Abstract：
:Synthetic immunosuppressive drugs are largely used in immune-related renal diseases and in kidney transplantation. Most of these drugs have a low therapeutic index (the ratio that compares the blood concentration at which a drug becomes toxic and the concentration at which the drug is effective), which means that the drug should be dosed carefully and the patient monitored frequently. In this review, we consider the categories of synthetic immunosuppressive agents more frequently and conventionally used in clinical nephrology: glucocorticoids, Aalkylating agents (cyclophosphamide, chlorambucil), purine synthesis inhibitors (azathioprine, mycophenolate salts) and calcineurin inhibitors (cyclosporine, tacrolimus). For each category the possible side effects will be reviewed, the general and specific measures to prevent or treat the adverse events will be suggested, and the more common mistakes that may increase the risk of toxicity will be described. However, the efficacy and safety of immunosuppressive agents depend not only on the pharmacologic characteristics of single drugs but can be influenced also by the clinical condition and genetic characteristics of the patient, by the typology and severity of the underlying disease and by the interaction with other concomitantly used drugs.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Ponticelli C,Glassock RJdoi
10.1007/s40620-019-00602-5subject
Has Abstractpub_date
2019-12-01 00:00:00pages
851-870issue
6eissn
1121-8428issn
1724-6059pii
10.1007/s40620-019-00602-5journal_volume
32pub_type
杂志文章,评审abstract：OBJECTIVE:It is uncertain whether increasing 25-hydroxyvitamin D (25-D) levels in chronic kidney disease (CKD) patients above those recommended by current guidelines result in progressive amelioration of secondary hyperparathyroidism. Our objective was to identify a potential therapeutic 25-D target which optimally low...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究
doi：10.1007/s40620-015-0186-0
更新日期：2016-02-01 00:00:00
abstract：:The authors review the antineoplastic effect of mammalian target of rapamycin (mTOR) inhibitors and their biological basis. mTOR is an intracellular serine/threonine kinase that is a central controller of cell growth and proliferation. mTOR integrates signals from sources such as nutrients and growth factors. mTOR reg...
journal_title：Journal of nephrology
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更新日期：2009-07-01 00:00:00
abstract：:Percutaneous transluminal angioplasty of the renal artery (PTRA) has been increasingly used over the past 20 years for treating renovascular hypertension (RVH). From the experience gathered so far it is justified to state that this technique is the first choice for patients with fibromuscular renal artery stenosis (RA...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
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更新日期：2000-11-01 00:00:00
abstract：:One of the major concerns in organ transplantation is the early detection of humoral rejection, through improved diagnostic and prognostic biomarkers. Long-term survival of renal allografts is significantly lower in recipients developing donor-specific anti-HLA antibodies (DSAs) either pretransplant or posttransplant....
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/jn.5000240
更新日期：2013-03-01 00:00:00
abstract：AIM:The objective of this study was to determine whether the baseline estimated glomerular filtration rate (eGFR) level was independently associated with in-hospital mortality in generalized patients with hospital-acquired acute kidney injury (HA-AKI) in China. METHODS:All of the patients admitted to a tertiary medica...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-015-0238-5
更新日期：2016-06-01 00:00:00
abstract：:The hallmark of IgA nephropathy (IgAN) is macroscopic hematuria coinciding with, or immediately following, a mucosal infection, usually of the upper respiratory airways. The role of mucosal pathogens has been proven in different experimental models. Mucosal (or innate) immunity acts through the recognition of pathogen...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2010-11-01 00:00:00
abstract：AIMS:To examine the distribution of bone mineral density (BMD) in different histological groups of renal osteodystrophy. PATIENTS:We prospectively studied 62 patients, 41 men and 21 women, aged 57+/-11.5 years, who had been on hemodialysis for 60+/-55 months. The women had been amenorrheic for 13+/-4 years and 7 patie...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND AND AIMS:Arterial stiffness is a risk factor for chronic kidney disease progression (CKD). Pulse pressure is a surrogate marker of arterial stiffness. It is unclear if pulse pressure predicts CKD progression in type 2 diabetes mellitus. METHODS:This was prospective study involving 1494 patients with estimat...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-020-00954-3
更新日期：2021-01-25 00:00:00
abstract：INTRODUCTION:We analyzed renal histologic and immunohistologic findings in children with nephrotic syndrome (NS) who did (n=5) or did not (n=17) develop cyclosporine A (CyA) nephropathy despite appropriately low serum CyA concentrations being maintained over 2 years. METHODS:To discriminate embryonic-type from mature ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/JN.2010.5793
更新日期：2011-07-01 00:00:00
abstract：AIMS:The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population. METHOD:We analyzed 49 kidney transplant recipients...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究
doi：10.1007/s40620-017-0449-z
更新日期：2018-02-01 00:00:00
abstract：:Preemptive isolated liver transplantation (PLTX) can cure the metabolic defect in primary hyperoxaluria type 1 (PH1) but there are no uniformally accepted recommendations concerning the timing of this transplantation procedure. We have performed PLTX successfully in 4 children (age 3-9 years) with PH1 with no mortalit...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1998-03-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/jn.5000233
更新日期：2013-07-01 00:00:00
abstract：:The aging process results in remarkable changes in the kidney. These changes are both anatomical and functional and have been considered the cause of the increased propensity of the elderly to acute or chronic renal failure. However, the majority of the early studies on aging enrolled institutionalized elderly patient...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2010-09-01 00:00:00
abstract：:The presence of circulating permeability factors (cPFs) has been hypothesized to be associated with recurrence of focal segmental glomerulosclerosis (rFSGS) in renal allografts. The available methods to detect cPFs are complex, not easily repeatable and inappropriate to represent the anatomical characteristics of the ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-019-00683-2
更新日期：2020-08-01 00:00:00
abstract：:Recent molecular cloning experiments have identified the existence of four NBC isoforms (NBC1, 2, 3 and 4) and two NBC-related proteins AE4 and NCBE (Anion Exchanger 4 and Sodium-dependent Chloride-Bicarbonate Exchanger). Except for AE4 which does not transport Na, all are presumed to mediate the cotransport of Na+ an...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-03-01 00:00:00
abstract：:The origin of the Teutonic Order of Hospitalers St. Mary (Ordo Hospitalis S. Mariae Teutonicorum Hi-erosolymitani) is presented. The St. Mary Hospitaler Teutonic Order arrived in the XIIIth century to Pomezania, then inhabited by pagan Prussian tribes. The Knights of the Order started to Christianize the Prussians, th...
journal_title：Journal of nephrology
pub_type： 历史文章,杂志文章
doi：
更新日期：2006-05-01 00:00:00
abstract：:The term thin glomerular basement membrane disease (TBMD) refers to a condition characterised by thinning of the GBM at electron microscopy examination and, clinically, by isolated hematuria, frequently occurring in other family members, with no extra-renal manifestations. Progression towards chronic renal failure (CR...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2000-01-01 00:00:00
abstract：INTRODUCTION:During potassium (K) depletion, many adaptive responses are likely mediated through a complex network that involves expression of a variety of genes. We identified that the Nrf2 gene was differentially expressed between normal and K-depleted rat kidney. METHODS:To investigate the effect of Nrf2 on colonic...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/JN.2011.8448
更新日期：2012-03-01 00:00:00
abstract：:Clinically apparent venous thromboembolism (VTE) occurs in approximately 7% of patients with membranous nephropathy. Hypoalbuminemia at diagnosis is an independent risk factor for VTE, and risk increases significantly as albumin falls. Optimal prophylactic and treatment anticoagulation regimens in the nephrotic syndro...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-0552-9
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:The relationship between malnutrition in hemodialysis (HD) patients with a chronic inflammatory condition and the expression levels of leukocyte integrins and their adhesiveness to fibronectin was investigated. METHODS:Subjective global assessment, albumin and body mass index were used as nutritional marker...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2010-03-01 00:00:00
abstract：BACKGROUND:Plasmin has recently been reported to be associated with renal fibrosis in experimental models, but its role in human renal diseases is unclear. METHODS:Fifty-seven patients with IgA nephropathy (IgAN) were evaluated retrospectively. Plasmin in their renal biopsy tissues was assessed by in situ zymography u...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-015-0205-1
更新日期：2016-02-01 00:00:00
abstract：INTRODUCTION:Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedu...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2009-05-01 00:00:00
abstract：:Survival analysis is the statistical method for studying the time between entry to a study and a subsequent event. Survival is often the most important outcome in both observational and intervention studies. The analysis of survival, however, is not simple because of a number of factors. The time between entry to a st...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2004-03-01 00:00:00
abstract：BACKGROUND:Peripheral artery disease (PAD) represents a major complication in chronic kidney disease (CKD) patients, but its early diagnosis is still problematic. Traditionally, ankle-arm blood pressure index (API) determined by means of a simple hand-held unidimensional Doppler device has been used for noninvasive dia...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Neurocognitive impairment is commonly reported in patients with chronic kidney disease (CKD). The precise nature of this impairment is unclear, due to the lack of objective and quantitative assessment tools used. The feasibility of using robotic technology to precisely quantify neurocognitive impairment in p...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-020-00912-z
更新日期：2021-01-05 00:00:00
abstract：:Diabetic nephropathy (DN) is a common complication of Diabetes Mellitus (DM) Types 1 and 2, and prevention of end stage renal disease (ESRD) remains a major challenge. Despite its high prevalence, the pathogenesis of DN is still controversial. Initial glomerular disease manifested by hyperfiltration and loss of glomer...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0423-9
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:The most frequent cause of death in hemodialysis (HD) patients is cardiovascular disease (CVD), and chronic inflammation has been identified as an epidemiologically important risk factor for CVD. Elevated levels of minor acute phase reactants, such as ceruloplasmin (Cp) and transferrin, have been related to ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2004-09-01 00:00:00
abstract：BACKGROUND AND AIMS:Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodiu...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0371-9
更新日期：2018-02-01 00:00:00
abstract：:Sudden cardiac death (SCD) is a major cause of concern in end stage renal disease (ESRD), contributing to 70% of cardiovascular mortality and 27% of all-cause mortality in dialysis patients. Yet its mechanisms and pathogenesis remain largely obscure. This review discusses the potential reasons for an exaggerated risk ...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-014-0151-3
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:The G-1082A polymorphism of the interleukin-10 (IL-10) gene has been associated with modified gene expression and the progression of primary IgA nephropathy (IgAN). In the present study, we evaluated its influence on recurrent IgAN after renal transplantation. METHODS:We studied 103 patients who suffered fr...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2008-11-01 00:00:00
