Alsharhan L, Beck LH Jr. Membranous Nephropathy: Core Curriculum 2021. Am J Kidney Dis. 2021 Mar;77(3):440-453. [PubMed link] [Free full text]
Sethi S. New 'Antigens' in Membranous Nephropathy. J Am Soc Nephrol. 2021 Feb;32(2):268-278. [PubMed link]
Use of laser microdissection and mass spectrometry enabled identification of 4 new targets antigens causing MN: exotosin 1 (EXT1) - exotosin 2 (EXT2), NELL1, Sema3B, and PCDH7. Further studies are required to understand the pathophysiology, response to treatment, and outcomes of these new MNs.
Caravaca-Fontán F, Trujillo H, Alonso M, et al. Validation of a Histologic Scoring Index for C3 Glomerulopathy. Am J Kidney Dis. 2021 Epub ahead of print. [PubMed link]
With a proposed prognostic Histologic Index that include activity iscore (mesangial hypercellularity, endocapillary proliferation, MPGN morphology, leukocyte infiltration, crecents, fibrinoid necrosis, and interstitial inflammation) and chronicity score (glomerulosclerosis, interstitial fibrosis, tubulary atrophy, and arteriosclerosis). Only tubular atrophy and interstitial fibrosis were identified as predictors in a model with histological variables. When the Total Activity Score and Total Chronicity Score were added to the model, only the latter (Total Chronicity Score) was identified as an independent predictor of kidney failure.
Del Sordo R, Covarelli C, Brugnano R, Sciri R, Bellezza G, Mandarano M, Sidoni A. PLA2R Immunohistochemistry Staining in Membranous Glomerulopathy: A Challenging Stain to Interpret But a Potentially Useful Diagnostic Tool. Appl Immunohistochem Mol Morphol. 2021 Epub ahead of print. [PubMed link]
Detection of PLA2R antigen in renal tissue, with immunohistochemistry (PLA2R IHC), strongly correlates with serum PLA2R-Ab, although in literature has no univocal interpretation.
Akilesh S, Nast CC, Yamashita M, Henriksen K, Charu V, Troxell ML, Kambham N, Bracamonte E, Houghton D, Ahmed NI, Chong CC, Thajudeen B, Rehman S, Khoury F, Zuckerman JE, Gitomer J, Raguram PC, Mujeeb S, Schwarze U, Shannon MB, De Castro I, Alpers CE, Najafian B, Nicosia RF, Andeen NK, Smith KD. Multicenter Clinicopathologic Correlation of Kidney Biopsies Performed in COVID-19 Patients Presenting With Acute Kidney Injury or Proteinuria. Am J Kidney Dis. 2021 Jan;77(1):82-93.e1. [PubMed link]
A case series of 17 patients with SARS-CoV-2 infection confirmed by reverse transcriptase-polymerase chain reaction, only 3 presented with severe COVID-19 symptoms. Acute kidney injury (n=15) and proteinuria (n=11) were the most common indications for biopsy and these symptoms developed concurrently or within 1 week of COVID-19 symptoms in all patients. Acute tubular injury (n=14), collapsing glomerulopathy (n=7), and endothelial injury/thrombotic microangiopathy (n=6) were the most common histologic findings. 2 of 3 transplant recipients developed active antibody-mediated rejection weeks after COVID-19.
Angelotti ML, Antonelli G, Conte C, Romagnani P. Imaging the kidney: from light to super-resolution microscopy. Nephrol Dial Transplant. 2021 Jan 1;36(1):19-28. [PubMed link]
This review provides an overview of available kidney imaging strategies, with a focus on the possible impact of the most recent technical improvements.
Kudose S, Santoriello D, Debiec H, Canetta PA, Bomback AS, Stokes MB, Batal I, Ronco P, D'Agati VD, Markowitz GS. The clinicopathologic spectrum of segmental membranous glomerulopathy. Kidney Int. 2021 Jan;99(1):247-255. [PubMed link]
Segmental membranous glomerulopathy (MGN) is a glomerulonephritis with only segmental immune deposits. It is a rare PLA2R-negative variant of MGN with favorable prognosis, even in the absence of immunosuppressive treatment.
Loupy A, Haas M, Roufosse C, et al. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell- and antibody-mediated rejection. Am J Transplant. 2020;20(9):2318-2331. [PubMed link]