Monoclonal gammopathy of unknown significance (MGUS), commonly considered a benign condition, is characterized by a low level of detectable monoclonal immunoglobulin (Ig) in the serum (<30 g/L) and <10% monoclonal plasma cells on bone marrow biopsy. Assuming these low levels of circulating Igs do not cause any end organ damage, treatment is usually not recommended for MGUS. However, in some patients with MGUS, these low levels of Ig or kappa/lambda light chains can cause direct kidney deposition or activation of complements leading to kidney diseases. Because of this, in 2012, the term “monoclonal gammopathy of renal significance” (MGRS) was coined
Diabetic nephropathy is the leading cause of chronic kidney disease (CKD) in the United States and one of the most common complications of diabetes mellitus, increasing the risk of cardiovascular disease in individuals with diabetes. Risk factors for developing diabetes-related kidney disease include poor glycemic control, hypertension, older age, dyslipidemia, and genetic factors, among others (1). Jia Xin Huang, MD, et al. (2) recently published an article about the role of acute kidney injury (AKI) and diabetic ketoacidosis (DKA) in the development of proteinuria in children with diabetes.
The study is a well-designed retrospective chart review
Traditionally, the field of hematology-oncology has elicited a feeling of despair and morbidity in many until a few years ago. However, with the growing advances in the field of oncology, there are a larger number of patients who are being diagnosed with cancers and an even larger number surviving cancer. With this change in the field of oncology, we—as nephrologists—encounter many patients who develop kidney diseases due to cancer or the therapy used for the treatment of cancer.
From electrolyte and acid-base imbalance to acute and chronic kidney disease, including glomerular diseases, nephrologists are seeing a growing number of patients
Committed to creating a world without kidney diseases, the American Society of Nephrology (ASN)—together with other members of the kidney community—has produced incredible results in federal legislative and regulatory policy during the past decade, such as the landmark Executive Order on Advancing American Kidney Health. At a national level, patient advocates, health professionals, and policymakers are rallying around the four priorities of ASN's We’re United 4 Kidney Health campaign: intervene earlier, transform transplant, accelerate innovation, and achieve equity.
Due to greater disinformation, polarization, and blowtorch politics, one in five people in the United States believes “The government, media, and financial
Pamidronate has been found to be associated with CG in patients with multiple myeloma and breast cancer. In these patients, pamidronate is used in higher doses to prevent skeletal complications. It is hypothesized that pamidronate affects the glomerular epithelial cells (1).
Light microscopy: Jones silver stain, proliferation of visceral epithelial cells and collapse of glomerulus known as collapsing focal segmental glomerulosclerosis (FSGS). Image credit: K.S. Vinay.
Chronic kidney disease (CKD) is associated with physical function decline and worsening comorbidity burden. A recent study published in the Journal of the American Society of Nephrology (1) reports findings from the LANDMARK III study, a years-long, longitudinal randomized study of a multi-disciplinary, clinic-based and lifestyle intervention for Australian patients with CKD stages 3a−4. The intensive intervention required a treatment team of nurse practitioners, exercise physiologists, dieticians, diabetes educators, psychologists, and nephrologists. Risk factors addressed included blood pressure, weight, and cardiorespiratory fitness. The 81 intervention-group patients attended 4 weeks of behavior and lifestyle intervention and 8
A 23-year-old female with primary focal segmental glomerulosclerosis (FSGS), diagnosed at the age of 16, underwent a living-related kidney transplantation (KT). She was on hemodialysis for 2 years before transplant but still had residual urine output of 500 mL/day with a random urine protein-to-creatinine ratio (UPCR) of 1.5 g/gCr. On post-operative day 4, UPCR was noted as 14 g/gCr. A kidney allograft biopsy demonstrated diffuse effacement of podocyte foot processes with no evidence of acute rejection.
What are the risk factors and mechanisms of recurrent primary FSGS posttransplant? What treatment options (pre- and posttransplant) might benefit this patient?
A llogeneic stem cell transplant (SCT) is used to cure several hematological disorders. The incidence of both acute kidney injury and chronic kidney disease (CKD) post-SCT remains high. A rare cause of CKD post-allogeneic SCT is development of glomerular disease, which by many is considered to be a manifestation of chronic graft-versus-host disease (GVHD) affecting the kidney (1). Based on mouse models, it has been proposed that GVHD could be a direct T cell-mediated injury or that the chronic systemic inflammatory state of GVHD leads to autoimmune induction and glomerulopathy (2). The incidence of nephrotic syndrome