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]
Un comemntario editorial sobre el artículo anterior.
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.
Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-1412. [PubMed link]
These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity.
Chen T, Li X, Li Y, Xia E, Qin Y, Liang S, Xu F, Liang D, Zeng C, Liu Z. Prediction and Risk Stratification of Kidney Outcomes in IgA Nephropathy. Am J Kidney Dis. 2019 Sep;74(3):300-309. [PubMed link]
The authors use a supervised machine learning approach with a larger number of variables to predict outcomes; 36 characteristics, including demographic, clinical, and pathologic variables were analyzed. Three variables were the more important: urine protein excretion, global sclerosis, and tubular atrophy/interstitial fibrosis.
Nasr SH, Fogo AB. New developments in the diagnosis of fibrillary glomerulonephritis. Kidney Int. 2019 Sep;96(3):581-592. [PubMed link]
Recently, DnaJ homolog subfamily B member 9, has been identified. Immunohistochemical studies confirmed the high sensitivity and specificity of DnaJ homolog subfamily B member 9 for this disease. The identification of this tissue biomarker has already entered clinical practice and undoubtingly will improve the diagnosis of this rare disease, particularly in developing countries where electron microscopy is less available. Future research is needed to determine whether DnaJ homolog subfamily B member 9 is an autoantigen or just an associated protein in fibrillary glomerulonephritis, whether it can serve as a noninvasive biomarker, and whether therapies that target this protein are effective in improving prognosis. A review.
Hanna RM, Barsoum M, Arman F, Selamet U, Hasnain H, Kurtz I. Nephrotoxicity induced by intravitreal vascular endothelial growth factor inhibitors: emerging evidence. Kidney Int. 2019 Sep;96(3):572-580. [PubMed link]
Recent data indicate that VEGF inhibitors are associated with accelerated hypertension, worsening proteinuria, glomerular disease, thrombotic microangiopathy, and possible chronic renal function decline. A review.
Araújo SA, Neves PDMM, Wanderley DC, Reis MAD, Dias CB, Malheiros DMAC, Onuchic LF. The immunohistological profile of membranous nephropathy associated with chronic Schistosoma mansoni infection reveals a glomerulopathy with primary features. Kidney Int. 2019 Sep;96(3):793-794. [PubMed link]
A series of 12 patients.
Trimarchi H, Coppo R. Podocytopathy in the mesangial proliferative immunoglobulin A nephropathy: new insights into the mechanisms of damage and progression. Nephrol Dial Transplant. 2019 Aug;34(8):1280-1285. [PubMed link]
In IgAN, the podocytopathic changes are the consequence of initial alterations in the mesangial area with accumulation of IgA containing immune material. Podocytes are therefore affected by interactions of messages originally driven from the mesangium. After continuous insult, podocytes detach from the glomerular basement membrane. This podocytopathy favours not only the development of glomerular focal and segmental sclerosis, but also the progressive renal function loss. A review.
Denic A, Ricaurte L, Lopez CL, Narasimhan R, Lerman LO, Lieske JC, Thompson RH, Kremers WK, Rule AD. Glomerular Volume and Glomerulosclerosis at Different Depths within the Human Kidney. J Am Soc Nephrol. 2019 Aug;30(8):1471-1480. [PubMed link]
Glomerular volume and glomerulosclerosis differed by depth across three cortical regions (superficial, middle, and deep). Although most clinical associations with glomerulosclerosis and glomerulomegaly did not differ by cortical depth, there were important exceptions. Age-related glomerulosclerosis appeared to be an ischemic process and was more evident in the superficial (subcapsular) region. Diabetes-related glomerulosclerosis was more evident in the deep (juxtamedullary) region. Obesity more strongly associated with larger glomeruli in the superficial region.
Bijol V, Farag YMK, Harris DCH, Levin A, Roy-Chaudhury P, Singh AK, Jhaveri KD. Renal pathology practice globally: identifying needs and meeting the challenge. Kidney Int. 2019 Aug;96(2):258-261. [PubMed link]
The lack of trained nephropathologists and inability to process samples with special stains and IF/immunohistochemistry are a very common problem for the most of Africa, Asia, and Latin America, leading to underutilization of kidney biopsy procedures. An interesting analysis.
Noris M, Donadelli R, Remuzzi G. Autoimmune abnormalities of the alternative complement pathway in membranoproliferative glomerulonephritis and C3 glomerulopathy. Pediatr Nephrol. 2019 Aug;34(8):1311-1323 [PubMed link]
The complement-activating autoantibodies called C3-nephritic factors (C3NeFs), which are present in 40-80% of patients, form a heterogeneous group of autoantibodies that stabilise the C3 convertase or the C5 convertase of the alternative pathway or both. A review.
Hirano D, Ishikawa T, Inaba A, Sato M, Shinozaki T, Iijima K, Ito S. Epidemiology and clinical features of childhood-onset anti-neutrophil cytoplasmic antibody-associated vasculitis: a clinicopathological analysis. Pediatr Nephrol. 2019 Aug;34(8):1425-1433. [PubMed link]
The diagnoses were as follows: microscopic polyangiitis (n = 38, 78%), granulomatosis with polyangiitis (n = 9, 18%), eosinophilic granulomatosis with polyangiitis (n = 1, 2%), and other (n = 1, 2%). After a median follow-up of 43 months, seven (14%) patients (all with microscopic polyangiitis) progressed to end-stage renal disease.
Yamanouchi M, Hoshino J, Ubara Y, Takaichi K, Kinowaki K, Fujii T, Ohashi K, Mise K, Toyama T, Hara A, Shimizu M, Furuichi K, Wada T. Clinicopathological predictors for progression of chronic kidney disease in nephrosclerosis: a biopsy-based cohort study. Nephrol Dial Transplant. 2019 Jul 1;34(7):1182-1188. [PubMed link]
Despite attracting more attention recently, nephrosclerosis remains poorly understood, especially with regard to its pathological features and their association with progression of chronic kidney disease. Nephrosclerosis is defined pathologically by an increase of segmental or global sclerosis, interstitial fibrosis, tubular atrophy and arteriosclerosis, although it has also been diagnosed clinically on the basis of albuminuria and renal impairment in older persons and patients with chronic lifestyle-related diseases.
Wong ECL, Di Lena R, Breau RH, Pouliot F, Finelli A, Lavallée LT, So A, Tanguay S, Fairey A, Rendon R, Richard PO, Lattouf JB, Kawakami J, Mallick R, Kapoor A. Morphologic subtyping as a prognostic predictor for survival in papillary renal cell carcinoma: Type 1 vs. type 2. Urol Oncol. 2019 Jun 5. pii: S1078-1439(19)30195-4. [PubMed link]
A study with 509 patients with clinically localized papillary RCC type 2 (n = 172) or type 1 (n = 337) histology. Patients with clinically localized type 2 papillary RCC present with higher risk disease and have worse prognosis.