Overview of the Current Approach to Glomerular Disease Classification

Mejía-Vilet, Juan M.; Parikh, Samir

doi:10.1007/978-3-319-27334-1_5-1

Cited by 3 publications

(3 citation statements)

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“…Most patients present with hematuria, proteinuria, and impaired glomerular filtration rate (Chadban and Atkins, 2005). This pathological condition can be acute or chronic (developing over several months to years) based on the timing of clinical presentation (Mejia-Vilet and Parikh, 2019). Acute GN that develops into rapidly progressive disease most often results from conditions that involve an abnormal immune reaction.…”

Section: Crescentic Glomerulonephritismentioning

confidence: 99%

Crescentic Glomerulonephritis: Pathogenesis and Therapeutic Potential of Human Amniotic Stem Cells

2021

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Chronic kidney disease (CKD) leads to significant morbidity and mortality worldwide. Glomerulonephritis (GN) is the second leading cause of CKD resulting in end stage renal failure. The most severe and rapidly progressive type of GN is characterized by glomerular crescent formation. The current therapies for crescentic GN, which consist of broad immunosuppressive drugs, are partially effective, non-specific, toxic and cause many serious side effects including infections, cancer, and cardiovascular problems. Therefore, new and safer therapies are needed. Human amniotic epithelial cells (hAECs) are a type of stem cell which are isolated from the placenta after birth. They represent an attractive and novel therapeutic option for the treatment of various inflammatory conditions owing to their unique and selective immunosuppressive ability, as well as their excellent safety profile and clinical applicability. In this review, we will discuss the immunopathogenesis of crescentic GN, issues with currently available treatments and how hAECs offer potential to become a new and harmless treatment option for this condition.

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Section: Crescentic Glomerulonephritismentioning

confidence: 99%

Crescentic Glomerulonephritis: Pathogenesis and Therapeutic Potential of Human Amniotic Stem Cells

2021

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“…[7] The aetiologies that lead to RPGN are grouped into three main categories [6,9] based on the pattern of immunoglobulin (Ig) deposition on immune-histological examination. [6,10,11] These are: immune-complex-mediated, which include post-infectious glomerulonephritis (Fig. 1), membranoproliferative glomerulonephritis, lupus nephritis and IgA nephropathy; pauci-immune crescentic glomerulonephritis (PICGN), which is commonly attributed to anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis; and antiglomerular basement membrane (anti-GBM) disease.…”

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confidence: 99%

“…1), membranoproliferative glomerulonephritis, lupus nephritis and IgA nephropathy; pauci-immune crescentic glomerulonephritis (PICGN), which is commonly attributed to anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis; and antiglomerular basement membrane (anti-GBM) disease. [10,11] The exact incidence of CGN is unknown; however, in various studies it has been reported to account for about 5% of renal biopsies. [5] Regarding CGN in paediatric patients, a few African studies are noted.…”

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confidence: 99%

Crescentic glomerulonephritis in children: A retrospective review of data from Chris Hani Baragwanath Academic Hospital

Mansoor¹

2023

S Afr J Child Health

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Background. Crescentic glomerulonephritis (CGN) as a cause of progressive renal failure is rare. Crescent formation on kidney biopsyrepresents a response to injury of the glomerular capillary walls. There are limited published reports on paediatric CGN in Africa.Objectives. To describe the clinical presentation and outcome of children with CGN in Soweto, South Africa, over a 22-year period.Methods. A retrospective study was conducted at the Paediatric Renal Unit at Chris Hani Baragwanath Academic Hospital. Childrenyounger than 14 years with crescent formation in more than 50% of glomeruli on renal biopsy were included in the study. Kidney biopsy specimens were examined by light microscopy, immunofluorescence and electron microscopy. Demographic and clinical data were extracted from the patient files.Results. During the study period, 961 kidney biopsies were performed. Fourteen patients (1.5%) met inclusion criteria of crescents in>50% of glomeruli. Common clinical findings were oedema (n=13; 93%), microscopic haematuria (n=12; 86%), hypertension (n=11; 79%)and proteinuria (n=10; 71%). The median estimated glomerular filtration rate (eGFR) at presentation was 23.9 mL/min/1.73m2. Thirteen patients (93%) had immune-complex-mediated glomerulonephritis. The underlying cause was acute post-infectious glomerulonephritis in 9 patients (64%), membranoproliferative glomerulonephritis and IgA nephropathy in 2 patients each (14%) and global sclerosis in 1 patient (7%). Prolonged duration of symptoms resulted in a lower eGFR at follow-up. Treatment included peritoneal dialysis, methylprednisolone and cyclophosphamide. Seven (54%) patients had a normal eGFR at a median (range) follow-up of 36.7 (4.5 - 61.5) months. Six (46%) patients had progressed to chronic kidney disease stages 2 - 5. One patient was followed up for less than 3 months, and therefore was not included in the follow-up results.Conclusion. Poor outcomes were observed in patients who presented late. The clinical findings of haematuria, hypertension and acutekidney injury warrant early referral and kidney biopsy to determine management.

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Síndrome Edematoso Generalizado por Citomegalovirus

Meneses Zurita,

Miranda Bustamante

2023

GMB

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El síndrome edematoso generalizado o anasarca está presente secundario a un desequilibrio de la homeostasis hídrica, electrolítica y osmolar del organismo, En el adulto el estado de anasarca es más frecuente secundario a insuficiencia cardiaca, en pediatría, el edema que se generaliza está asociado con más frecuencia a bajo aporte proteico, baja síntesis de proteínas o debido a perdida de proteínas de origen gastrointestinal o renal. La disminución de la presión oncótica plasmática genera fuga de líquidos a compartimientos intersticiales de forma generalizada y produce edema. Existen múltiples patologías y mecanismos para la producción del edema generalizado; el conocimiento de la fisiopatología de su desarrollo permite un análisis clínico, de laboratorio y de gabinete que orientan al diagnostico. La infección por citomegalovirus es una causa poco frecuente de edema generalizado, reconocer esta entidad y llegar a un adecuado diagnóstico diferencial es el objetivo de esta revisión.

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Overview of the Current Approach to Glomerular Disease Classification

Cited by 3 publications

References 83 publications

Crescentic Glomerulonephritis: Pathogenesis and Therapeutic Potential of Human Amniotic Stem Cells

Crescentic Glomerulonephritis: Pathogenesis and Therapeutic Potential of Human Amniotic Stem Cells

Crescentic glomerulonephritis in children: A retrospective review of data from Chris Hani Baragwanath Academic Hospital

Síndrome Edematoso Generalizado por Citomegalovirus

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