Glomerulonephritis Channel: Hypertension, Dialysis and Clinical Nephrology (HDCN): Renal Kidney Disease Electronic Journal / Hypertension, Dialysis, Nephrology Information Server

Gammopathies and the Kidney and Thrombotic Microangiopathy

Ronald J. Falk, MD
(ASN Board Review Course, August, 2008.)
Falk: What is the pathogenesis of amyloidosis? What are the most common types? What causes differential tissue deposition? How does this look on biopsy? How does one separate AL-amyloidosis from light chain deposition disease? How useful are serologic tests (immunoelectrophoresis) and biopsy? Is stem cell transplant still indicated in 2008-2009? What did the RCT by Jaccard et al show? If so, under what circumstances? What about secondary, AA-amyloid? Does eprodisate help? How does the clincal picture of multiple myeloma vary depending on site of light chain deposition? Is plasmapheresis indicated in an AKI situation due to myeloma? How do fibrillary GN and immunotactoid GN differ? For which one does one have to worry about ruling out CLL? How is TPP different from HUS? What type of nephropathy does sunitinib cause? Is testing from ADAMTS13 useful? Is plasma exchange for TTP useful? What about rituximab? How is complement factor H involved in atypical HUS? What's new in HUS caused by toxin-producing E. coli? (more...)

DILEMMAS IN THE TREATMENT OF GLOMERULAR DISEASE:
Treatment of Frequently Relapsing/Steroid Dependent Minimal Change Disease (Hogg);
Evaluation and Treatment Approach to Steroid-Resistant Primary FSGS in Adults (Meyrier).
Ronald J. Hogg, MD and Alain Y. Meyrier, MD
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Hogg: What are the long-term options to treat frequently relapsing nephrotic syndrome and steroid-dependent nephrotic syndrome? What is the optimal way to use steroids in such patients. What about non-corticosteroid therapies? Can treatment be stopped? If so, when? What is the role for cyclosporine and mycophenolate in such patients? Meyrier: How do we treat steroid-resistant, primary FSGS in adults? How do we rule out secondary FSGS? When do we look for familial (genetic) disease, and how? Does histopathology matter? What is the response to corticosteroids? What is undertreatment? What is overtreatment? What are the roles of alkylating agents, tacrolimus, cyclosporine, sirolimus, MMF, and rituximab?
(more...)

The Genetics of FSGS.
Friederich Hildebrandt MD, and Frederick J. Kaskel, MD, PhD.
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Hildebrandt: What are the most common point mutations that cause FSGS and childhood nephrotic syndrome. How and when do they present? To what extent do they respond to treatment? Are any of them steroid responsive? Are they associated with recurrence post-transplantation? Where can one turn for gene analysis when an inherited mutation is suspected in a child with nephrotic syndrome? What are the characteristics of PLCE1 mutations (phospholipase C epsilon), and what should the approach to therapy of these patients be? Kaskel: What are predictors of outcome in FSGS? What are the general treatment approaches? How should steroids be used? Does cyclophosphamide or chlorambucil have a role? What do randomized trials show in terms of cyclosporine? What is the experience with MMF? With rapamycin? Pulse dexamethasone? What is the design of the ongoing NIH/NIDDK Study and when will we have results? When is plamapheresis indicated? What do preliminary results with rituximab show?
(more...)

Mycophenolate in Lupus and Non-Glomerular Renal Diseases
Leslie M. Shaw, PhD and Gerald B. Appel, MD, FASN
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Shaw: How is MMF metabolized? How is MPA excreted? Why is enterhepatic circulation of MPA glucuronide important, and how is it affected by intestinal bacteria and cyclosporine? What does the new MPA assay measure? What are provisional guidelines for trough levels of MPA and area under the curve for MPA in transplantation? Appel: How does ethnicity affect response of lupus nephritis to treatment? What did the major trials show in terms of MMF use for maintenance treatment of lupus nephritis as well as for induction treatment? What are the options for use of MMF with additional immunosuppressive drugs?
(Edited by Jai Radhakrishnan, MD). (more...)

Biopsy Conference: A middle-aged Hispanic male with microhematuria and proteinuria
(Columbia University Nephrology and Pathology Faculty; January, 2008)
A middle-aged Hispanic male had with history of incarceration, occupation as a welder, heroin abuse, presented with proteinuria 3.4 g/day and microhematuria. No DM. Mild HTN. Normal sized kidneys. Negative serological tests. Initial DDx: Membranous, IgA, FSGS. Discussion focus: Hint: IgG deposits were found.
(Edited by Jai Radhakrishnan, MD). (more...)

May29

Three days of fasting every 10 days improve autoimmune diseases (in mice).

Dec14

Even more news on the new HDCN Facebook page!

Nov30

Multinucleated giant cells and amyloidosis

Nov22

Renal pathologists soon will be replaced by pigeons.

Nov21

Orphan drug designation may lead to high drug prices, like for rituximab.

May30

Vagal nerve stimulation lowers inflammatory response in rheumatoid arthritis

May27

Binding site for PLA2R antibodies identified and blocking molecules synthesized

Nov18

Abatacept slows or halts proteinuria in FSGS.

Sep18

Vaccinating cattle against toxigenic E. Coli could cut risk of infection in humans.

Apr05

Malic acid mouth spay for xerostomia.

Mar07

High salt diet linked to activation of Th-17 helper cells and multiple sclerosis in mice.

Dec10

Reprogrammed T-cells using an attenuated strain of HIV result in remission of acute lymphoblastic leukemia.

Nov19

Nanotechnology cures multiple sclerosis in mice; are other autoimmune diseases next?

Nov05

Eculizumab for atypical HUS shows promise on longer term treatment.

Oct19

Egg freezing works to preserve fertility.

General

Advances

Emphasis

archive

	Management of the Nephrotic Syndrome (B. Appel) ASN Renal Week 2008
	Antibody-Mediated Rejection: Update in Banff Criteria and Recognition of Sub-Clinical Syndromes (C. Racusen) ASN Renal Week 2008
	The Dysproteinemias (M. Korbet) ASN Renal Week 2008
	Diagnosis and Treatment of Anti-GBM Disease (D. Pusey) ASN Renal Week 2008
	ANCA Small Vessel Vasculitis (H. Nachman) ASN Renal Week 2008
	Treatment Issues in Rapidly Progressive Glomerulonephritis: A Case-Based Discussion (H. Nachman) ASN Renal Week 2008
	Remission Clinics: Assessing Risk/Benefit of Treatment (Remuzzi) ASN Renal Week 2008
	Current and New Treatments of Lupus Nephritis (B. Appel) ASN Renal Week 2008
	Glomerular Collagen: An Overview (G. Hudson) ASN Renal Week 2008
	What is the Effect of Proteinuria on Pharmacokinetics of Immunosuppressants? (S. Joy,) ASN Renal Week 2008
	Nail-Patella Syndrome (B. Thomas) ASN Renal Week 2008
	What Are the Causes of Ethnic Differences in Outcomes among Patients with SLE? (Contreras) ASN Renal Week 2008
	A New Approach to Classification: The Clinician-Pathologist Collaborative Project (S.D. Roberts) ASN Renal Week 2008
	IgA Nephropathy (J. Glassock) ASN Renal Week 2008
	Presentation Should Alter Management Strategy (or... All Cases of IgA Are Not the Same) (Feehally) ASN Renal Week 2008
	Spectrum of Membranoproliferative Glomerulonephritis (G. Rennke) ASN Renal Week 2008
	Individualized Induction Therapy (F. Flores-Suarez) ASN Renal Week 2008
	Overview of the Pathology of Minimal Change Disease, Focal Segmental Glomerulosclerosis, and Membranous Nephropathy (G. Rennke) ASN Renal Week 2008
	Approach to the Management of Challenging Extra-Renal Manifestations of Systemic Vasculitis (Specks) ASN Renal Week 2008
	Treatment of Minimal Change Disease with Case-Based Discussion (B. Appel) ASN Renal Week 2008
	Approach to the Management of the Patient with Multiple Relapses/Resistant Disease (Segelmark) ASN Renal Week 2008
	Treatment of Focal Segmental Glomerulosclerosis with Case-Based Discussion (M. Korbet) ASN Renal Week 2008
	Role of Steroids/Immunosuppressives in Treatment (J. Hogg) ASN Renal Week 2008
	Membranous Nephropathy with Case-Based Discussion (C. Cattran) ASN Renal Week 2008
	Does Proteinuria Reduction Top Blood Pressure Control in Estimating Prognosis? (C. Cattran) ASN Renal Week 2008
	Management Cases (Audience and Panel Generated) (B. Appel) ASN Renal Week 2008
	Mesangial Collagen Glomerulopathies (H. Cohen) ASN Renal Week 2008
	Therapy: Does One Size Fit All? Should We Stratify Therapy? How? (H. Rovin) ASN Renal Week 2008
	Thrombotic Microangiopathies (B. Appel) ASN Renal Week 2008
	Thin Basement Membrane Nephropathy and Alport Syndrome (E. Kashtan) ASN Renal Week 2008
	Long Term Immunosuppression: Is it Really Necessary? (F. Wetzels) ASN Renal Week 2008
	Gammopathies and the Kidney and Thrombotic Microangiopathy (Falk) ASN Board Review 2008
	The Genetics of FSGS (Hildebrandt, Kaskel) ASN Renal Week 2007
	Viral Glomerulonephritides: HIV, HBV, and HCV (L. Kupin) ASN Renal Week 2007
	Therapy of Lupus Nephritis: How Long and with What? (Tak Mao Chan) ASN Renal Week 2007
	Glomerular Disorders (Radhakrishna) ASN Renal Week 2007
	Complement Activation in Membranous Nephropathy: Can We Intervene Therapeutically (J. Quigg) ASN Renal Week 2007
	Membranous Nephropathy in 2007 (C. Cattran) ASN Renal Week 2007
	Bone Marrow Progenitor Cells in the Treatment of Glomerular Disease: Alport Syndrome, et. al. (J. Anders) ASN Renal Week 2007
	Evaluation and Treatment Approach to Steroid-Resistant Primary FSGS in Adults (Y. Meyrier) ASN Renal Week 2007
	Management of the Nephrotic Syndrome (B. Appel) ASN Renal Week 2007
	Spectrum of Membranoproliferative Glomerulonephritis (G. Rennke) ASN Renal Week 2007
	ANCA Small Vessel Vasculitis (H. Nachman) ASN Renal Week 2007
	New Aspects of Membranous Nephropathy (A. Austin) ASN Renal Week 2007
	IgA Nephropathy: 2007 Update (J. Glassock) ASN Renal Week 2007
	Thrombotic Microangiopathies (B. Appel) ASN Renal Week 2007
	Cellular Response to Injury in Membranous Nephropathy (J. Shankland) ASN Renal Week 2007
	When Do We Biopsy? Will the Information Help? (C. Racusen) ASN Renal Week 2007
	Mutations and FSGS: Alpha-Actinin-4, TRPC6, and NPHS2 (including Obesity Related Glomerulopathy) (N. Vats) ASN Renal Week 2007
	Basic Science in Renal Diseases (Floege) ASN Renal Week 2007
	Remission of Proteinuria in Idiopathic Nephrotic Syndrome: What is the Goal and at What Price? (C. Cattran) ASN Renal Week 2007
	Newer Therapies for Glomerular Diseases (Coppo) ASN Renal Week 2007
	The Dysproteinemias (M. Korbet) ASN Renal Week 2007
	IgA Nephropathy (S.D. Roberts) ASN Renal Week 2007
	FSGS (Hariharan) ASN Renal Week 2007
	Growth Factors, Cytokines, and Cell Cycling as Targets for Glomerular Therapeutics (Floege) ASN Renal Week 2007
	Treatment Options in MN: Towards Pathophysiology - Driven Therapies (M. Ronco) ASN Renal Week 2007
	Current and New Treatments of Lupus Nephritis (B. Appel) ASN Renal Week 2007
	Treatment of FSGS and Its Recurrence (J. Kaskel) ASN Renal Week 2007
	Anca-Associated Vasculitis (Jennette) ASN Renal Week 2007
	Evolution of our Understanding of Membranous Nephropathy (G. Couser) ASN Renal Week 2007
	Diagnosis and Treatment of Anti-GBM Disease (D. Pusey) ASN Renal Week 2007
	Treatment and Pathology of Diabetic Nephropathy in 2007 (Jennette) ASN Renal Week 2007
	Treatment of Frequently Relapsing/Steroid Dependent Minimal Change Disease (J. Hogg) ASN Renal Week 2007
	Global and Gene-Specific DNA Methylation in Lupus Nephritis (C. Richardson) ASN Renal Week 2007
	Treatment of Focal Segmental Glomerulosclerosis (M. Korbet) ASN Renal Week 2007
	Lupus Nephritis (Ferrario) ASN Renal Week 2007
	Glomerular Disorders (Radhakrishna) ASN Renal Week 2007
	Treatment of Hepatitis C-Related Cryoglobulinemia (Roccatello) ASN Renal Week 2007
	Pathology and Pathogenesis of Minimal Change Disease and Focal Segmental Glomerulosclerosis (G. Rennke) ASN Renal Week 2007
	Pregnancy after Transplant: Newer Immunosuppressive Agents and the Outcome of Pregnancy and the Offspring (B. McKay) ASN Renal Week 2007
	Treatment of Frequently Relapsing/Steroid Dependent Minimal Change Disease (Hogg); Evaluation and Treatment Approach to Steroid-Resistant Primary FSGS in Adults (Meyrier). (Hogg, Meyrier) ASN Renal Week 2007
	Mycophenolate in Lupus and Non-Glomerular Renal Diseases (Shaw, Appel) ASN Renal Week 2007
	Genetic Screening in Steroid-Resistant FSGS (Hildebrandt) ASN Renal Week 2007
	ntegrating Advanced Practice Nurses and Physician Assistants Into Nephrology Practice: When Is The Right Time? (A. Golper) RPA 2007
	Evidence-Based Indications for Plasmapheresis (Bargman) ADC 2007
	Basic Science for Clinical Nephrologists - Mechanisms of Injury in Glomerulonephritis: A Review and Update (Julian, VanderWoude, Botto) ASN 2005 Renal Week (audiofiles)
	Why is TNF a Good Therapeutic Target? (Feldman) ASN 2005 Renal Week (audiofiles)
	Glomerulonephritis Update: Diagnosis and Therapy (Part 1 and 2) (Appel, Rennke, Cattran, Falk, Korbet, Glassock) ASN 2005 Renal Week (audiofiles)
	Glomerulonephritis Update: Diagnosis and Therapy (Part 3 and 4) (Falk, Pusey, Appel, Korbet, Kupin, Charytan) ASN 2005 Renal Week (audiofiles)
	Membranoproliferative Glomerulonephritis Pathology Update (Walker) ASN 2005 Renal Week
	Membranoproliferative Glomerulonephritis: Clinical Spectrum (Glassock) ASN 2005 Renal Week
	The Role of Podocytes in Proteinuria and Progressive Renal Disease (Kriz, Salant) ASN 2005 Renal Week (audiofiles)
	New Insights in IgA Nephropathy (Haas, Monteiro, Feehally, Hsu) ASN 2005 Renal Week (audiofiles)
	Antibody Mediated Responses in Allo and Autoimmunity (Wasowska) ASN 2005 Renal Week (audiofiles)
	Renal Biopsy: Clinical Correlations (Walker, Smith, Chander, Barisoni) ASN 2005 Renal Week (audiofiles)
	Non-Amyloid Dysproteinemias and the Kidney (Ronco, Korbet, Madore) ASN 2005 Renal Week (audiofiles)
	Issues in Lupus Nephritis (Rifkin, Levine, Austin Appel) ASN 2005 Renal Week (audiofiles)
	Management Issues in Systemic Lupus Erythematosus (Austin, Parfrey, Cohen) ASN 2005 Renal Week (audiofiles)
	Renal Amyloidosis: Pathogenesis, Diagnosis, and Therapy (Benson, Herrera, Seldin) ASN 2005 Renal Week (audiofiles)
	Progression and Treatment of Fibrosis (Bissell) ASN 2005 Renal Week (audiofiles)
	Collapsing Glomerulopathy - A Distinct Pathogenic Entity (Barisoni, Kopp, Nelson) ASN 2005 Renal Week (audiofiles)
	Infectious Diseases After Immunosuppression in the Non-Transplant Kidney Patient Population (Brennan) ASN 2004 Renal Week
	Non-Standard Therapy in Membranous Nephropathy (Remuzzi) ASN 2004 Renal Week
	Therapy of ANCA-Associated Vasculitis and EUVAS Trials (Jayne) ASN 2004 Renal Week
	ANCA-associated RPGN: Role of Plasmapheresis (Pusey) ASN 2004 Renal Week
	Indications for Immunosuppression in Membranous Nephropathy (Cattran) ASN 2004 Renal Week
	Advances in the Treatment of Focal Glomerulosclerosis (FSGS) (Kaskel) ASN 2004 Renal Week

	The spectrum of kidney disease in patients with AIDS in the era of antiretroviral therapy Kidney Int (Feb 2009)
	Screening for HIV in health care settings: a guidance statement from the American College of Physicians and HIV Medicine Association Ann Intern Med (Jan 2009)
	Antiviral therapy for adults with chronic hepatitis B: a systematic review for a National Institutes of Health Consensus Development Conference Ann Intern Med (Jan 2009)
	National Institutes of Health Consensus Development Conference Statement: Management of hepatitis B (Consensus Conference) Ann Intern Med (Jan 2009)
	Biopsy conference: Intravascular hemolysis and acute renal failure after mitral and aortic valve repair Am J Kidney Dis (Nov 2008)
	Rust urine after intense hand drumming is caused by extracorpuscular hemolysis Clin J Am Soc Nephrol (Jul 2008)
	Idiopathic membranous nephropathy: diagnosis and treatment Clin J Am Soc Nephrol (May 2008)
	Rapid remission of steroid and mycophenolate mofetil-resistant minimal change nephrotic syndrome after rituximab therapy Nephrol Dial Transplant (Jan 2008)
	Inherited diseases of the glomerular basement membrane Nature Clin Pract Nephrol (Jan 2008)
	Rituximab treatment of idiopathic membranous nephropathy Kidney Int (Jan 2008)
	Renal transplantation in the ANCA-associated vasculitides (Geetha et al) Am J Transplant (Dec 2007)
	Quantitative appraisal of treatment options for IgA nephropathy (Ballardie et al) J Amer Soc Nephrol (Nov 2007)
	Prophylactic anticoagulation in nephrotic syndrome: a clinical conundrum (Glassock) J Am Soc Nephrol (Aug 2007)
	ANCA are detectable in nearly all patients with active severe Wegener's Granulomatosis (Finkielman et al) Am J Med (Jul 2007)
	Renal manifestations of plasma cell disorders (Leung et al) Am J Kidney Dis (Jul 2007)
	Why are rheumatologists treating lupus nephritis? (Bargman JM) NCPN Jun 07
	Pathogenesis and prevention of bone loss in patients who have kidney disease and receive long-term immunosuppression. JASN (01-07)
	Lupus nephritis: Toll the trigger! (KD Smith, commenting on a study by Pawar et al). JASN 12-06
	Recurrent glomerulonephritis after kidney transplantation (Choy, Chan, Lai) Am J Transplant 11-06
	Modern treatment of amyloidosis: unresolved questions J Am Soc Nephrol (Mar 2009)