Abstract:
:Management of idiopathic glomerular disease associated with nephrotic syndrome (INS) remains controversial and one of the most complex areas relates to utilization of the drug cyclosporin. This is despite its demonstrated effectiveness in several histologic types of the INS in randomized controlled trials. Cyclosporin is effective in inducing remission of proteinuria in approximately 80% of steroid-sensitive cases of minimal change disease (MCD). Cyclosporin is also effective in both the induction of remission and long-term preservation of renal function in steroid-dependent/-resistant MCD and steroid-resistant focal segmental glomerulosclerosis (FSGS). The overall response rate in FSGS is lower than in MCD, and long-term therapy (>12 months) may be required to both achieve remission and sustain it. Cyclosporin therapy is also of benefit in reducing proteinuria in 70-80% of patients with steroid-resistant membranous nephropathy (MGN). In MGN, the maximum benefit is often delayed compared to MCD (>12 weeks). Cyclosporin is generally well tolerated and safe. The major concern remains the nephrotoxicity, but with careful monitoring of the patient's renal function; minimizing the maintenance dose and utilizing repeat renal biopsy in those receiving long-term therapy, this risk can be minimized. The algorithms have been developed derived from the best evidence in the literature in each of the histologic types to help provide a guide to the integration of cyclosporin into the management of INS for the practicing nephrologist.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Cattran DC,Alexopoulos E,Heering P,Hoyer PF,Johnston A,Meyrier A,Ponticelli C,Saito T,Choukroun G,Nachman P,Praga M,Yoshikawa Ndoi
10.1038/sj.ki.5002553subject
Has Abstractpub_date
2007-12-01 00:00:00pages
1429-47issue
12eissn
0085-2538issn
1523-1755pii
S0085-2538(15)52590-8journal_volume
72pub_type
共识发展会议,杂志文章abstract::Renal proximal tubule cells from spontaneously hypertensive rats (SHR), compared with normotensive Wistar-Kyoto rats (WKY), have increased oxidative stress. The contribution of mitochondrial oxidative phosphorylation to the subsequent hypertensive phenotype remains unclear. We found that renal proximal tubule cells fr...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2013.397
更新日期:2014-03-01 00:00:00
abstract::Previous studies in living animals have suggested that variations in the serum concentrations of calcium and phosphate directly affect renal tubular bicarbonate transport. To examine this area more directly, we measured the bicarbonate and the fluid transport in isolated rabbit proximal convoluted and straight tubules...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1982.43
更新日期:1982-03-01 00:00:00
abstract::Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a recently described member of the epidermal growth factor (EGF) family. It binds to heparan sulfate proteoglycans via a cationic domain and is a potent mitogen for epithelial cells, fibroblasts and vascular smooth muscle cells. In the present stud...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1998.00846.x
更新日期:1998-05-01 00:00:00
abstract::Hypocalcemia, hyperphosphatemia, and resistance to the action of PTH are well characterized features in the setting of advanced chronic renal failure (CRF). Although the underlying mechanisms are ill-understood, clinical and experimental evidence points to both PTH receptor down-regulation and post-receptor abnormalit...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1994.79
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Hypertension is a recognized complication of partial correction of anemia with recombinant human erythropoietin (epoetin) in hemodialysis patients. We used interdialytic ambulatory blood pressure (ABP) monitoring to study the effects of partially corrected anemia versus normal hematocrit (hct) on BP in hemod...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1523-1755.1999.00531.x
更新日期:1999-07-01 00:00:00
abstract::Because the size of renal cysts in the native kidneys of patients with ADPKD who have been transplanted was found to be reduced when rapamycin was the immunosuppressant, we tested the involvement of the mTOR pathway in cyst enlargement. Here, male pcy mice, with mutation in one of the nephronophthisis genes, were trea...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2009.147
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Left ventricular enlargement is very common at the inception of dialysis therapy, and highly predictive of future cardiac morbidity and mortality. It is not known whether cardiac size increases further while on dialysis therapy and whether potentially reversible risk factors for later progression can be iden...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1998.00154.x
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Increased venous pressure (VP) and decreased access flow (Qa) are predictors of dialysis access graft thrombosis. VP is easily obtainable. Qa assessment requires a special device and takes more time. The aims of our randomized multicenter studies were to compare outcome in patients with grafts monitored by V...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1523-1755.2001.0590041551.x
更新日期:2001-04-01 00:00:00
abstract::Transport and metabolism of adenosine were studied in the S1, S2, and S3 segments of the rabbit proximal renal tubule. Isolated segments were perfused in vitro with uniformly labelled 14C-adenosine to measure the lumen-to-bath flux of adenosine. This flux rate was measured by the disappearance of 14C from the luminal ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1992.174
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Many studies have reported that blocking the renin-angiotensin-system (RAS) with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker in the patient with diabetes mellitus leads to an increase in renal plasma flow (RPF), no change in glomerular filtration rate (GFR), and a fall...
journal_title:Kidney international
pub_type: 临床试验,杂志文章
doi:10.1046/j.1523-1755.2003.00701.x
更新日期:2003-01-01 00:00:00
abstract::In rodents, mercuric chloride (HgCl2) causes an autoimmune disorder with glomerulonephritis (GN), and represents an animal model for the pathogenesis of GN. We have tested the hypothesis that HgCl2 induces major histocompatibility complex (MHC) expression in renal parenchymal cells, and studied the kinetics of this in...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1991.33
更新日期:1991-02-01 00:00:00
abstract::Intercellular adhesion molecule-1 (ICAM-1) and MHC class II (Ia) antigens are increased on proximal tubular epithelial cells (TEC) in autoimmune nephritis and transplant rejection. ICAM-1 is a member of the immunoglobulin gene superfamily that increases the avidity of T cell interactions with antigen-presenting cells ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1990.221
更新日期:1990-09-01 00:00:00
abstract::Data from the national French Renal Epidemiology and Information Network (REIN) registry were used to compare survival between transplant recipients under age 65 who resumed dialysis after graft failure during 2007-2009 and transplant-naïve incident dialysis patients matched for age, gender, diabetes mellitus, and yea...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2014.6
更新日期:2014-07-01 00:00:00
abstract::Vascular sclerosis is often seen in renal biopsies. It is usually associated with diabetes mellitus, hypertension, smoking, etc. However, whether inherited thrombophilic states such as factor V gene mutation, prothrombin gene mutation, and methylenetetrahydrofolate reductase (MTHFR) gene mutation are associated with t...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5001551
更新日期:2006-08-01 00:00:00
abstract::The relationship of protein intake to urinary oxalate and glycolate excretion was examined in a large cohort (N = 101) of normal individuals on self-selected diets and in 11 individuals on controlled protein diets. On self-selected diets no correlation was detected between protein intake and urinary oxalate or glycola...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1993.253
更新日期:1993-08-01 00:00:00
abstract::Autosomal dominant polycystic kidney disease (ADPKD) is associated with a urine-concentrating defect attributed to renal cystic changes. As PKD genes are expressed in the brain, altered central release of arginine vasopressin could also play a role. In order to help determine this we measured central and nephrogenic c...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2012.225
更新日期:2012-11-01 00:00:00
abstract::Scavenger receptor A (SR-A) is a key transmembrane receptor in the endocytosis of lipids and contributes to the pathogenesis of atherosclerosis. To assess its role in hyperlipidemic chronic kidney disease, wild-type and SR-A-deficient (knockout) mice underwent uninephrectomy followed by either normal or high-fat diet....
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2011.457
更新日期:2012-05-01 00:00:00
abstract::Many features of chronic kidney disease may be reversed, but it is unclear whether advanced lesions, such as adhesions of sclerotic glomerular tufts to Bowman's capsule (synechiae), can resolve during treatment. We previously showed, using a renal ablation model, that the renoprotective effect of the AT-1 receptor blo...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2008.528
更新日期:2009-01-01 00:00:00
abstract::EDTA (calcium disodium edetate) lead mobilization and x-ray fluorescence (XRF) finger bone lead tests were done in 42 patients with chronic renal failure and without persisting lead intoxication. Nineteen of 23 patients with gout and 8 of 19 without gout had positive EDTA lead mobilization tests. Those patients with g...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1984.175
更新日期:1984-09-01 00:00:00
abstract::We used the perfused hemicorpus preparation to measure individual rates of protein synthesis and degradation. Using fed animals, perfused either with or without insulin, muscle protein synthesis and hemicorpus protein degradation rates were similar, but myofibrillar protein degradation was clearly increased in the ure...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1986.119
更新日期:1986-06-01 00:00:00
abstract::The risk of death in hemodialysis patients treated with calcium-containing phosphate binders or sevelamer is not known. We assessed all-cause mortality in 127 patients new to hemodialysis assigned to calcium-containing binders or sevelamer after a median follow-up of 44 months from randomization. This was a predetermi...
journal_title:Kidney international
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.ki.5002059
更新日期:2007-03-01 00:00:00
abstract::One hundred six patients with terminal renal insufficiency and 29 medical personnel were given three doses of hepatitis B vaccine at an interval of 0, 1, and 6 months (Merck, Sharp and Dohme, West Point, Pennsylvania, part of a joint study no. 649). Chronic hemodialysis patients (N = 99) received 40 micrograms vaccine...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1984.18
更新日期:1984-01-01 00:00:00
abstract::X-linked Alport syndrome (AS) associated with diffuse esophageal leiomyomatosis (DL) has been reported to be due to deletions removing the 5' ends of both the COL4A5 and COL4A6 genes, encoding the alpha 5 and alpha 6 chains of type IV collagen, respectively, whereas a variety of mutations in COL4A5 has been identified...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1995.489
更新日期:1995-12-01 00:00:00
abstract::Intrarenal artery infusions of hypertonic saline can activate tubuloglomerular feedback (TGF), decreasing renal blood flow (RBF) and glomerular filtration rate (GFR). The response to infusion of hypertonic saline is enhanced by salt depletion and attenuated by salt loading, but has not previously been investigated in ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1987.236
更新日期:1987-10-01 00:00:00
abstract::Circulating donor-reactive effector memory T cells have been associated with allograft injury in humans. The next step to translate this observation into clinical practice is the design of clinical trials aimed at individualization of T cell-targeted therapy. The administration of immunosuppressive therapy based on th...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2013.295
更新日期:2013-12-01 00:00:00
abstract::The kidneys excrete the daily acid load mainly by generating and excreting ammonia but the underlying molecular mechanisms are not fully understood. Here we evaluated the role of the inwardly rectifying potassium channel subunit Kir4.2 (Kcnj15 gene product) in this process. In mice, Kir4.2 was present exclusively at t...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2019.09.028
更新日期:2020-02-01 00:00:00
abstract::Both single-frequency bioimpedance and multiple-frequency spectroscopy are equally accurate in measuring total-body water and intracellular fluid. Estimates are consistent at a population level but not at the individual level, because of wide limits of agreement. There is no real 'gold standard' method providing estim...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2013.434
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Small, uncontrolled studies of dialysis-dependent chronic kidney disease (CKD) patients have demonstrated abnormalities of cardiovascular autonomic control and vascular compliance, which may contribute to adverse cardiovascular morbidity in this population. However, there is little information utilizing newe...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00165.x
更新日期:2005-03-01 00:00:00
abstract::Australia's Indigenous people have high rates of chronic kidney disease and kidney failure. To define renal disease among these people, we reviewed 643 renal biopsies on Indigenous people across Australia, and compared them with 249 biopsies of non-Indigenous patients. The intent was to reach a consensus on pathologic...
journal_title:Kidney international
pub_type: 杂志文章,多中心研究
doi:10.1038/ki.2012.307
更新日期:2012-12-01 00:00:00
abstract::A major problem in cyclosporine A (CsA) therapy is its nephrotoxicity, characterized by a marked fall in glomerular filtration rate (GFR). Since the glomerular ultrafiltration area is an important determinant of GFR and has been proposed to be regulated by mesangial (MS) cell contraction, we examined the effect of CsA...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1988.149
更新日期:1988-07-01 00:00:00