Vervaet BA, et al. Chronic Interstitial Nephritis in Agricultural Communities Is a Toxin-Induced Proximal Tubular Nephropathy. Kidney Int 2020; 97 (2), 350-369. [PubMed link]
The authors identified a unique constellation of proximal tubular cell findings including large dysmorphic lysosomes with a light-medium electron-dense matrix containing dispersed dark electron-dense non-membrane bound "aggregates", and conclude that "CINAC is a toxin-induced disease", although they do not do toxicological studies and show no relationship with any toxins.
Haas M. Uncovering the etiology of CINAC, a complex and mysterious renal syndrome: the invaluable role of histopathology and electron microscopy. Kidney Int 2020 Feb; 97 (2), 258-260. [PubMed link]
A comment on the previous paper.
Malvar A, Albertob V, Lococo B, et al. Kidney Biopsy-Based Management of Maintenance Immunosuppression Is Safe and May Ameliorate Flare Rate in Lupus Nephritis. Kidney Int 2020; 97 (1), 156-162. [PubMed link]
The authors postulate that continuing therapy for patients with persistent histologic activity on kidney biopsies done during maintenance and discontinuing therapy only for patients without histologic activity would minimize subsequent lupus nephritis flares.
Hogan JJ, Alexander MP, Leung N. Dysproteinemia and the Kidney: Core Curriculum 2019. Am J Kidney Dis. 2019 Dec;74(6):822-836. [PubMed link]
A concise review.
van de Logt AE, Fresquet M, Wetzels JF, Brenchley P. The anti-PLA2R antibody in membranous nephropathy: what we know and what remains a decade after its discovery. Kidney Int. 2019 Dec;96(6):1292-1302. [PubMed link]
In this review we highlight unresolved issues, addressing initiation of antibody formation, the timeline of antibody production, the role of IgG subclass, and the pathogenicity of the antibodies in concert with complement to produce glomerular pathology and proteinuria.
Kudose S, Santoriello D, Bomback AS, Stokes MB, D'Agati VD, Markowitz GS. Sensitivity and Specificity of Pathologic Findings to Diagnose Lupus Nephritis. Clin J Am Soc Nephrol. 2019 Nov 7;14(11):1605-1615. [PubMed link]
The authors conclude: "combinations of pathologic features can distinguish lupus nephritis from nonlupus glomerulopathies with high specificity and varying sensitivity. Even with stringent criteria, however, rare examples of nonlupus glomerulopathies may exhibit characteristic features of lupus nephritis".
Cai Q, Shi S, Wang S, Ren Y, Hou W, Liu L, Lv J, Haas M, Zhang H. Microangiopathic Lesions in IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2019 Nov;74(5):629-639. [PubMed link]
A Chinese cohort with 944 adult patients. Renal arteriolar microangiopathic lesions were detected using light microscopy. Overall, 194 (20.6%) patients had renal arteriolar microangiopathic lesions. "Renal arteriolar microangiopathic lesions are frequent in IgAN and their presence is independently associated with progression to kidney failure".
Watanabe A, Feltran LS, Sampson MG. Genetics of Nephrotic Syndrome Presenting in Childhood: Core Curriculum 2019. Am J Kidney Dis. 2019 Oct;74(4):549-557. [PubMed link]
A very interesting and concise review.
Nasr SH, Wehbe E, Said SM, Dasari S, Quoc T, Kurtin PJ. Paraneoplastic Cast Nephropathy Associated With Pancreatic Mixed Acinar-Neuroendocrine Carcinoma: A Case Report. Am J Kidney Dis. 2019 Oct;74(4):558-562. [PubMed link]
Kidney biopsy showed cast nephropathy characterized by fractured periodic acid-Schiff-negative casts, associated with mononuclear and giant cell reaction. Casts did not show immunoglobulin light chain restriction on immunofluorescence. Analysis using liquid chromatography-tandem mass spectrometry and immunohistochemistry identified 2 acinar cell-specific proteins: regenerating islet-derived 1α and carboxypeptidase A1, in both tubular casts and tumor cells.