Renal thrombotic microangiopathy associated to worse renal prognosis in Lupus Nephritis

Strufaldi, Fernando Louzada; Neves, Precil Diego Miranda de Menezes; Dias, Cristiane Bitencourt; Yu, Liang; Woronik, Viktoria; Cavalcante, Lívia Barreira; Malheiros, Denise Maria Avancini Costa; Jorge, Lectícia Barbosa

doi:10.1007/s40620-020-00938-3

Cited by 12 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are partly in contrast with previous studies that identified an association between worse renal prognosis and TMA in LN [14,38,39], since we did not find that TMA J o u r n a l P r e -p r o o f significantly predicted ESKD by itself, despite the independent correlation between PI-LowC3 and TMA.…”

Section: J O U R N a L P R E -P R O O Fcontrasting

confidence: 99%

Persistent Isolated C3 Hypocomplementemia as a Strong Predictor of End-Stage Kidney Disease in Lupus Nephritis

Rossi

Maggiore

Peyronel

et al. 2022

Kidney International Reports

View full text Add to dashboard Cite

Section: J O U R N a L P R E -P R O O Fcontrasting

confidence: 99%

Persistent Isolated C3 Hypocomplementemia as a Strong Predictor of End-Stage Kidney Disease in Lupus Nephritis

Rossi

Maggiore

Peyronel

et al. 2022

Kidney International Reports

View full text Add to dashboard Cite

“…Although in recent years the interest in vascular lesions in lupus nephritis has grown, these lesions are still overlooked when they occur with immunecomplex-mediated lesions, and this may lead to an underestimation of the actual prevalence of APSN in these patients. Nonetheless, renal TMA carries the worst outcome among the various forms of lupus nephritis vascular damage and requires thorough evaluation [100][101][102][103][104]. This is consistent with the results of a study performed by Moroni and colleagues on 111 patients with lupus nephritis followed up for over 15 years, which showed that aPL-positive patients carried the worst kidney outcome [98].…”

Section: Apsn In Slesupporting

confidence: 84%

Antiphospholipid Syndrome and Kidney Involvement

De Simone,

Sciascia,

Fenoglio

et al. 2023

Kidney Blood Press Res

View full text Add to dashboard Cite

Background: Antiphospholipid syndrome is an autoimmune disease characterized by the development of autoantibodies and the impairment of the coagulation system. Knowledge about this syndrome is increasing over time, but kidney involvement, especially APS nephropathy, still represents a challenge for physicians. Summary: A “two hit” model has been hypothesized to explain APS pathophysiology, and the role played by some factors, such as the complement system, is becoming more and more clear. From a clinical point of view, along with thrombosis in any site and/or obstetric morbidities, that are the hallmarks of APS, a constellation of several other clinical symptoms is related to APS. These symptoms alone are not sufficient to fulfill Sydney criteria for APS and this could potentially lead to omitting some diagnoses. The mainstay of management of APS is antithrombotic therapy but there are expectations for new drugs that regulate the immune system. APS could affect the kidneys in many ways and among them, APS nephropathy is an intriguing entity that has been overlooked in recent years. Novel studies on APS nephropathy are lacking. Key messages: In this review we discuss what we currently know about APS and its relationship with the kidney, with an eye towards the future perspectives. Multicenter studies on APS nephropathy are necessary in order to develop targeted therapies.

show abstract

“…First, it was based on the assessment of PAS-stained slides, and other histological stains, such as haematoxylin-eosin and Masson trichrome, immunofluorescence, and electron microscopy were not included. Thus, vital diagnostic information, such as immune complex deposition or membranous nephropathy, could not be detected and this study could not confirm whether classes III and IV LN were combined with class V. Second, various other parameters, such as tubulointerstitial inflammation or renal thrombotic microangiopathy, which is an important renal prognostic feature [37], remain to be integrated before the renal biopsy pathology can be evaluated comprehensively. Third, because of difficulties in obtaining normal or minimal mesangial LN (class I) renal tissues from needle biopsy, this study did not obtain enough cases as controls in the model.…”

Section: Discussionmentioning

confidence: 85%

Deep Learning-Based Artificial Intelligence System for Automatic Assessment of Glomerular Pathological Findings in Lupus Nephritis

et al. 2021

View full text Add to dashboard Cite

Accurate assessment of renal histopathology is crucial for the clinical management of patients with lupus nephritis (LN). However, the current classification system has poor interpathologist agreement. This paper proposes a deep convolutional neural network (CNN)-based system that detects and classifies glomerular pathological findings in LN. A dataset of 349 renal biopsy whole-slide images (WSIs) (163 patients with LN, periodic acid-Schiff stain, 3906 glomeruli) annotated by three expert nephropathologists was used. The CNN models YOLOv4 and VGG16 were employed to localise the glomeruli and classify glomerular lesions (slight/severe impairments or sclerotic lesions). An additional 321 unannotated WSIs from 161 patients were used for performance evaluation at the per-patient kidney level. The proposed model achieved an accuracy of 0.951 and Cohen’s kappa of 0.932 (95% CI 0.915–0.949) for the entire test set for classifying the glomerular lesions. For multiclass detection at the glomerular level, the mean average precision of the CNN was 0.807, with ‘slight’ and ‘severe’ glomerular lesions being easily identified (F1: 0.924 and 0.952, respectively). At the per-patient kidney level, the model achieved a high agreement with nephropathologist (linear weighted kappa: 0.855, 95% CI: 0.795–0.916, p < 0.001; quadratic weighted kappa: 0.906, 95% CI: 0.873–0.938, p < 0.001). The results suggest that deep learning is a feasible assistive tool for the objective and automatic assessment of pathological LN lesions.

show abstract

Renal thrombotic microangiopathy associated to worse renal prognosis in Lupus Nephritis

Cited by 12 publications

References 29 publications

Persistent Isolated C3 Hypocomplementemia as a Strong Predictor of End-Stage Kidney Disease in Lupus Nephritis

Persistent Isolated C3 Hypocomplementemia as a Strong Predictor of End-Stage Kidney Disease in Lupus Nephritis

Antiphospholipid Syndrome and Kidney Involvement

Deep Learning-Based Artificial Intelligence System for Automatic Assessment of Glomerular Pathological Findings in Lupus Nephritis

Contact Info

Product

Resources

About