Mycophenolate mofetil in nonlupus glomerulonephropathy

Lupus ◽  
2005 ◽  
Vol 14 (3_suppl) ◽  
pp. 39-41 ◽  
Author(s):  
MY Karim ◽  
IC Abbs
Keyword(s):  
Mycophenolate Mofetil ◽  
Hepatitis C ◽  
Maintenance Therapy ◽  
Iga Nephropathy ◽  
Small Groups ◽  
Membranous Nephropathy ◽  
Membranoproliferative Glomerulonephritis ◽  
Clinical Course ◽  
Glomerular Diseases ◽  
Lupus Glomerulonephritis

Mycophenolate mofetil (MMF) initially found widespread use in the immunoprophylaxis of rejection in organ transplantation. It has subsequently been used in lupus glomerulonephritis, where early studies have shown it to be effective in induction and maintenance therapy. The randomized studies have mostly studied small groups of patients and their conclusions do need to be confirmed in larger studies. MMF has also been used in small numbers of patients in a variety of nonlupus glomerulopathies, which have different underlying immunopathology as well as clinical course, including IgA nephropathy, membranous nephropathy, focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, hepatitis-C-associated glomerulonephritis and even Goodpasture's syndrome. In this article, we discuss its use in such nonlupus glomerular diseases.

P0501THE EPIDEMIOLOGICAL FEATURES OF PIRMARY GLOMERULAR DISEASES IN TURKEY: THE MULTICENTER STUDY OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES (TSN-GOLD) WORKING GROUP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Aydin Turkmen ◽  
Abdullah Sumnu ◽  
Egemen Cebeci ◽  
Halil Yazici ◽  
Necmi Eren ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Membranous Nephropathy ◽  
Working Group ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
The Mean ◽  
Primary Glomerular Diseases ◽  
Turkish Society

Abstract Background and Aims The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD)Working Group. Method The data of patients who underwent renal biopsy and diagnosed as primary glomerular disease were recorded in the database prepared for the study. Between May 2009 and May 2019, a total of 4399 patients from 47 centers were evaluated. Basal data of 3875 patients were analyzed after exclusion of those lacking light microscopy and immunofluorescence findings. Results The mean age was 41.5 ± 14.9 years. Of the patients, 1690 were female (43.6%) and 2180 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGH was IgA nephropathy (25.7%), followed by membranous nephropathy (25.6%) and FSGS (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. Mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. Median proteinuria was 3300 (IQR: 1467-6307) mg / day, mean serum creatinine, estimated GFR and albumin values were 1.4 ± 1.5 mg / dl, 80.7 ± 39.1 ml / min and 3.2 ± 0.9 g / dl, respectively. Conclusion In Turkey, the incidence of IgA nephropathy patients have become more common than membranous nephropathy among PGD patients diagnosed with renal biopsy.

scholarly journals Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Aydin Turkmen ◽  
Abdullah Sumnu ◽  
Egemen Cebeci ◽  
Halil Yazici ◽  
Necmi Eren ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Membranous Nephropathy ◽  
Working Group ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
The Mean ◽  
Primary Glomerular Diseases ◽  
Turkish Society

Abstract Background The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results The mean age was 41.5 ± 14.9 years. 1690 patients were female (43.6%) and 2185 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGD was IgA nephropathy (25.7%) followed by membranous nephropathy (25.6%) and focal segmental glomerulosclerosis (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. The mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467–6307) mg/day, 1.0 (IQR: 0.7–1.6) mg/dL, 82.9 (IQR: 47.0–113.0) mL/min and 3.2 ± 0.9 g/dL, respectively. Conclusions The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy.

scholarly journals Management and treatment of glomerular diseases (part 1): conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference

2020 ◽  
Vol 24 (2) ◽  
pp. 22-41 ◽  
Author(s):  
Jűrgen Floege ◽  
Sean J. Barbour ◽  
Daniel C. Cattran ◽  
Jonathan J. Hogan ◽  
Patrick H. Nachman ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Iga Nephropathy ◽  
Membranous Nephropathy ◽  
Work Group ◽  
Glomerular Disease ◽  
Glomerular Diseases ◽  
General Management ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The Kidney Disease: Improving Global Outcomes (KDIGO) initiative organized a Controversies Conference on glomerular diseases in November 2017. The conference focused on the 2012 KDIGO guideline with the aim of identifying new insights into nomenclature, pathogenesis, diagnostic work-up, and, in particular, therapy of glomerular diseases since the guideline’s publication. It was the consensus of the group that most guideline recommendations, in particular those dealing with therapy, will need to be revisited by the guideline-updating Work Group. This report covers general management of glomerular disease, IgA nephropathy, and membranous nephropathy.

scholarly journals KM55 in the evaluation of IgA containing glomerular diseases

2021 ◽  
Author(s):  
Rahul Raj ◽  
Alok Sharma ◽  
Adarsh Barwad ◽  
Soumita Bagchi ◽  
Sanjay Kumar Agarwal ◽  
...  
Keyword(s):  
Liver Disease ◽  
Lupus Nephritis ◽  
Chronic Liver Disease ◽  
Iga Nephropathy ◽  
Membranoproliferative Glomerulonephritis ◽  
Chronic Liver ◽  
Henoch Schonlein Purpura ◽  
Glomerular Diseases ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Introduction: Mucosal derived galactose deficient IgA is central to the pathogenesis of primary IgA nephropathy. Recent reports suggest similar pathogenesis in Henoch Schonlein purpura and secondary IgA nephropathy. Its role in other IgA containing glomerular diseases is still under investigation. It can be detected in glomeruli with the recently described antibody, KM55. We aimed to evaluate the role of KM55 by immunostaining a wide spectrum of IgA containing glomerular diseases. Methods: After standardization and co localization in a case of IgA nephropathy, a spectrum of 60 cases including IgA nephropathy, Henoch Schonlein purpura, chronic liver disease related IgA nephropathy, other secondary IgA Nephropathy, IgA dominant/co dominant membranoproliferative glomerulonephritis and lupus nephritis were subjected to immunofluorescence with KM55. KM55 was used to resolve diagnostic dilemma in cases of IgA deposition with confounding histology. Results: The group of primary IgA Nephropathy (17 cases), Henoch Schonlein purpura (4 cases) and secondary IgA nephropathy (19 cases) including chronic liver disease showed 2 -3+ granular staining with KM55 suggesting mucosal derived IgA. In contrast, cases of IgA dominant/co dominant membranoproliferative glomerulonephritis (8 cases) and lupus nephritis (12 cases) were negative for KM55, suggesting systemic derivation of IgA. In cases of IgA deposition with confounding histology such as membranoproliferative or diffuse endocapillary proliferative pattern, KM55 helped to resolve the diagnosis. Discussion/Conclusion: This cross-sectional study concludes that KM55 is useful in the evaluation of IgA containing glomerular diseases from a pathogenetic perspective, and is a practical tool in resolving differential diagnosis in cases with overlapping histopathologic features.

scholarly journals Socioeconomic Position and Incidence of Glomerular Diseases

2020 ◽  
Vol 15 (3) ◽  
pp. 367-374 ◽  
Author(s):  
Mark Canney ◽  
Dilshani Induruwage ◽  
Anahat Sahota ◽  
Cathal McCrory ◽  
Michelle A. Hladunewich ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Confidence Interval ◽  
Iga Nephropathy ◽  
Socioeconomic Position ◽  
Membranous Nephropathy ◽  
Rate Ratio ◽  
Population Level ◽  
Income Quintile ◽  
Inverse Association ◽  
Glomerular Diseases

Background and objectivesSocial deprivation is a recognized risk factor for undifferentiated CKD; however, its association with glomerular disease is less well understood. We sought to investigate the relationship between socioeconomic position and the population-level incidence of biopsy-proven glomerular diseases.Design, setting, participants, & measurementsIn this retrospective cohort study, a provincial kidney pathology database (2000–2012) was used to capture all incident cases of membranous nephropathy (n=392), IgA nephropathy (n=818), FSGS (n=375), ANCA-related GN (ANCA-GN, n=387), and lupus nephritis (n=389) in British Columbia, Canada. Quintiles of area-level household income were used as a proxy for socioeconomic position, accounting for regional differences in living costs. Incidence rates were direct standardized to the provincial population using census data for age and sex and were used to generate standardized rate ratios. For lupus nephritis, age standardization was performed separately in men and women.ResultsA graded increase in standardized incidence with lower income was observed for lupus nephritis (P<0.001 for trend in both sexes) and ANCA-GN (P=0.04 for trend). For example, compared with the highest quintile, the lowest income quintile had a standardized rate ratio of 1.7 (95% confidence interval, 1.19 to 2.42) in women with lupus nephritis and a standardized rate ratio of 1.5 (95% confidence interval, 1.09 to 2.06) in ANCA-GN. The association between income and FSGS was less consistent, in that only the lowest income quintile was associated with a higher incidence of disease (standardized rate ratio, 1.55; 95% confidence interval, 1.13 to 2.13). No significant associations were demonstrated for IgA nephropathy or membranous nephropathy.ConclusionsUsing population-level data and a centralized pathology database, we observed an inverse association between socioeconomic position and the standardized incidence of lupus nephritis and ANCA-GN.

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