TY - JOUR. T1 - Predominance of Th1 Immune Response in Diffuse Proliferative Lupus Nephritis. AU - Masutani, Kohsuke. AU - Akahoshi, Mitsuteru. AU - Tsuruya, Kazuhiko. AU - Tokumoto, Masanori. AU - Ninomiya, Toshiharu. AU - Kohsaka, Tsutomu. AU - Fukuda, Kyoichi. AU - Kanai, Hidetoshi. AU - Nakashima, Hitoshi. AU - Otsuka, Takeshi. AU - Hirakata, Hideki. PY - 2001/9. Y1 - 2001/9. N2 - Objective. Lupus nephritis, which shows various histologic patterns, is a serious complication of systemic lupus erythematosus (SLE). We previously demonstrated the importance of Th1 cell-mediated immune response in patients with diffuse proliferative lupus nephritis (DPLN). The aim of this study was to examine the relationship between the peripheral blood Th1/Th2 balance and the intrarenal immune response. Methods. The Th1:Th2 ratio in peripheral blood was measured by intracellular staining for cytokines with flow cytometry. Immunohistochemical analysis of renal biopsy specimens was performed to clarify the ...
TY - JOUR. T1 - Successful transplantation of a donor kidney with diffuse proliferative lupus nephritis and crescents - A case report. AU - Magoon, Sandeep. AU - Zhou, Eric. AU - Pullman, James M.. AU - Greenstein, Stuart M.. AU - Glicklich, Daniel G.. PY - 2010/12. Y1 - 2010/12. N2 - Pre-existing diffuse proliferative glomerulonephritis (DPGN) in a potential deceased kidney donor has been considered a contraindication for transplantation. We report a case of a patient who underwent a successful deceased donor renal transplantation from a donor with history of systemic lupus erythematosus (SLE) whose baseline biopsy revealed DPGN. Although the histology was relatively benign in the procurement kidney biopsy done by frozen section, the final light microscopy available after transplantation showed diffuse proliferative lupus nephritis, WHO class IV, with 44% crescents. The post-transplant course was complicated by delayed allograft function requiring haemodialysis for the first week. A repeat ...
Renal Diets are the most concerned question among patients with kidney disease, including Lupus Nephritis patients. In fact, diet therapy plays a significant role in treatment of lupus nephritis. Now, lets see the LN patients on renal diet.
Background and objective The rate of end-stage renal disease from lupus nephritis has not declined, in spite of recent advances in therapeutics, such as mycophenolate mofetil (MMF). To provide insight into rates of the clinical outcomes in current practice after biopsy-proven lupus nephritis, we used a prospective cohort of the patients with newly diagnosed lupus nephritis, treated with MMF and observed their outcomes. Method Twenty systemic lupus erythematosus (SLE) patients who began mycophenolate mofetil shortly after a biopsy-confirmed diagnosis of lupus nephritis were included in the analysis. There were five patients with class III, nine with class IV, four with class III-V, one with class IV-V and two with class V lupus nephritis. The initial dose of mycophenolate mofetil was 1000 mg twice daily. If no improvement was observed, the dose was increased to 1500 mg twice daily after one month. We estimated the survival function for the time until the urine protein/creatinine reached 0.50 grams or
Lupus nephritis, which has various histological patterns and variable clinical outcomes, is one of the most important complications of systemic lupus nephritis (SLE). This pathogenetic mechanism in each histologically different type of lupus nephritis (LN) remains unclear. Although SLE is suggested to be a Th2-driven disease, elevation of both Th1 and Th2 cytokines occurs in both humans and mice, suggesting that SLE is a complex disease driven by different lymphocyte subsets with high heterogeneity of clinical manifestations and organ involvement. Recent findings in LN elucidate an essential role for the Th1, IL-17 producing T cells and Th17 cells in the development of diffuse proliferative lupus nephritis (DPLN), and Th2 cytokine in that of membranous lupus nephritis (MLN). These data support the hypothesis that individual Th1/Th2 balance is one of the critical determinants for histopathology of LN.
Results The percentage change from baseline in eGFR at week 24 was greater in both LAQ groups vs. placebo (0.5mg vs. 1mg LAQ vs. placebo: 18.0 ± 30.7 vs. 24.3 ± 28.8 vs. 12.1 ± 20.2, respectively). The percent change from baseline in spot urine protein: creatinine ratio also showed a difference between treatment arms in favor of LAQ (0.5mg vs. 1mg LAQ vs. placebo: -61.4 ± 22.8 vs. -23.0 ± 53.6 vs. -8.3 ± 81.26, respectively). Renal responses were greater at week 24 with LAQ vs. placebo (ALMS study criteria - based on spot urine instead of 24hr collection): In the LAQ 0.5mg group, 10 patients (62.5%) achieved renal response compared to 6 (40%) in the LAQ 1mg group and 5 (33.3%) in the placebo group. There was no difference among the three treatment groups in the frequency of common adverse events (AEs) including infections. Four patients in each group experienced serious AEs (SAEs). 6 SAEs were due to infection, 3 SAEs were related to lupus, 3 were thromboembolic events, and one patient ...
Background Severe renal manifestation of systemic lupus erythematosus (SLE) is not uncommon and is associated with an indeterminate prognosis. Complete remission can be obtained, however, at least in...
Reddy PS, Legault HM, Sypek JP, Collins MJ, Goad E, Goldman SJ, Liu W, Murray S, Dorner AJ, OToole M: Mapping similarities in mTOR pathway perturbations in mouse lupus nephritis models and human lupus nephritis. Arthritis Res Ther. 2008, 10: R127-10.1186/ar2541.PubMedCentralCrossRefPubMedGoogle Scholar ...
Bone loss in Lupus Nephritis (LN) patients is common and multifactorial. The aim of this study was to evaluate the bone status of newly diagnosed LN patients and their correlation with inflammatory fa...
Background/Purpose: Lupus nephritis (LN) afflicts 12-69% lupus patients. Even with the best available therapies, complete response is achieved in only 10-85% of patients. The risk of nephritis and its poor outcomes is significantly higher in blacks. To gain better understanding of the pathogenesis specific for LN, biopsy samples from LN and other glomerulopathies (controls) were evaluated for differential gene expression levels.. Methods: Patients with LN meeting ACR SLE criteria and controls consented to donate additional samples during a clinically indicated renal biopsy. Forty-one LN and 8 control samples were analyzed after rRNA was depleted from total RNA. Libraries were prepared and sequenced with Illumina HiSeq 2500 and mapped onto the human genome. Differentially expressed genes (DEG) were selected by DESeq2. Signaling Pathway Impact Analysis identified pathways enriched for DEGs that were mapped to the Reactome database. Key transcripts were correlated with clinical and histologic ...
Results 138 episodes of ASR occurred in 98 patients during the study period. 53 episodes (in 38 patients) were treated with pre-emptive increase in immunosuppression while 85 episodes (in 60 patients) were not, and patients were followed up for 88.8±77.3 months and 82.8±89.7 months respectively after ASR occurred. Pre-emptive treatment was associated with superior renal relapse-free survival (100%, 95% and 90% at 6, 12 and 24 months respectively) compared with no pre-emptive treatment (93%, 68% and 65% respectively, p=0.007), while extra-renal relapse-free survival did not differ between the two groups (Figure 1). 5 (9.4%) of 53 ASR episodes treated pre-emptively developed renal flare at 14.3±6.7 months after ASR. Patients who received pre-emptive treatment for ASR and did not develop renal flares showed also better eGFR slope (+0.54±0.43 ml/min/1.73 m2/year) compared with the non-pre-emptive groups with or without renal flares (−2.11±0.50 and −1.00±0.33 ml/min/1.73 m2/year ...
Results Plasma ADAMTS-13 activity in lupus nephritis patients was significantly lower than that in normal controls (84%±21% vs. 90%±13%, p=0.005). The plasma levels of vWF was significantly higher in lupus nephritis group than that in normal controls (1.00±0.79 vs. 0.70±0.30, p=0.025). Plamsa ADAMTS-13 activity was negatively correlated with the level of serum creatinine and proteinuria (r=−0.354, p,0.001; r=−0.200, p=0.011, respectively). Patients with higher ADAMTS-13 activity had significantly higher levels of factor H (401.51±183.01 µg/ml vs. 239.02±155.45 µg/ml, p=0.005). Plasma ADAMTS-13 activity was negatively associated with the total pathological AI scores ,acute glomerular vascular lesions, acute renal vascular lesions (all p,0.001) and tubular atrophy ( p=0.011). Low activity of ADAMTS-13 was a risk factor for renal outcomes (p=0.039, HR=0.047, 95% CI: 0.120-1.005). ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
Background Systemic lupus erythematosus (SLE) is accompanied by alterations in T cell homeostasis including an increased effector response. Migrated effector memory T cells (CD45RO+CCR7-; TEM) appear to be involved in tissue injury. The objective of this study was to investigate the distribution and phenotype of effector memory T cells in the peripheral blood (PB), and their presence in renal biopsies and urine of patients with SLE. The hypothesis that these TEM cells migrate to the kidney during active disease was tested.. Methods A total of 43 patients with SLE and 20 healthy controls were enrolled. CD4+TEM cells and CD8+TEM cells were analysed in PB and urine using flow cytometric analysis. In 10 patients with active lupus nephritis a parallel analysis was performed on the presence of TEM cells in kidney biopsies.. Results The percentage of circulating CD8+TEM cells in patients with SLE was significantly decreased versus healthy controls (33.9±18.3% vs 42.9±11.0%, p=0.008). In patients with ...
Mycophenolate mofetil (MMF) is metabolized to mycophenolic acid, which inhibits inosine monophosphate dehydrogenase and in turn inhibits the de novo pathway for guanine nucleotide synthesis. As the proliferation of B and T cells is highly dependent on this pathway, MMF has a potent cytostatic effect on lymphocytes.15. Within the last decade, MMF has been shown in studies to be effective for induction therapy for lupus nephritis. In a study conducted in Hong Kong, 42 patients with diffuse proliferative lupus nephritis were randomized to either oral MMF (2 g daily for 6 months followed by 1 g daily for 6 months) or oral cyclophosphamide (2.5 mg/kg/day for 6 months) followed by oral azathioprine (1.5 mg/kg/day for 6 months). Both arms of the study also received oral prednisolone daily. After 12 months of follow-up, there were no significant differences between the groups in terms of complete or partial remission rates. There were also no significant differences in relapse rate between the two arms; ...
The kidney is affected to some degree in almost all patients with SLE. Renal disease is associated with higher morbidity and mortality rates. The study of the prognosis of lupus nephritis has underscored the potential importance of a number of demographic (sex, race, age), clinical, and histological parameters (WHO class, activity, and chronicity indices) which contribute to the outcome. SLE occurs more commonly in women (90%) than in men, and age at onset ranges from 16 to 50 years 8. In the present study, 89.6% of the patients with lupus nephritis were women and mean age onset of lupus nephritis was 25.8 10.2 years. Genetic factors are important in lupus nephritis, with a strong racial preponderance. The prevalence and mortality of lupus are ten times higher in black women than in whites 5. In contrast to the literature, our study showed a higher incidence of lupus nephritis among white patients (76.7%). Many clinical parameters have been used to estimate the prognosis of lupus nephritis. ...
B: Nephritic Syndrome together with Nephritis Syndrome. The patients with this kind of symptoms often have hematuria, hypertension, and kidney damage and also are accompanied with active SLE manifestations. The patients with the above symptoms belong to diffuse proliferative Lupus Nephritis. If the patients do not receive effective treatment, most of the patients can develop into Renal Failure in 2 years ...
Remission of proteinuria in patients with diffuse proliferative lupus nephritis is associated with a good prognosis, researchers reported
How to Avoid Dialysis for End-stage Renal Disease due to Lupus Nephritis? Immunotherapy is the most effective treatment for end-stage renal disease due to lupus nephritis patients avoid dialysis.Immunotherapy in China is a breakthrough in biomedical science, which brings new hope to patients in the end stage of renal failure. What is more, Immunotherapy needs no surgery or cause sufferings or blood matching at all, which help the patients save valuable time. It does not have side effects at all ...
Chinese medicine is very popular in china, which is widely used in treating all kinds of diseases. More and more kidney diseases patients want to know can chinese medicine help chronic nephritis patients. Following this article to get the answer of chines
TY - JOUR. T1 - Antiproteinuric effect of chemokine C-C motif ligand 2 inhibition in subjects with acute proliferative lupus nephritis. AU - Ble, Alessandro. AU - Mosca, Marta. AU - Di Loreto, Giorgio. AU - Guglielmotti, Angelo. AU - Biondi, Giuseppe. AU - Bombardieri, Stefano. AU - Remuzzi, Giuseppe. AU - Ruggenenti, Piero. PY - 2011/10. Y1 - 2011/10. N2 - Background/Aims: To test the role of chemokine C-C motif ligand 2 (CCL2) in the pathogenesis of lupus nephritis (LN), we evaluated the effects of CCL2 inhibition by bindarit therapy in patients with systemic lupus and active renal disease. Methods: In this proof-of-concept, prospective, randomized, double-blind clinical study, 22 subjects with acute LN were assigned on a 1:1 ratio to 24-week treatment with bindarit (1,200 mg/day) or matching placebo. All subjects were on the same standardized steroid background therapy. Urinary CCL2, urinary albumin excretion (UAE), estimated glomerular filtration rate, time to remission and time to relapse ...
A case of a 42-year-old female with hyperthyroidism was subsequently diagnosed to have systemic lupus erythematosus with distal RTA. The clinical examination on admission showed swelling of the knee joints and the urinalysis showed pH 6.5, pro 3+. Her blood routine results were as follows: white blood cells 1.85×109/L, platelets 100×109/L, erythrocyte 3.06×1012/L. The serum potassium was 3.11 mmol/L, 24 hour urinary electrolyte: K 68.87 mmol/24 H, antinuclear antibodies (ANA) 1:1 000, speckled pattern. The anti-double stranded DNA antibody (anti-dsDNA), anti SS-A(52) antibody and anti SS-A(60) antibody were positive. The light microscopy and immunofluorescence showed diffuse proliferative lupus nephritis. These data were compatible with the diagnosis of systemic lupus erythematosus. The diagnosis of hyperthyroidism and distal RTA is clear. This report showed that other autoimmune disease in the diagnosis of hyperthyroidism should not be ignored.. ...
Lupus nephritis is a cause of significant morbidity in systemic lupus erythematosus (SLE) and its genetic background has not been completely clarified. The aim of this investigation was to analyze single nucleotide polymorphisms (SNPs) for association with lupus nephritis, its severe form proliferative nephritis and renal outcome, in two Swedish cohorts. Cohort I (n = 567 SLE cases, n = 512 controls) was previously genotyped for 5676 SNPs and cohort II (n = 145 SLE cases, n = 619 controls) was genotyped for SNPs in STAT4, IRF5, TNIP1 and BLK. Case-control and case-only association analyses for patients with lupus nephritis, proliferative nephritis and severe renal insufficiency were performed. In the case-control analysis of cohort I, four highly linked SNPs in STAT4 were associated with lupus nephritis with genome wide significance with p = 3.7x10(-9), OR 2.20 for the best SNP rs11889341. Strong signals of association between IRF5 and an HLA-DR3 SNP marker were also detected in the lupus ...
TY - JOUR. T1 - Pathogenic autoantibodies in lupus nephritis. AU - Waldman, M.. AU - Madaio, Michael P.. PY - 2005/2/21. Y1 - 2005/2/21. N2 - Lupus nephritis is a major complication of systemic lupus erythematosus (SLE) and is associated with a high rate of morbidity and mortality. While many different immunologic and nonimmunologic factors contribute to disease expression in lupus nephritis, a large body of evidence suggests that the production of anti-DNA antibodies and the formation of glomerular immune deposits are important initial events in the pathogenesis of the disease. This review will summarize our current understanding of the differences between pathogenic and nonpathogenic autoantibodies, the mechanisms by which these autoantibodies induce renal injury and the effector mechanisms which are subsequently activated by the deposited autoantibodies that ultimately lead to the expression of the different lupus lesions.. AB - Lupus nephritis is a major complication of systemic lupus ...
The information concerning non-invasive, easily obtainable, and accurate biomarkers for diagnosis of lupus nephritis (LN) is extremely limited. The aim of this study was to evaluate the diagnostic performance of cystatin C (CysC) and complement component 1q (C1q) for LN. A case-control study that included 905 patients with systemic lupus erythematosus (SLE) without LN (group SLE), 334 patients with active lupus nephritis (group LNA), 255 patients with inactive lupus nephritis (group LNI), and 497 healthy individuals (group HC) was performed in Mianyang Central Hospital from March 2017 to December 2018. The serum levels of CysC, C1q, urea (Urea), and creatinine (Creat) were measured, and 2 estimated glomerular filtration rates (eGFRCysC and eGFRCreat) were calculated by equations which were based on serum CysC established by our group and the modification of diet in renal disease (MDRD), respectively. ANOVA analysis or Kruskal-Wallis test was used for comparing the differences among the groups, and
TY - JOUR. T1 - Predictors of end stage renal disease in African Americans with lupus nephritis. AU - Franco, Carlos. AU - Yoo, Wonsuk. AU - Franco, Domingo. AU - Xu, Zeng. PY - 2010/1/1. Y1 - 2010/1/1. N2 - Lupus nephritis is one of the most serious manifestations of systemic lupus erythematosus (SLE). African Americans generally have a more severe presentation and more often progress to end stage renal disease (ESRD) than Caucasians. Several studies point to higher creatinine, low complement levels, thrombocytopenia, anemia, hypertension, and proliferative glomerulonephritis as predictors of ESRD in lupus nephritis within multi-ethnic cohorts. The purpose of the current study was to correlate clinical, serological, and immunological variables with the development of ESRD requiring dialysis in the African American population. Materials and Methods: A small retrospective study was performed with African American patients who had been diagnosed with lupus nephritis and biopsied between 1996 and ...
Patients must be 18 years of age or older and able to provide informed consent.. Patients must have at least 4 criteria for SLE as defined by the American Rheumatism Association (ARA).. Active glomerulonephritis with:. Renal biopsy within 1 year with class III or class IV active lupus nephritis, AND;. Abnormal urine analysis:. Greater than 10 RBC/hpf and cellular (RBC, WBC or mixed) casts, OR;. Greater than 10 RBC/hpf and proteinuria greater than 2 g/day, OR;. Proteinuria greater than 3.5 g/day.. No patients with severe proliferative lupus nephritis: a. very active renal histology with crescents or necrosis in more than 25% of glomeruli; or b. rapidly progressive glomerulonephritis (doubling of serum creatinine in less than or equal to 3 months); or c. severe impairment of renal function Cr greater than 2.5 mg/dL or GFR less than 50 mL/min measured by inulin clearance.. Patient has not had previous immunosuppressive therapy:. Patients must not be receiving azathioprine, cyclosporine, ...
Patients must be 18 years of age or older and able to provide informed consent.. Patients must have at least 4 criteria for SLE as defined by the American Rheumatism Association (ARA).. Active glomerulonephritis with:. Renal biopsy within 1 year with class III or class IV active lupus nephritis, AND;. Abnormal urine analysis:. Greater than 10 RBC/hpf and cellular (RBC, WBC or mixed) casts, OR;. Greater than 10 RBC/hpf and proteinuria greater than 2 g/day, OR;. Proteinuria greater than 3.5 g/day.. No patients with severe proliferative lupus nephritis: a. very active renal histology with crescents or necrosis in more than 25% of glomeruli; or b. rapidly progressive glomerulonephritis (doubling of serum creatinine in less than or equal to 3 months); or c. severe impairment of renal function Cr greater than 2.5 mg/dL or GFR less than 50 mL/min measured by inulin clearance.. Patient has not had previous immunosuppressive therapy:. Patients must not be receiving azathioprine, cyclosporine, ...
The role of macrophages in the pathogenesis of lupus nephritis, in particular their differentiation to a certain subtype (e.g., M1- or M2-like) modulating the inflammatory reaction, is unknown. Here we investigated whether the differentiation in M1- or M2-like macrophages depends on the stage of lupus nephritis and whether this correlates with clinical parameters. Using immunohistochemical analysis we analyzed renal biopsies from 68 patients with lupus nephritis (ISN/RPS classes II-V) for infiltration with M1-like (iNOS+/CD68+), M2a-like (CD206+/CD68+), M2c-like macrophages (CD163+/CD68+), and FoxP3+ regulatory T-cells. In addition, clinical parameters at the time of renal biopsy, i.e., blood pressure, proteinuria and serum urea were correlated with the macrophage infiltration using the Spearman test. The mean number of CD68+ macrophages was related to the diagnosed ISN/RPS class, showing the highest macrophage infiltration in biopsies with diffuse class IV and the lowest number in ISN/RPS class V. In
There has been a continuing quest for better treatments for lupus nephritis over the past few decades. Against the backdrop of a veritable clinical exigency, our group has sought to refine existing treatments and to establish new therapies that can improve patient outcomes. Our original research on mycophenolate mofetil, which demonstrated its efficacy and tolerability, has led to a change in the treatment paradigm for proliferative lupus nephritis. This article reviews our clinical research studies in the different types of lupus nephritis ...
We reported previously that a treatment regimen that comprised prednisolone and 12 mo of MMF showed equivalent efficacy as our standard regimen of prednisolone and 6 mo of cyclophosphamide followed by azathioprine in the treatment of DPLN, both achieving remission rates of approximately 80% (6). The treatment failures were attributed to death (only in the CTX-AZA group) or withdrawal as a result of drug intolerance (4.8% in each group), and none of the patients had uncontrolled disease activity that was resistant to treatment. Leukopenia, alopecia, and amenorrhea were observed only in the CTX-AZA group, and there was a trend toward fewer infections in MMF-treated patients. These differences, however, did not reach statistical significance because of the small sample size (n = 42). In addition, although the renal function remained stable in both groups, the short study duration of 12 mo precluded conclusions regarding relapse and long-term renal preservation. This extended study aimed to define ...
Clinical trial evaluating EQ001 for the treatment of refractory lupus nephritis to commence in 2H 2019. Ongoing EQ001 development programs in acute graft-versus-host disease and severe asthma remain on-track. Company to host conference call today, Tuesday, February 26, at 4:30 p.m. ET. LA JOLLA, Calif., Feb. 26, 2019 (GLOBE NEWSWIRE) -- Equillium, Inc. (Nasdaq: EQ), a biotechnology company leveraging deep understanding of immunobiology to develop products to treat severe autoimmune and inflammatory disorders with high unmet medical need, today announced that it plans to develop EQ001 for the treatment of lupus nephritis (LN). Equillium remains on track to initiate the EQUATE Phase 1b/2 trial in acute graft-versus-host disease (aGVHD) in the first quarter of 2019 and initiate a proof-of-concept trial in severe asthma in the second quarter of 2019. Equillium will host a conference call today to provide further details.. "Our decision to explore EQ001 for the treatment of lupus nephritis is ...
In general, glomerulonephritis is the most common form of nephritis. This type of nephritis can result in urinary protein and hematuria .And the interstitial nephritis mentioned above, hematuria, proteinuria can be relatively mild, or no an
The team is internationally recognized for their research output in lupus nephritis. In 2000 he published, in the New England Journal of Medicine, the first randomized controlled trial demonstrating the efficacy and tolerability of mycophenolate mofetil (MMF) in the treatment of severe lupus nephritis. Extended follow-up data from this investigator-initiated study was later published in the J Am Soc Nephrol (2005) and Rheumatology (Oxford) (2013). These results have subsequently been reconfirmed by other investigators and large-scale international multicenter studies, and MMF is now an established first-line standard of care treatment for lupus nephritis. The team has also investigated the potential of calcineurin inhibitors and proliferation signal inhibitors as novel treatments for lupus nephritis. Their basic research on lupus nephritis pathogenesis focuses on the interaction of anti-dsDNA antibodies with resident renal cells. They discovered that human anti-dsDNA antibodies could bind to ...
The huge remission-rate improvement would make voclosporins eventual applications seem like a slam dunk for approval, but there were some deeply disturbing issues that have kept Aurinia Pharmaceuticals stock from soaring. Among 256 lupus nephritis patients enrolled, 13 died during the Aura study. Also, there was a lower complete response rate among patients given a higher dosage of voclosporin.. Investors like to see responses rise with dosages because it suggests the experimental drug is actually driving the observed improvement. I think the benefit observed for both voclosporin doses at 48 weeks, though, was strong enough to allay those fears. As for the high number of patient deaths, investigators stated there wasnt any link to voclosporin. The claim has since been reinforced by the FDA, which allowed the company to begin a larger, late-stage study with voclosporin earlier this year.. Those fears have pressured Aurinias market cap down to a sprightly $519 million at recent prices, which ...
Results:. As scored by the readers, the mean chronicity index score varied from 2.3 to 4.8 on a 12-point scale (P = 0.001) and the mean activity index score varied from 5.8 to 11.4 on a 24-point scale (P = 0.0001). Pairs of readers gave scores within 1 point for the chronicity index and within 2 points for the activity index in 50% of cases, and risk group assignments based on chronicity index (three strata) and activity index (two strata) were concordant in 59% and 76% of cases, respectively. Intraclass correlation coefficients for inter-reader agreement were 0.58 for the chronicity index (P , 0.01) and 0.52 for the activity index (P , 0.01). Intrareader agreement was uniformly higher than inter-reader agreement, but mean intraclass correlation coefficients exceeded 0.70 for only 1 of the 10 index components. Repeated readings yielded chronicity index scores that were more than 1 point discordant in 45% of cases and activity index scores that were more than 2 points discordant in 43% of cases. ...
In general, use of ACE inhibitors significantly reduced the development of proteinuria and/or biopsy-proven lupus nephritis and was associated with a decreased risk of disease activity [86]. Concomitant use of antimalarial drugs (chloroquine and hydroxychloroquine) at diagnosis of lupus nephritis reduced the risk of progression to end-stage renal failure and frequency of hypertension [87].. Specific treatment follows the class of lupus nephritis, which is defined by the revised ISN criteria. Class I and class II require no therapy directed at the kidney in consequence of good long-term renal outcome [88]. In contrast, high-dose steroid therapy rapidly resolved nephrotic syndrome in a majority of SLE patients with minimal change disease either in the absence or with underlying class II lupus nephritis based on renal biopsy findings [82, 83]. Immunosuppressive treatment is required in the management of class III (focal), class IV (diffuse) and class V (membranous nephropathy) lupus nephritis and ...
Nephritis essentially involves the inflammation of the kidneys. It is the responsibility of the kidneys to filter out waste and excess fluid from the body, and when swelling occurs, their ability to filter properly is reduced. When this happens, the body accumulates both excess water and waste in the blood stream, while blood and protein are lost in the urine.. Because nephritis is a general term used to describe any kidney inflammation, the outcome and severity are entirely dependant on the underlying cause. In some cases, nephritis goes unnoticed and may not cause any serious problems. In other cases, nephritis is very serious and may lead to kidney disease such as glomerulonephritis, inflammation such as lupus nephritis, infections such as pyelonephritis, or even kidney failure in severe cases.. ...
Aim: The aim of this study was to assess clinicopathological characteristics and outcomes of a cohort of Chinese patients with late onset lupus nephritis. Methods: Clinical, pathological and outcome data for patients with late onset lupus nephritis (
Lupus Nephritis is serious kidney inflammation which is caused by system lupus erythematosusa disorder in which the bodys immune system attacks the bodys own cells and organs. And the protienuria is one of the symptoms of Lupus Nephritis. W
There are different treatment for Lupus Nephritis according to severity and progression of the illness. Immunotherapy is the latest therapy for lupus nephritis. Page
Steroids would the common treatment for patients with lupus nephritis. As the treatment can not help patients enjoy a better life, patients are wondering that what are the natural remedies for stage 4 lupus nephritis. Stage 4 lupus nephriti
TY - JOUR. T1 - Long-term outcome in Japanese patients with lupus nephritis. AU - Kono, M.. AU - Yasuda, S.. AU - Kato, M.. AU - Kanetsuka, Y.. AU - Kurita, T.. AU - Fujieda, Y.. AU - Otomo, Kotaro. AU - Horita, T.. AU - Oba, K.. AU - Kondo, M.. AU - Mukai, M.. AU - Yanai, M.. AU - Fukasawa, Y.. AU - Atsumi, T.. PY - 2014/1/1. Y1 - 2014/1/1. N2 - The objective of this study was to clarify the long-term outcome in patients with lupus nephritis (LN) according to the International Society of Nephrology and Renal Pathology Society classification. This retrospective analysis comprised 186 Japanese patients given a diagnosis of LN by renal specimen with a mean observation period of 12 years. Primary end point was defined as death or end-stage renal disease, and standardized mortality ratios were calculated. Five patients presented with histopathological class I, 62 with II, 21 with III or IIIV, 73 with IV or IVV and 25 with V. Fourteen deaths occurred, corresponding to an overall standardized ...
Refractory lupus nephritis, broadly defined as failure to attain clinical remission after appropriate induction immunosuppressive therapy, is associated with an increased risk of progression to end-stage kidney disease and mortality. This is a challenging issue in clinical practice, as modern induction therapy despite proven efficacy can still be associated with treatment failure. Moreover, newer therapies have failed in recent years to displace or even match existing protocols for effective induction of remission. Refractory disease is generally assessed on the basis of clinical parameters, which may be unreliable, and renal biopsy, which is often not performed in a standard or timely fashion. Persisting histological inflammation in 30%-50% of patients who have attained clinical remission highlights the disparity between clinical and immunological response to therapy. The lack of an international consensus regarding what constitutes refractory lupus nephritis compounds clinician indecision ...
[70 Pages Report] Check for Discount on Lupus Nephritis - Market Insights, Epidemiology and Market Forecast - 2025 report by Delve Insight. DelveInsight s Lupus Nephritis - Market Insights, Epidemiology and Market Forecast ...
Nowadays, more and more people are living with kidney disease driven by unhealthy living style, genetic disorder and immune disorder, lupus nephritis is one of them. While, what are the treatments for lupus nephritis with creatinine 300 ? N
I have lupus nephritis with 60 percent function not working right. Can you help me? Lupus nephritis is an autoimmune system disease. 60% renal function is in stage 3 kidney disease. You are still in a reversible stage. With proper treatment, you can
The answer to this question is unfortunately no. There is as of now no cure for Lupus Nephritis. The main aim of treatment is to prevent any worsening of the condition. If Lupus Nephritis is diagnosed and treated early then it may prevent the need for a kidney transplant.
Lupus Nephritis affects far more than your kidneys. Lupus Nephritis Knowledge column tells you all concerns and hot issues, such as pregnance, marriage and sexual life. Page
A 23-year-old woman presented to a hemodialysis appointment with a one-day history of fever and rigours. Blood cultures grew Gram-negative diplococci, raising concern for Neisseria species bacteremia.. The patients previous medical diagnoses included systemic lupus erythematosus with lupus nephritis (proliferative glomerulonephritis), arthritis, pericarditis, myositis and adenopathy. Systemic lupus erythematosus was complicated by flares with hypocomplementemia and increased anti-double-stranded DNA, idiopathic intracranial hypertension and systemic hypertension.. Two months before presentation, the patient had developed systemic thrombotic microangiopathy and severe kidney injury that required hemodialysis. She received a diagnosis of atypical hemolytic uremic syndrome, based on high-titre anti-complement factor H antibody. Moreover, a kidney biopsy showed thrombotic microangiopathy without features of active lupus nephritis; serum anti-double-stranded DNA levels were normal; and there were no ...