superior outcomes compared with dialysis. Recurrent GN was previously considered to be a minor contributor to graft loss, but with the prolongation of graft survival, the effect of recurrent disease on graft outcome assumes increasing importance. Thus the extent of recurrence of original kidney disease after kidney transplantation has been underestimated for several reasons. This review aims to provide updated knowledge on one particular recurrent renal disease after kidney transplantation, immunoglobulin A nephropathy (IgAN). IgAN is one of the most common GNs worldwide. The pathogenesis of IgAN is complex and remains incompletely understood. Evidence to date is most supportive of a several hit hypothesis. Biopsy is mandatory not only to diagnose the disease in the native kidney, but also to identify and characterize graft recurrence of IgAN in the kidney graft. The optimal therapy for IgAN recurrence in the renal graft is unknown. Supportive therapy aiming to reduce proteinuria and control hypertension is the mainstream, with corticosteroids and immunosuppressive treatment tailored for certain subgroups of patients experiencing a rapidly progressive course of the disease with active lesions on renal biopsy and considering safety issues related to infectious complications.

scholarly journals Prognostic factors for renal allograft survival in patients with immunoglobulin A nephropathy: A case control study

2014 ◽  
Vol 9 (4) ◽  
pp. 1179-1184 ◽  
Author(s):  
JUN-QI GUO ◽  
BAO-LIN SONG ◽  
ZHI-XIAN WU ◽  
WEI-ZHEN WU ◽  
LIU-TAO LUO ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Renal Allograft ◽  
Case Control Study ◽  
Immunoglobulin A ◽  
Case Control ◽  
Immunoglobulin A Nephropathy ◽  
Allograft Survival ◽  
Control Study

scholarly journals Spatiotemporal trends and prognosis of end-stage renal disease patients with biopsy-proven immunoglobulin A nephropathy in France from 2010 to 2014

2020 ◽  
Author(s):  
Thomas Robert ◽  
Rodolphe Jantzen ◽  
Alexandra Cambier ◽  
Matthieu Jamme ◽  
Cecile Couchoud ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Immunoglobulin A ◽  
Mortality Rates ◽  
Treatment Modalities ◽  
Immunoglobulin A Nephropathy ◽  
Spatiotemporal Trends ◽  
Stage Renal Disease ◽  
End Stage ◽  
Preemptive Transplantation

Abstract Background Although end-stage renal disease (ESRD) is frequently used as an outcome marker for primary immunoglobulin A nephropathy (IgAN), the clinical course after reaching ESRD is not well documented. This study examined patients’ characteristics and survival in ESRD-related biopsy-proven IgAN in France. Methods French Renal Epidemiology and Information Network Registry data from 2010 to 2014 were used to analyse patients’ survival and outcome in incident ESRD patients >16 years of age with biopsy-proven primary IgAN, in comparison with other primary and secondary glomerulonephritis (GN), adult polycystic kidney disease (ADPKD) or diabetes. Multivariable survival analysis was adjusted for age, sex, time on dialysis and comorbidities. Results Among 17 138 incident dialysis patients with ESRD, IgAN (242.8/10 000 dialysis initiation) represents the most common GN related to ESRD during 2010. IgAN patients were the youngest, and had the fewest comorbidities and the highest use of peritoneal dialysis (PD) (17%). In comparison with the haemodialysis group, hazard ratios for death were not different in the preemptive transplantation group [0.46, 95% confidence interval (CI) 0.17–1.28] and in the PD group (0.77, 95% CI 0.44–1.33). Mortality rates in IgAN patients with preemptive transplantation and in those receiving dialysis waiting for transplantation were 2.9% (95% CI 0.0–5.6) and 6.7% (95% CI 0.9–12.3). Mortality rates of ADPKD patients receiving dialysis waiting for transplantation were higher (18%, 95% CI 3.1–30.6). Conclusion IgAN has the best prognosis among primary and secondary GN. IgAN patients receiving dialysis waiting transplantation seem to have a more favourable prognosis than ADPKD patients, who usually comprise the reference population. The underlying reasons for the difference in access treatment modalities should be investigated to improve survival with respect to renal disease.

Immunoglobulin A Nephropathy in a Renal Allograft of a Black Transplant Recipient

1992 ◽  
Vol 12 (1-2) ◽  
pp. 121-125 ◽  
Author(s):  
Susan Francisco ◽  
Barry M. Wall ◽  
Robert Cooke
Keyword(s):  
Transplant Recipient ◽  
Renal Allograft ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy
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