Journal of Nephrology, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 20, 2024
Language: Английский
Pediatric Nephrology, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 1, 2025
Language: Английский
Citations
0
World Journal of Clinical Cases, Journal Year: 2025, Volume and Issue: 13(19)
Published: March 18, 2025
Immunoglobulin (Ig) A nephropathy is the most common type of primary glomerulonephritis globally. It typically manifests with microscopic hematuria and a spectrum proteinuria, although rapidly progressive may occur in rare instances. Deposition IgA mesangium seems to be underlying disease mechanism. Despite current treatment, progress into end-stage renal disease, indicating necessity for development new therapeutic agents. Lifestyle modifications anti-proteinuric treatment are recommended, steroids have shown beneficial high risk groups. Nevertheless, other conventional immunosuppressive agents, such as cyclophosphamide mycophenolate mofetil, considered, despite lack sufficient evidence support their efficacy. considerable proportion cases remain unresponsive these treatments, underscoring need novel approaches. There several promising drugs, B-cell lineage depleting agents or complement system inhibitors, that currently undergoing clinical trials. These therapies considered use selected cases.
Language: Английский
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0
Nephrology Dialysis Transplantation, Journal Year: 2025, Volume and Issue: unknown
Published: March 25, 2025
Language: Английский
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0
Journal of Nephrology, Journal Year: 2025, Volume and Issue: unknown
Published: April 1, 2025
Language: Английский
Citations
0
Biomedicines, Journal Year: 2024, Volume and Issue: 12(6), P. 1250 - 1250
Published: June 4, 2024
Background: Patients with IgA nephropathy (IgAN), a chronic kidney disease (CKD), are significantly more likely to have cardiovascular (CV) mortality and morbidity than the general population. The occurrence of metabolic syndrome (MetS) risk factors independent for CV renal progression. purpose this study was determine how characteristics in homogeneous population CKD patients relate prognosis. Methods: A total 145 stages 1–4 diagnosed (92 men 53 women, aged 54.7 ± 13 years) were examined monitored median 190 months. All-cause any event, such as stroke, myocardial infarction, revascularization (CV), end-stage disease, replacement therapy (renal), been included composite endpoints (CV renal). Results: MetS had primary endpoint events (23/65 vs. 15/60 patients, p < 0.001) compared non-MetS group. group statistically significant increase both (18/65 10/60, = 0.001), (7/65 6/60, 0.029) among secondary separately). Based on Cox regression analysis, main predictors survival dyslipidemia, eGFR, hemoglobin, urine albuminuria, diabetes mellitus. Independent albumin, eGFR. Predictors gender, BMI, diabetes. When Kaplan–Meier curves analyzed at combined renal) or each independently, differences seen between non-MetS. With components, rate increased (MetS comp. 0 2+, endpoints, 0.012). Conclusions: Our results show that profile has prognostic role not only but also IgAN. hyperuricemia, hypertension, predictive value prognosis nephropathy.
Language: Английский
Citations
2
Medicina, Journal Year: 2024, Volume and Issue: 60(2), P. 274 - 274
Published: Feb. 5, 2024
IgA nephropathy (IgAN) represents the most prevalent form of primary glomerulonephritis, and, on a global scale, it ranks among leading culprits behind end-stage kidney disease (ESKD). Presently, strategy for managing IgAN revolves around optimizing blood pressure and mitigating proteinuria. This is achieved through utilization renin–angiotensin system (RAS) inhibitors, namely, angiotensin-converting enzyme inhibitors (ACEi) angiotensin receptor blockers (ARBs). As outlined by KDIGO guidelines, individuals who continue to show persistent high risk progressive ESKD, even with comprehensive supportive care, are candidates glucocorticoid therapy. Despite these therapies, some patients have refractory treatment, defined as that present 24 h urinary protein persistently >1 g after at least two rounds regular steroids (methylprednisolone or prednisone) and/or immunosuppressant therapy (e.g., mycophenolate mofetil), do not tolerate The aim this Systematic Review revise current literature, using biomedical database PubMed, investigate possible therapeutic strategies, including SGLT2 endothelin blockers, targeted-release budesonide, B cell proliferation differentiation fecal microbiota transplantation, well blockade complement components.
Language: Английский
Citations
1
Kidney & Blood Pressure Research, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 1
Published: May 31, 2024
<b><i>Introduction:</i></b> IgA nephropathy (IgAN) is a prevalent worldwide glomerular disease with complex pathophysiology that has significant economic implications. Despite the lack of successful research, this study aims to discover potential competing endogenous RNA (ceRNA) network autophagy-associated genes in IgAN and examine their correlation immune cell infiltration. <b><i>Methods:</i></b> Autophagy-related hub were discovered by assessing GSE116626 dataset constructing protein-protein interaction network. Nephroseq v5 analysis engine was used analyze correlations between proteinuria, filtration rate (GFR), serum creatinine levels. Then, ceRNA construction CIBERSORT tool for infiltration also performed. Additionally, differentially expressed autophagy-related predict targeted medications IgAN. <b><i>Results:</i></b> Overall, 1,396 identified along 25 messenger RNAs. Enrichment revealed involvement autophagy apoptosis biological processes. Next, we evaluated top nodes based on highest degrees. The ability discrimination confirmed GSE35487 GSE37460 datasets validating five genes: SIRT1, FOS, CCL2, CDKN1A, MYC. In engine, clinical confirmed. Furthermore, 18 circular RNAs 2 microRNAs associated Our investigation hsa-miR-32-3p hsa-let-7i-5p as having elevated expression levels substantial diagnostic value. Finally, four distinctively infiltrated cells found be genes, 67 drugs therapeutic options <b><i>Conclusion:</i></b> This sheds light novel regulatory mechanism development.
Language: Английский
Citations
1
World Journal of Nephrology, Journal Year: 2024, Volume and Issue: 13(4)
Published: Nov. 6, 2024
Recently, new findings have been clarified concerning both pathogenesis and treatment of IgA nephritis. The four hits theory has confirmed but several genetic wide association studies allowed finding genes connected with the disease. All these apply to each hits. Additionally, discoveries microbiota its connection immune system generation out role mucosa in nephropathy pathogenesis. is also changed included future possibilities. chronic kidney disease, associated nephropathy, mandatory, since beginning classical immunosuppressive agents poor effect. corticosteroids remain an important cornerstone any phase More effect related B cells plasma cells. In particular, very recent documented efficacy anti cell-activating factor A proliferation-inducing ligand agents. Most are date II/III. Finally, targeting complement arising. These still randomized trials act principally hit 4 where immunocomplexes mesangium activate different pathways cascade.
Language: Английский
Citations
1
Published: April 15, 2024
Background: Cardiovascular (CV) morbidity and mortality are many times higher in chronic kidney disease (CKD), as well IgA nephropathy (IgAN), than the general population. The occurrence of metabolic syndrome (MetS) risk factors independent for CV renal progression. study aimed to determine prognostic role profiles a homogenous group CKD patients. Methods: One hundred forty-five patients (92 male, 53 female, age 54.7 ± 13 years) with stage 1-4 were investigated followed median 190 months. composite (CV renal) endpoints included all-cause any event such stroke, myocardial infarction, revascularization (CV), end-stage disease, replacement therapy (renal). Results: Patients MetS had significantly more endpoint events (16/27 vs. 15/98 patients, p = 0.001) compared nonMetS group. Of secondary or separately), rate was (p 0.001 0.029). primary predictors survival dyslipidemia, eGFR, hemoglobin, urine albuminuria, diabetes mellitus, determined by Cox regression analysis. Independent albumin, eGFR. Predictors cardiovascular gender, BMI, diabetes. Kaplan-Meier curves showed significant differences non-MetS when examined at combined each separately. increased number components (MetS comp. 0 2+, endpoints, 0.012). Conclusion: Our results that profile has not only but also IgAN. hyperuricemia, hypertension, have predictive value prognosis nephropathy.
Language: Английский
Citations
0
Kidney International Reports, Journal Year: 2024, Volume and Issue: 9(10), P. 2848 - 2850
Published: Aug. 9, 2024
See [article type, i.e., Clinical Research] on Page xxx. Several long-term cohorts have revealed that the outcomes of patients with IgA nephropathy (IgAN) are far worse than previously expected. With rapidly emerging clinical research, supportive therapy for IgAN has expanded from renin angiotensin system blockade to include sodium-glucose cotransporter 2 inhibitors, and endothelin A receptor antagonists.1Caster D.J. Lafayette R.A. The treatment primary nephropathy: Change, Change.Am J Kidney Dis. 2024; 83: 229-240https://doi.org/10.1053/j.ajkd.2023.08.007Abstract Full Text PDF PubMed Scopus (8) Google Scholar,2Selvaskandan H. Barratt J. Cheung C.K. Novel paradigms: nephropathy.Kidney Int Rep. 9: 203-213https://doi.org/10.1016/j.ekir.2023.11.026Abstract (4) Scholar Among specific subpopulations IgAN, low-dose corticosteroids, hydroxychloroquine, mycophenolate mofetil, B-cell targeting agents, complement antagonists also been explored as potentially beneficial interventions.1Caster As all new therapeutics, risks treatment, such hyperkalemia, fluid retention, heart failure, hepatotoxicity, infection, need be balanced potential benefits patient. Optimizing is notoriously challenging clinicians; however, current data derived these trials insufficient develop a comprehensive algorithm guide decision making.2Selvaskandan Scholar, 3Lafayette R. Kristensen Stone A. et al.Efficacy safety targeted-release formulation budesonide in (NefIgArd): 2-year results randomised phase 3 trial.Lancet. 2023; 402: 859-870https://doi.org/10.1016/S0140-6736(23)01554-4Abstract (60) 4Lv Wong M.G. Hladunewich M.A. al.Effect oral methylprednisolone decline kidney function or failure TESTING randomized trial.JAMA. 2022; 327: 1888-1898https://doi.org/10.1001/jama.2022.5368Crossref (129) 2021 Disease: Improving Global Outcomes guidelines5Kidney (KDIGO) Glomerular Work GroupKDIGO practice guideline management glomerular.Kidney Suppl. 2021; 100: S1-S276https://doi.org/10.1016/j.kint.2021.05.021Abstract (1066) outlined glucocorticoids mofetil may used who remain at high risk progression despite maximum care, use agents should carefully considered, taking into account patients' toxicity drugs. Caution advised because immunosuppressive therapy, particularly glucocorticoids, can pose significant demonstrated by study.4Lv crucial question then becomes, which more likely respond glucocorticoid therapy? According recent study,6Harada K. Akai Y. Yamaguchi al.Prediction corticosteroid responsiveness based fibroblast-specific protein 1 (FSP1) nephropathy.Nephrol Dial Transplant. 2008; 23: 3152-3159https://doi.org/10.1093/ndt/gfn240Crossref (15) experienced decrease proteinuria less 1.0 g/d, known responders, had significantly lower number 1–positive (FSP1+) cells their renal tissue nonresponders. amount interstitial damage, percentage glomerulosclerosis per total glomeruli, chronic inflammation showed positive correlation FSP1+ cells. Cox regression analysis was strongest most predictor responsiveness. Patients >32.6 cells/HPF diagnosis were exhibit steroid resistance.6Harada Nevertheless, detected tissue, counterproductive dynamic monitoring, they only predict resistance IgAN.6Harada In this issue International Reports, study Li al. 7Li Lv M. al.Correlation urinary soluble CD163 levels disease activity response https://doi.org/10.1016/j.ekir.2024.07.031Abstract (u-sCD163) correlated both IgAN. cross-sectional analysis, baseline u-sCD163 associated macrophage infiltration, crescentic area, well active lesions. They demonstrate probability benefiting alone, whereas relative benefit much higher.7Li Compared placebo, full-dose regimens lowered levels, reduction events, included ³40% estimated glomerular filtration rate, death due disease.7Li findings consistent previous higher intensity CD206+ CD68+ infiltration increased likelihood immunosuppression.8Xie D. Zhao Xu X. al.Intensity glomeruli predicts nephropathy.J Am Soc Nephrol. 32: 3187-3196https://doi.org/10.1681/ASN.2021060815Crossref (26) Collectively, studies suggest inflammatory lesions related receive early immunosuppression. extends our repertoire identifying infiltration; though previously, could confirmed histologically through biopsy, we now measurements, practical tool monitoring across varied settings. This novel biomarker extraordinarily stable over years storage, expands centers limited resources being able reliably send out testing biomarker. unanswered questions concerning selection remain. Can magnitude change degree glucocorticoids? Does responders imply relapse IgAN? Will accompany remission alone? recurrent transplanted kidneys? Another important concern how optimize promptly assess efficacy therapeutic drugs become available. Targeted-release budesonide, newer preparation, proven good side effects treatment.3Lafayette It will interesting see whether lead changes u-sCD163, allowing us expand its predicting therapy. Questions around when existing therapies repurposed setting For example, employing components monitored? Our work using proteomics technology multiple urine pathological parameters, suggesting role biomarkers management,9Wang Wu C. Chen S. al.Urinary profile characteristics.Front Immunol. 141117995https://doi.org/10.3389/fimmu.2023.1117995Crossref (3) further evaluation needed. Whether u-SCD163 therapeutics remains seen. Further exploring yet-unanswered needed integration making. New emerging, knowledge base continuously expanding. Undoubtedly, play an optimizing decisions prognostication toolkit continues grow. validation care help improve patients. GL scientific advisor AstraZeneca. other author declared no competing interests. Elevated Ambient Temperature Associated Increased Cardiovascular Disease–Risk HemodialysisKidney Reports
Language: Английский
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