B7/CD28 costimulatory molecules involved in the immune mechanism of kidney disease / 国际儿科学杂志

The body′s specific immune response is a very complicated process involving a series of immune cells and molecules that regulate and restrict each other.At present, the pathogenesis of most kidney diseases is not clear.B7(CD80)is located on antigen-presenting cells that regulate CD4+ and CD8+ T cells and play a role in enhancing or amplifying immune responses by binding to the cellular glycoprotein CD28.It also binds to cytotoxic T lymphocyte-Antigen4(CTLA-4)to inhibit the immune response.In general, renal tissue has no or low expression of B7.However, some glomerular diseases are associated with increased B7, which reduces the ability of podocytes to attach to the glomerular basement membrane and increases inflammation and renal fibrosis.When the B7-CTLA-4 interaction occurs, the immune response is attenuated.The disease can be prevented by blocking CD28 or enhancing the CTLA-4 signal.This article reviewed the role of costimulatory molecule B7/CD28 in the pathogenesis of kidney diseases, such as pod-cell damage, primary glomerulonephritis, purpura nephritis, lupus nephritis.Furthermore, it discussed the feasibility of B7 blockers were used as targeted therapies for kidney diseases.

Blood pressure management in elderly patients with glomerular disease / 中华老年医学杂志

Hypertension is one of the common complications in elderly patients with glomerular disease.Effective blood pressure control can delay the progress of the disease and reduce the occurrence of cardiovascular events.Combined with the 2020 Kidney Disease: Improving Global Outcomes(KDIGO)glomerulonephritis guidelines, this review discusses the blood pressure characteristics, antihypertensive targets, antihypertensive treatment suggestions and precautions of elderly patients with glomerulonephritis, so as to provide new ideas for clinical practice.

Spectrum of Secondary Glomerular Diseases in Adult Nephrotic Syndrome.

Background: In developing countries like India, thecauses for end stage renal failure has been changingwith glomerular diseases occupying an important place.The trend of various primary and secondary causes ofNephrotic Syndrome (NS) over the past few decadeshas been debatable especially with reference togeographical locations. Aim and Objectives: This studywas intended to find out the histologic patterns ofglomerular disease associated with NS in South Indiaand analyze the corresponding clinical and biochemicalabnormalities associated with these conditions.Material and Methods: One hundred eighty eightpatients in the age group of 18-80 years with NS whounderwent renal biopsy between the periodst thfrom1 January 2018 to 30 September 2019 wereincluded in this study. Baseline investigations and otherinvestigations related to renal profile evaluationincluding complement levels and HIV antibody weredone. Results: Focal Segmental Glomerulosclerosis(FSGS) accounted for the majority (25.5%) amongprimary glomerular diseases while among thesecondary glomerular diseases Lupus Nephritis (LN)(51.19%) constituted the majority and a substantialcontribution from Human Immunodeficiency VirusAssociated Nephropathy (HIVAN). LN was seen onlyin female patients with a mean age of 33.36 ± 10.74years. Among LN, Class III was the most predominantwhile Class IIIC was less frequent. C3 and C4complement levels were less than normal in Class IVand Class variants of LN. Conclusion: This studyhighlights the spectrum of Lupus Nephritis and HIVassociated nephropathy as a cause for adult NS in atertiary care center in South India

Vasculitis en adultos mayores. A propósito de dos casos y revisión de la literatura / Vasculitis in elderly. About two clinical cases and literature review

Resumen Actualmente vivimos un proceso de transición en la pirámide poblacional. Por lo tanto, se hacen más frecuentes las enfermedades renales en los ancianos. Así, las vasculitis primarias en adultos mayores son enfermedades raras, causadas por la inflamación de los vasos sanguíneos y muy poco diagnosticadas. La literatura se limita a escasos casos clínicos. La vasculitis por anticuerpo citoplasmático anti neutrófilo (ANCA) positivo (VAA) es más frecuente en personas mayores de 50 años. La detección de ANCA es de peor pronóstico en esta población. También, es importante la alta sospecha y diagnóstico oportuno, ya que así se puede brindar un tratamiento óptimo y disminuir las complicaciones propias de la enfermedad y aquellas asociadas a la inmunosupresión. Los adultos mayores con VAA tienen mayor compromiso renal, hipertensión, dislipidemia y mortalidad incrementada. Por lo que a continuación se detallan dos casos clínicos desde la fecha del diagnóstico, edad, valores de laboratorio de la presentación inicial y la escala de actividad de vasculitis de Birmingham confirmados con biopsia renal (ANCA positivo) identificados en un hospital de especialidades de Ecuador.

Abstract Currently we live a process of transition in the population pyramid. Therefore, kidney diseases become more frequent in the elderly. Thus, primary vasculitis in older adults are rare diseases, caused by the inflammation of blood vessels and poorly diagnosed. The literature is limited to few clinical cases. Cytoplasmic anti-neutrophil antibody (ANCA) positive vasculitis (AAV) is more common in people older than 50 years. The detection of ANCA gives a very poor prognosis in this population. Also, high suspicion and timely diagnosis is important, as this can provide optimal treatment and reduce the complications of the disease and those associated with immunosuppression. Older adults with AAV have greater renal involvement, hypertension, dyslipidemia and increased mortality. Therefore, two clinical cases from the date of diagnosis, age, laboratory values of the initial presentation and the scale of activity of Birmingham vasculitis confirmed with renal biopsy (ANCA positive) identified in a specialty hospital of Ecuador are detailed below.

Progress in the relationship between urokinase plasminogen activator receptor and its soluble form and renal disease / 国际儿科学杂志

Glomerular disease refers to a class of diseases in which the lesions are mainly located in the glomerulus,and the clinical manifestations are mainly hematuria,proteinuria,edema,hypertension and renal dysfunction.In recent years,it has been found that the urokinase-type plasminogen activator (uPA) of the plasminogen activator family,urokinase-type plasminogen activator receptor (uPAR) and its soluble form have been up-regulated in the pathogenesis of certain glomerular diseases.The combination with integrin affects signaling pathways and changes the morphology and function of podocytes to promote disease progression.In this paper,the relevant research progress is summarized as follows.

A Study of Frequency of Glomerular Diseases (Biopsy Proven) from a Tertiary Care Center of North West Rajasthan.

Aims and Objective: Glomerular disease (GD) is one of the most common forms of renal diseases and can have many different clinical presentations and there is a variation in the prevalence of the type of GD according to geographical location and race of the study population, so our aim is to report the frequency of biopsy-proven glomerular disease (GD) in a single center in North-west Rajasthan. Materials and Methods: Medical records of 48 patients with biopsy-proven GD over a period of 1 year from October 2013 to October 2014 were prospectively analyzed. The clinical, laboratory, and histological data were recorded. All biopsy specimens were examined by the same pathologist with light and immunofluorescence microscopy. Electron microscopic analysis was performed only in selected cases. Results: According to renal biopsies, chronic thrombotic microangiopathy was present in 1 patient and it belonged to secondary glomerular disease, 2 patients had diffuse lupus nephritis class IV and they also had secondary glomerular disease, 17 patients had FSGS and out of them 16 belonged to primary glomerular disease, 9 patients had IgA Nephropathy. We identified 5 patients each had MPGN and MGN and they all belonged to primary glomerular disease. Three patients had mesangioproliferative glomerulonephritis. Minimal change disease was present in 3 patients while 1 patient had renal amyloidosis. Out of total 48 patients, 31 had nephrotic syndrome while 17 patients had nephritic syndrome out of them 28 and 15 patients had primary glomerular disease respectively. Conclusion: Our study showed that FSGS as most common cause of primary glomerular disease {the most common variant is not otherwise specified (NOS)}, followed by IgA nephropathy in North West Rajasthan. Lupus nephritis was more common in patients who had secondary glomerular disease in our study. The spectrum of GD varies according to the area of study and changes over time.

The correlation analysis of urinary protein electrophoresis and pathologic in children with glomerular diseases / 重庆医学

Objective To understand the significance of urinary protein components in children with different pathological types of glomerular diseases ,to explore the significance to diagnosis and treatment of disease .Methods Totally 120 children with glomerular diseases ,from November 2010 to July 2012 in the First Affiliated Hospital of Zhengzhou University were collected ,in which 6 children with acute glomerulo nephritis(AGN) ,35 children with minimal change disease(MCD) ,9 children with focal seg‐mental glomerulosclerosis(FSGS) ,44 children with Nephritis of Schonlein‐Henoch Purpura(HSPN) ,17 children with IgA nephrop‐athy(IgAN) and 9 children with hemolytic uremic syndrome(HUS) .Urine protein electrophoresis and urineβ2‐microglobulin(β2‐MG)levels were investigated in different glomerular diseases .Results Significant difference was detected inβ2‐microglobulin ,lyso‐zyme ,retinol‐binding protein ,free light chain ,α1‐microglobulin ,light chain dimmer ,albumin and transferring levels in different glo‐merular diseases(P=0 .016 ,P=0 .017 ,P=0 .017 ,P=0 .023 ,P=0 .004 ,P=0 .025 ,P=0 .049 ,P<0 .01) .A significant correlation was detected between low molecular weight protein and urineβ2‐microglobulin levels(r=0 .243 ,P=0 .025) .Conclusion It is sig‐nificant for diagnosis and treatment of glomerular diseases to the combination of urine protein electrophoresis and renal pathology .Urinary protein profiles are different in different pathological types .Proteomics may be significant for the mechanism of glomerular diseases .

Progress of T helper cell 17,regulatory T cell,podocyte injury and primary glomerular disease / 国际儿科学杂志

In recent years,T helper cell 17(Th17),regulatory T cell(Treg) and podocyte injury attrac-ted widespread attention in the pathogenesis of primary glomerular disease. Th17 cells have the function of re-cruiting neutrophils and macrophages to the infected tissue through the secretion of cytokines such as IL-17. Treg cells have immune function, mediated immune tolerance, protecting the body against inflammatory injury. The imbalance of Th17 cells increase and Treg cells decrease could play an important role in the pathogenesis and progression of primary glomerular disease. As the important part of the glomerular filtration barrier,podocyte be-comes the focus in recent years. Study on relationship among Th17,Treg,podocyte injury and primary glomeru-lar disease will provide more theoretical basis for the prevention and treatment of primary glomerular disease.

Progress in common hereditary glomerular diseases / 医学研究生学报

Hereditary glomerular disease is an important part of kidney diseases .In recent years , hereditary glomerular disea-ses had a high incidence and poor prognosis .Thus, the studies involving hereditary glomerular diseases such as Alport syndrome , he-reditary nephritis syndrome and thin basement membrane disease , etc.have significant implications .This review mainly focuses on the pathogenesis , clinical features , diagnosis and treatment of Alport syndrome and hereditary nephritis syndrome .

Relationship between the incidence of hyperuricemia and the clinical and pathological features in patients with renal glomerular disease / 中国综合临床

Objective To explore the effect of clinical and pathological features on the incidence of Hyperuricemia (HUA) in renal glomerular disease.Methods A retrospective analysis was applied to review the clinical and pathological date collected from 3547 patients with renal glomerular disease.These patients were diagnosed as renal glomerular disease by renal biopsy from January 2007 to December 2011.Results (1) HUA incidence was 21.8％ (773/3547) in all of the patients,in which the incidence in secondary glomerular disease 27.2％ (240/882) was much higher than that in primary glomerular disease 20.7％ (552/2665),and the difference was significant (x2 =153.642,P ＜ 0.05).In primary glomerular disease,HUA incidence was the lowest in membranous nephropathy 14.4％ (96/665),while HUA incidence in lupus nephritis (LN) 45.3％(110/243) was the highest and small blood vessel infammation kidney damage 34.7％ (17/49) was the second in secondary glomerular disease.(2) With the increasing of glomerulosclerosis index,tubulointerstitial score,renal vascular lesions score and the stage of chronic kidney disease,HUA incidence increased (x2 =17.798-298.216,P =0.000).(3)Logistic regression analysis showed that high tubulointerstitial score,glomerulosclerosis index and renal dysfunction,male,overweight or obese,hypertension and hypertriglyceridemia were risk factors for hyperuricemia (OR:1.011-7.513,P ＜ 0.05).Conclusion The uric acid level is increased in nearly a quarter of patients with renal glomerular disease.Severe tubulointerstitial lesion,high glomerulosclerosis index,low glomerular filtration rate,male,overweight or obese,hypertension and hypertiglyceridemia were independent risk factors for HUA.

Diagnosis of Primary Glomerular Diseases / 대한내과학회지

Glomerular diseases occurring in the absence of a known systemic process are called primary. This review focuses on the approach and diagnosis of primary glomerular disease. Inflammatory and/or noninflammatory insults to glomeruli results in a multiplicity of signs and symptoms of diseases, including hematuria, proteinuria, azotemia, edema, and hypertension. Patients with glomerular diseases generally present with one of the following clinical syndromes: asymptomatic urinary abnormalities, nephrotic syndrome, acute nephritic syndrome, rapidly progressive glomerulonephritis, or chronic glomerulonephritis. The urinalysis, the degree of proteinuria, the estimated glomerular filtration rate, and patient characteristics often allow the differential diagnosis of glomerular disease prior to renal biopsy. However, a renal biopsy is usually required to establish diagnosis and treatment of most glomerular disease.

Frequency of primary glomerular disease in northeastern China

Most frequently reported Chinese renal biopsy data have originated from southeastern China. The present study analyzed the renal biopsy data from northeastern China. The records of 1550 consecutive native patients who were diagnosed with primary glomerular diseases (PGD) after renal biopsy at our hospital during 2005-2009 were used. These patients were divided into four age groups for stratified analysis: <15, 15-44, 45-59, and ≥60 years old. Among PGD, minimal change disease (MCD) was the most common histologically diagnosed disease (30.7 percent), followed by IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis (MsPGN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), and endocapillary proliferative glomerulonephritis (EnPGN). MCD was the disease most frequently observed (43.7 percent) in the <15-year-old group. MsPGN was the most common disease in the elderly group (38.1 percent). MsPGN was more prevalent in females (27.8 percent), whereas MCD was more prevalent in males (35.3 percent). Primary glomerular diseases constituted the most commonly encountered group of diseases with a high prevalence of MCD, which predominantly affected males and young adults. The prevalence of MCD was high in northeastern China. Further study is necessary to expand the epidemiologic data available for renal disease in China.

An Analysis of 3,000 Cases of Percutaneous Renal Biopsy: Single Center Study / 대한신장학회지

PURPOSE: The incidence of glomerular diseases varies according to population characteristics and time period. METHODS: A total of 3,000 renal biopsies were performed over the 29 years' period from 1978 to 2007. We reviewed the patient records of all patients who underwent renal biopsies at our institution. The patients were grouped for analysis in three time intervals: before 1990, 1991 to 2000, and after 2001. RESULTS: There were 2,377 cases of native kidney biopsies and 623 cases of allograft kidneys. The principal long-term changes were an increase in the mean age of patients with undergoing biopsy and an increase in the percentage of asymptomatic urinary abnormalities as an indication for biopsy. In the primary glomerulonephritis (GN), the most common pathologic diagnosis was IgA nephropathy (IgAN, 26.6%), followed by minimal change disease (MCD, 21.4%), membranous nephropathy (8.9%), focal segmental glomerulosclerosis (7.7%). The major changes noted in primary GN were a marked increase in the frequency of IgAN and decrease in the frequency of MCD. Major causes of secondary GN were lupus nephritis (37.9%), and hepatitis associated GN (28.9%). In allograft biopsies, acute rejection (42.3%) and chronic rejection (19.4%) were the two most common diagnoses. Documented complications of renal biopsies included perirenal hematoma (25.1%), but the rate of serious complications that required surgical intervention or embolization was very low (1.0%). There was no death or nephrectomy case in our study. CONCLUSION: IgAN was the most common primary GN in this study. The multi-center studies are needed to evaluate the distribution and changing trends of renal disease in Korea.

Analysis of risk factors for carotid atherosclerosis in patients with renal glomerular diseases / 中国综合临床

Objective To study the relationship between intrarenal arterial lesions(IAL)and carotid atherosclerosis(AS)in patients with renal glomerular disease.Methods 251 cases with IAL were selected and 129 age-,pressure-and eGFR-matched renal glomerular disease cases without IAL were randomly selected.The carotid intima-media thickness(IMT)was detected.Clinical and laboratory examination and renal histological characteristics were compared the two guoups.Results ①The detection rate of carotid AS was higher in patients with IAL than those without IAL(38.2%vs.20.2%),and higher in patients≥40 years than in patients＜40 years(51.3%vs.13.1%)(P<0.05 for each). ②The carotid AS group was older and had higher frequencey of fasting blood glucose,body mass index,smoking,and family history of hypertension,longer duration of established hypertension and renal glomerular disease,higher prevalence of hypertension,IAL and renal lesions,and had lower eGFR than the carotid normal group(all P＜0.05).Binary logistic regression analysis revealed that IAL and age emerged as an independent risk factor for carotid AS(OR=1.826 and 1.129,P=0.001 and 0.003).Conclusion The intrarenal arterial lesion is an independent risk factor for carotid atherosclerosis in patients with renal glomerular disease.Controlling blood glucose,blood pressure,weight,smoking quit and delaying progression of kidney disease have important significance in relieving or preventing atherosclerosis and intrarenal arterial lesions of patients with renal glomerular diseases.

Analysis of pathological and clinical manifestations in 377 children with renal disease / 重庆医科大学学报

Objective:To explore the relationship between the pathological classification and clinical manifestations of renal glomerular disease in children. Methods:Pathological diagnosis and laboratory routine examinations of total 377 patients with renal disease during Feb,1999 to Feb,2006 were reviewed and compared. Results:(1)There were 250 male and 127 female among 377 patients who received renal biopsy,and the ratio of male to female was 1.97. Among these patients,217(57.6%) cases of primary glomerular disease,158(41.9%) cases of secondary glomerular disease,1(0.25%) case of heritage glomerular diseases and 1 case of renal vascular disease were found, respectively. (2)The most common clinical diagnosis and pathological category in primary glomerulary disease were nephritic syndrome and mesangial proliferative glomerulonephritis(MsPGN), respectively,and that in secondary glomerulary disease were Henoch-Schonlein purpura nephritis and MsPGN,respectively. The mean age in group of secondary glomerulary disease[(10.36?2.83)years] was older than that in group of primary glomerulary disease[(9.72?3.07)years],(P

Evaluación de los regímenes inmunosupresores utilizados en pacientes con transplante renal y glomerulopatías primarias: servicio de nefrología del Hospital Regional Teodoro Maldonado Carbo / Evaluation of immunosupresive drug regimens used in patients with renal transplant and primary glomerular diseases: nephrology Service at Teodoro Maldonado Carbo Regional Hospital

Tipo de estudio: retrospectivo, analítico, longitudinal. Objetivos: evaluar el uso del micofenolato de mofetil (MMF) en el tratamiento inmunosupresor en pacientes con transplante renal y glomerulopatías primarias. Materiales y métodos: se realizó un estudio retrospectivo que evaluó a 19 pacientes de 23-61 años: 14 con transplante renal (TR) y 5 con glomerulopatías primarias (GP). Todos los pacientes con TR recibieron: ciclosporina A (CsA) + prednisona (P), de los cuales 10 recibieron adicionalmente azatriopina (AZA) y 4 MMF. Las pacientes con GP recibieron MMF exclusivamente. Ambos grupos fueron seguidos por 12 meses, tiempo durante el cual se evaluó la función renal y efectos adversos. Resultados: el valor del injerto mejoró significativamente en aquellos pacientes tratados con esquemas que incluían MMF. Los valores promedio de creatinina sérica a los 12 meses fueron de 1.5  0.4 mg/dL grupo MMF vs. 1.7  0.2 mg/dL AZA. Los efectos secundarios se presentaron en un 40% en el grupo AZA y en un 25 % en el grupo MMF. Algunos pacientes con GP mejoraron su función renal. Conclusiones: en aquellos pacientes que recibieron tratamiento inmunosupresor con MMF, la función renal del injerto mejoró al ser comparado con el esquema que incluía AZA. En las GP los resultados fueron poco concluyentes.

Objective: Evaluate the usefulness of mycophenolate mofetil (MMF) as an immunosuppressive therapy for patients with renal transplants and primary glomerular disease. Materials and methods: This was a retrospective study which evaluated a total of 19 patients aged 23-61: 14 with renal transplants (RT) and 5 with primary glomerular disease (PGD). All patients with RT received: cyclosporine A (CsA) + prednisone (P), 10 of those additionally received azathioprine (AZA) and 4 MMF. Patients with PGD received only MMF. Both groups were followed up for 12 months during which renal function and adverse effects were evaluated. Results: The value of the graft was significantly improved among those patients who received regimens with MMF. Average creatinine serum values at 12-month follow-up were 1.5  0.4 mg/dL in MMF group vs. 1.7  0.2 mg/dL in AZA group. Adverse effects presented in 40% of those treated with regimens including AZA and in 25% of those including MMF. Some patients with PGD improved their renal function. Conclusions: Renal graft function improved among patients receiving immunosuppressive regimens that included MMF when compared to those regimens that included AZA. Results among patients with PGD were inconclusive.

Glomerulonefritis por inmunocomplejos en la endocarditis infecciosa / Immune complex glomerulonephritis in infective endocarditis

Los pacientes con endocarditis infecciosa pueden desarrollar tres diferentes formas de enfermedad renal: Glomerulonefritis postinfecciosa mediada por complejos inmunes, nefritis intersticial aguda inducida por drogas o necrosis tubular aguda por aminoglucósidos y la enfermedad embólica renal. La glomerulonefritis mediada por inmunocomplejos es similar a la glomerulonefritis post Estreptocócica o la glomerulonefritis membranoproliferativa con antigenemia larga y persistente. Las manifestaciones clínicas son similares a las de aquellos pacientes con otras formas de glomerulonefritis aguda. Presentamos el caso de una paciente que cumplió los requisitos para entrar dentro el grupo de glomerulonefritis por complejos inmunes, destacando el hecho de presentar alteraciones en la función renal y sedimento urinario disipadas con la resolución de la patología de base.

Patients with infective endocarditis can develop three different forms of renal disease: post infectious immune complex mediated glomerulonephritis, drug induced acute intersticial nephritis or acute tubular necrosis due to aminoglucoside toxicity and renal embolic disease. Inmune complex glomerulonephritis is similar to post estreptococal glomerulonephritis or membrano proliferative glomerulonephritis with long standing and persistent antigenemia. The clinical manifestations are similar to those of other forms of glomerulonephritis. We present the case of a patient who fulfilled most criteria of immune complex mediated glomerulonephritis. emphasizing the fact that the alterations in renal function and urinary sediment resolved with the resolution of the primary disease.

A Case of Membranoproliferative Glomerulonephritis Type II: Dense Deposit Disease, DDD

Type II membranoproliferative glomerulonephritis (Dense deposit disease ) is an acquired primary glomerular disease characterized by electron microscopic evidence of a continuous dense membrane deposition replacing the lamina densa. It is a subtype of idiopathic membra- noproliferative glomrulonephritis, and was described as a separate entity by Berger and Galle in 1963. It frequently occurs in older chilren and young adults and the clinical course is variable, but is generally progressive. The presenting feature is nephrotic syndrome in many patients, and proteinuria and hematuria are also seen frequently. The purpose of this paper is to present a case of DDD (Dense deposit disease) from a 10 year old boy who was diagnosed as a acute poststreptococcal glomurulonephritis with protenuria, hematuria, and facial edema by renal biopsy 4 years ago.

Clinical and Histopathological Analysis of 494 Cases of Percutaneous Renal Biopsies / 대한신장학회잡지

Percutaneous renal biopsy is an essential component for diagnosis and management of glomerular diseases. In order to elucidate clinical and pathological features, 494 renal patients who had undergone renal biopsies at Gil Medical Center from January 1989 to June 1999 were studied retrospectively. The male to female ratio was 1.3 : 1 and average age was 33.2 years. There were 370(83.5%) cases of primary glomerular disease and 58(13.1%) cases of secondary glomerular disease. Among primary glomerular disease, IgA nephropathy was the most common(175 cases), followed by minimal change disease(84 cases), membranous glomerulonephritis(34 cases), and focal segmental glomerulosclerosis(33 cases). In secondary glomerular disease, lupus nephritis was the most common(21 cases), followed by 11 cases of hepatitis B associated glomerulonephritis, 9 cases of Henoch-Sch nlein purpura, and 4 cases of diabetic nephropathy. Among 99 cases of asymptomatic urinary abnormalities, IgA nephropathy was most common(69 cases) followed by 12 cases of thin basement membrane disease, 4 cases of minimal change disease, and 3 cases of focal segmental glomerulosclerosis, membranous glomerulonephritis, nonspecific glomerulonephritis. Among 159 cases of nephrotic syndrome, minimal change disease was most common(60 cases) followed by 25 cases of IgA nephropathy, 23 cases of focal segmental glomerulosclerosis, 21 cases of membranous glomerulonephritis, and 13 cases of lupus nephritis. Documented complication of renal biopsies included 23 cases of gross hematuria, 6 cases of perirenal hematoma, and 4 cases of infection. Death, AV fistula, aneurysm or serious compications that required surgical intervention were not reported. In conclusion, the percutaneous renal biopsy is relatively safe, and useful for diagnosis and management of glomerular diseases. The most common type of primary glomerular disease was IgA nephropathy.

Difference of Urine MCP-1 in Inflammatory and Non-Inflammatory Glomerular Diseases and Its Realtion to the Proteinuria / 대한신장학회잡지

Monocyte chemoattractant protein-1(MCP-1) has been known to play a role in pathophysiology of inflammatory glomerular disease through selective monocyte attraction and activation. The levels of urine and serum MCP-1 in 20 inflammatory glomerular diseases(IgA nephropathy 16, lupus nephritis 4), 17 non-inflammatory glomerular diseases(membranous nephrothy 9, minimal change disease 8), and 10 normal controls were evaluated by ELISA. The secretion of MCP-1 by peripheral blood mononuclear cells(PBMC) was examined in 5 patients with IgA nephropathy, membranous nephropathy, and minimal change disease respectively and 5 normal controls. After 4 week treatment with steroid, the urine and serum MCP-1 levels were followed up in eighteen patients who received steroid therapy. Urinary excretion of MCP-1 was significantly higher in patients with inflammatory glomerular disease(0.78+/-0.51ng/mg creatinine) compared to normal controls(0.18+/-0.12ng/mg creatinine). There were no differences in serum MCP-1 levels and MCP-1 production by PBMC between normal controls and patients. Positive correlation between urinary excretion of MCP-1 and proteinuria were observed in the patients with inflammatory glomerular disease but not in the patients with non-inflammatory glomerular disease. Any correlation between serum MCP-1 levels and urinary excretion of MCP-1 or proteinuria was not found. Urinary excretion of MCP-1 and proteinuria were decreased after steroid therapy. However, reduction in urinary excretion of MCP-1 does not seem to be related with decrease in proteinuria. Further studies are necessary to clarify the clinical significances of reduction in urinary excretion of MCP-1 with steroid therapy. In conclusion, our data support some role of MCP-1 in the pathophysiology of inflammatory glomerular diseases. MCP-1, however, does not seem to play an important role in those of membranous nephropathy and minimal change disease.