Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase,...Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase, Cochrane Library and Clinical Trials(December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission(CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated.Results Seven studies involved 120 patients(73% were men) were included in our systematic review and metaanalysis. All were prospective observation cohort studies or matched-cohort studies, mainly came from two medical centers, and one study was multi-centric(four nephrology units in northern Italy). The creatinine clearance was more than 20 ml/(min·1.73 m2) and persistent proteinuria higher than 3.5 g/d for at least 6 months. All patients received treatment previously [44(36.7%) had immunosuppressive treatment]. In 12-and 24-month, 56%(95%CI, 0.47-0.65) and 68%(95%CI, 0.41-0.87) patients could reach remission, while 15%(95%CI, 0.09-0.23) and 20%(95%CI, 0.12-0.32) patients could reach CR. The reduction in proteinuria was gradual and obvious, paralleled with upward trend of serum albumin level and decreasing serum cholesterol level. Renal functions were stable. Relapses happened in 24 months were around 8%. RTX related adverse events were mild and were mostly infusion-related reactions.Conclusions RTX treatment in IMN was efficient, well tolerated and safe. More than 60% patients can reach partial remission or CR in 24 months, and relapse is rare. Adverse events of RTX are mostly infusion-related reactions and generally mild.展开更多
Dear editor,Nephrotic syndrome is defined by the presence of peripheral edema,heavy proteinuria(greater than 3.5 g/24h),and hypoalbuminemia(less than 3 g/dL).^[1]Nephrotic syndrome is relatively rare,with an incidence...Dear editor,Nephrotic syndrome is defined by the presence of peripheral edema,heavy proteinuria(greater than 3.5 g/24h),and hypoalbuminemia(less than 3 g/dL).^[1]Nephrotic syndrome is relatively rare,with an incidence of 3 new patients per 100,000 per year in adults.^[1]Despite being a known cause for new onset edema in patients at any age,nephrotic syndrome is often neglected in considering differential diagnoses for this presentation in primary care settings,and initial workups often focus on ruling out cardiac and hepatic causes of edema.^[1-3]In this case report,we describe a 25-year-old male patient who presented to the emergency department(ED)complaining of a 10-day history of anasarca.He was later diagnosed with nephrotic syndrome secondary to minimal change disease.This case served as a reminder to include the differential diagnosis of nephrotic syndrome early in the workup of an adult with peripheral edema presenting to the ED.展开更多
THROMBOEMBOLISM is a well-known complicationof nephrotic syndrome. Deep vein thrombosis,pulmonary embolism and renal vein thrombosisare the most common venous thromboembolicdiseases in patients with nephrotic syndrome...THROMBOEMBOLISM is a well-known complicationof nephrotic syndrome. Deep vein thrombosis,pulmonary embolism and renal vein thrombosisare the most common venous thromboembolicdiseases in patients with nephrotic syndrome, while arterialthromboembolic complications are observed less frequently,and rarely when it occurs before the diagnosis of nephroticsyndrome.1 Here we report a case with minimal change ofnephrotic syndrome who presented initially as external iliacartery thrombosis, which may be associated with longsitting while playing Mah-Jong.展开更多
REVERSIBLE posterior leukoencephalopathy syn- drome （RPLS） is a rare neurological syndrome charac- terized by headache, altered mental status, seizures, and visual disturbance,associated with reversible white matter...REVERSIBLE posterior leukoencephalopathy syn- drome （RPLS） is a rare neurological syndrome charac- terized by headache, altered mental status, seizures, and visual disturbance,associated with reversible white matter cnanges,- n been commonly reported in patients with severe hypertension and pre-eclampsia. Here we report a case with nephrotic syndrome complicated by RPLS.展开更多
Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thr...Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome （ACS）. As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current litera- ture, publications contain less than 15 patients, most of whom are young children.展开更多
OBJECTIVE: To determine the effect of hypercholsterolemia induced by a high-lipid diet on glomerulosclerosis. METHODS: Twenty nephrotic syndrome (NS) Wistar rats administrated adriamycin (ADR) with a single intravenou...OBJECTIVE: To determine the effect of hypercholsterolemia induced by a high-lipid diet on glomerulosclerosis. METHODS: Twenty nephrotic syndrome (NS) Wistar rats administrated adriamycin (ADR) with a single intravenous dose of 5 mg/kg body weight, were divided into the standard and high-lipid chow groups. Another 20 weight-matched non-NS rats that received a vehicle alone were grouped as control. Urinary protein excretion and serum cholesterol were assayed; image analysis and techniques of pathology, immunohistochemistry, and molecular biology were used to determine morphological changes in glomeruli and the production of glomerular mesangial matrices in different groups. RESULTS: The serum total cholesterol level was significantly higher in rats with high-lipid chow in both non-NS [(2.2 +/- 0.3) g/L vs. (0.9 +/- 0.1) g/L, P展开更多
基金Supported by the Key Projects in the National Science and Technology Pillar Program during the Twelfth Five-year Plan Period(2011BAI10B03)
文摘Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase, Cochrane Library and Clinical Trials(December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission(CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated.Results Seven studies involved 120 patients(73% were men) were included in our systematic review and metaanalysis. All were prospective observation cohort studies or matched-cohort studies, mainly came from two medical centers, and one study was multi-centric(four nephrology units in northern Italy). The creatinine clearance was more than 20 ml/(min·1.73 m2) and persistent proteinuria higher than 3.5 g/d for at least 6 months. All patients received treatment previously [44(36.7%) had immunosuppressive treatment]. In 12-and 24-month, 56%(95%CI, 0.47-0.65) and 68%(95%CI, 0.41-0.87) patients could reach remission, while 15%(95%CI, 0.09-0.23) and 20%(95%CI, 0.12-0.32) patients could reach CR. The reduction in proteinuria was gradual and obvious, paralleled with upward trend of serum albumin level and decreasing serum cholesterol level. Renal functions were stable. Relapses happened in 24 months were around 8%. RTX related adverse events were mild and were mostly infusion-related reactions.Conclusions RTX treatment in IMN was efficient, well tolerated and safe. More than 60% patients can reach partial remission or CR in 24 months, and relapse is rare. Adverse events of RTX are mostly infusion-related reactions and generally mild.
文摘Dear editor,Nephrotic syndrome is defined by the presence of peripheral edema,heavy proteinuria(greater than 3.5 g/24h),and hypoalbuminemia(less than 3 g/dL).^[1]Nephrotic syndrome is relatively rare,with an incidence of 3 new patients per 100,000 per year in adults.^[1]Despite being a known cause for new onset edema in patients at any age,nephrotic syndrome is often neglected in considering differential diagnoses for this presentation in primary care settings,and initial workups often focus on ruling out cardiac and hepatic causes of edema.^[1-3]In this case report,we describe a 25-year-old male patient who presented to the emergency department(ED)complaining of a 10-day history of anasarca.He was later diagnosed with nephrotic syndrome secondary to minimal change disease.This case served as a reminder to include the differential diagnosis of nephrotic syndrome early in the workup of an adult with peripheral edema presenting to the ED.
基金Funded by Obershi blood purification academician workstation of Guangdong Province(2013B090400004)
文摘THROMBOEMBOLISM is a well-known complicationof nephrotic syndrome. Deep vein thrombosis,pulmonary embolism and renal vein thrombosisare the most common venous thromboembolicdiseases in patients with nephrotic syndrome, while arterialthromboembolic complications are observed less frequently,and rarely when it occurs before the diagnosis of nephroticsyndrome.1 Here we report a case with minimal change ofnephrotic syndrome who presented initially as external iliacartery thrombosis, which may be associated with longsitting while playing Mah-Jong.
文摘REVERSIBLE posterior leukoencephalopathy syn- drome （RPLS） is a rare neurological syndrome charac- terized by headache, altered mental status, seizures, and visual disturbance,associated with reversible white matter cnanges,- n been commonly reported in patients with severe hypertension and pre-eclampsia. Here we report a case with nephrotic syndrome complicated by RPLS.
基金The program is supported by grants from the National Na tural Science Foundation of China （No.81400238）.
文摘Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome （ACS）. As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current litera- ture, publications contain less than 15 patients, most of whom are young children.
文摘OBJECTIVE: To determine the effect of hypercholsterolemia induced by a high-lipid diet on glomerulosclerosis. METHODS: Twenty nephrotic syndrome (NS) Wistar rats administrated adriamycin (ADR) with a single intravenous dose of 5 mg/kg body weight, were divided into the standard and high-lipid chow groups. Another 20 weight-matched non-NS rats that received a vehicle alone were grouped as control. Urinary protein excretion and serum cholesterol were assayed; image analysis and techniques of pathology, immunohistochemistry, and molecular biology were used to determine morphological changes in glomeruli and the production of glomerular mesangial matrices in different groups. RESULTS: The serum total cholesterol level was significantly higher in rats with high-lipid chow in both non-NS [(2.2 +/- 0.3) g/L vs. (0.9 +/- 0.1) g/L, P
