A study of membranoproliferative glomerulonephritis in Iran.

Background: The aim of this study was to review the morphologic patterns of membranoproliferative glomerulonephritis (MPGN) in 100 Iranian patients using light microscopy (LM) and electron microscopy (EM), and to compare the treatment and outcome in 13 patients with two biopsies.

Patients And Methods: A retrospective study of 713 kidney biopsies of Iranian patients received between 1981 to 1994 was carried out. Of the 713 kidney biopsies, MPGN (n=106) and membranous glomerulopathy (n=112) made up the highest numbers of cases.

NSAIDs associated nephropathy.

Renal biopsy of 32 patients who developed renal complications after treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) were studied. The treatment with NSAIDs in these cases was used for many reasons such as: headaches, toothaches, dysmenorrea, osteochondrosis, polyarthritis and acute respiratory infections. The renal function of these patients, before the treatment with NSAIDs was normal.

Effect of protein diets on the renal function of baboons (Papio hamadryas) with remnant kidneys: a 5-year follow-up.

To assess the progression of renal disease and the effects of protein intake in a species phylogenically close to humans, 14 adolescent baboons (Papio hamadryas) were subjected to infarction of one third of the left kidney and, 2 months later, to right nephrectomy. They were then randomized to a synthetic protein diet containing either 8% or 25% casein. Hemodynamic and metabolic measurements were obtained in awake animals every 4 months.

Cyclosporin A nephropathy: standardization of the evaluation of kidney biopsies.

An advisory board of nephropathologists with personal experience in the evaluation of biopsies from patients treated with cyclosporin A (CyA) was set up to address the following problems: 1. Definition of CyA nephropathy as seen in patients with autoimmune diseases; 2. Evaluation of the reliability and reproducibility of the diagnostic criteria for the different morphological lesions seen in CyA nephropathy; 3.

Effect of chronic growth hormone administration on diabetic nephropathy in the rat.

Indirect data exist which implicate elevated growth hormone (GH) as a factor in the development of diabetic nephropathy. The administration of somatostatin (SRIH) has been shown to reverse many of the changes found in early diabetic nephropathy; however, it is unknown whether SRIH causes these effects by the suppression of GH or by other unspecified factors. To study directly the possible effect of excess GH in the development of diabetic nephropathy, either ovine growth hormone (0.

High sucrose diets increase blood pressure of both salt-sensitive and salt-resistant rats.

We examined the effects of a diet relatively high in sugar and low in protein content on systolic blood pressure (SBP) in rats with known pressure responses to salt (NaCl) in order to compare "sugar/protein sensitivity" to "salt sensitivity." Dahl salt-sensitive (DSS) and salt-resistant (DSR) rats were fed one of two low salt diets containing either high sugar (sucrose 51.5% w/w)/low protein (14.

NIH conference. Membranous nephropathy.

Membranous nephropathy is a worldwide problem that accounts for about 20% of the cases of the adult-onset nephrotic syndrome. This disease places many patients at risk for both end-stage renal failure and the complications of hyperlipidemia. Immune-mediated injury to the glomerular capillary wall in patients with membranous nephropathy is characterized by subepithelial immune complex formation and generation of the membrane attack complex of complement.

Nonamyloidotic fibrillary glomerulopathy, immunotactoid glomerulopathy, and the differential diagnosis of filamentous glomerulopathies.

Kidney biopsies from 12 patients between the ages of 10 and 63 yr were diagnosed as nonamyloidotic fibrillary glomerulopathy (NAFG) or immunotactoid glomerulopathy (IG) on the basis of the electron microscopic finding of filamentous or tubular material within the glomerular capillaries and mesangium. Six patients were male and six were female. Eleven presented with nephrotic syndrome and one with acute renal failure.

Renal function of baboons (Papio hamadryas) with a remnant kidney, and impact of different protein diets.

To assess progression of renal disease and the effects of protein intake in a species phylogenically close to man, 10 young adult baboons (Papio hamadryas) were subjected to 20 to 30% infarction of the left kidney and, two months later, to right nephrectomy. They were then randomized to a synthetic diet containing either 8% or 25% protein. Hemodynamic and metabolic measurements were obtained in awake animals every four months.

Morphologic differences between polyarteritis and Wegener's granulomatosis using light, electron and immunohistochemical techniques.

The differential diagnosis of renal biopsies of patients with polyarteritis nodosa (PAN) versus those with Wegener's granulomatosis (WG) is difficult because in both the morphologic expression is a focal proliferating and necrotizing glomerulonephritis (GN) with crescents. Twenty-nine biopsies of PAN and 29 of WG were studied by light, electron microscopy and immunohistochemistry. Whereas in PAN the dominent feature is severe focal fibrinoid necrosis of glomerular tufts, WG is characterized by destructive extracapillary GN with capsular breaks and periglomerulitis leading to complete glomerular destruction and replacement by a localized inflammatory exudate in the form of a granuloma.

Renal medullary amyloidosis in Dorcas gazelles.

Between January 1976 and September 1987 renal medullary amyloidosis (RMA) was diagnosed in 17 Dorcas gazelles; the necropsy prevalence rate was 17/32 (53%). The most severe amyloid deposits were in the renal medulla; glomeruli were spared. Renal cortical lesions of interstitial fibrosis and tubular atrophy and dilatation significantly correlated with RMA (P less than 0.

Evolution of ciclosporin nephrotoxicity in patients treated for autoimmune uveitis.

Among 73 patients treated with ciclosporin (CS) for autoimmune uveitis, a 50% elevation of serum creatinine was observed in 37% within 3 months of starting CS and in 25% after more than 6 months of relatively uncomplicated therapy. Sequential renal function and histologic evaluations were performed in 17 patients to further characterize the nephrotoxic effects of long-term CS therapy. Inulin clearance remained essentially unchanged in 12 patients despite CS dosage reductions in the majority.

Monoclonal antibodies to heparan sulfate proteoglycan: development and application to the study of normal tissue and pathologic human kidney biopsies.

Monoclonal antibodies (mAbs) (4F2 and 7E12) were prepared against heparan sulfate proteoglycan (HSPG) isolated from bovine glomeruli. Enzyme linked immunosorbent assays (ELISA) and immunoblotting demonstrated that the mABs reacted with HSPG. Indirect immunofluorescence (IF) showed that the mAbs stained renal basement membranes (BMs) and BMs in other organs of normal bovine and human tissues in patterns typical of HSPG.

Nephrotic syndrome associated with chronic persistent hepatitis B in an HIV antibody positive patient.

Several renal diseases have been reported to complicate both hepatitis B and human immunodeficiency virus infection. Establishing the exact renal diagnosis in patients with multiple viral infections requires renal biopsy. Exposure to human immunodeficiency virus may not determine renal histopathology.

NIH conference. Lupus nephritis.

Nephritis has long been considered one of the most ominous components of systemic lupus erythematosus. Accumulations of immune complexes and lymphoid cells in several locations within the kidney are the best-described elements of lupus nephritis. The extreme diversity of the renal changes indicates that many variables are likely to be involved.

Renal histopathologic alterations in patients treated with cyclosporine for uveitis.

To evaluate abnormalities of renal morphology associated with long-term cyclosporine therapy, we obtained percutaneous renal biopsy specimens from 17 patients who had been treated for autoimmune uveitis with cyclosporine for an average of two years. For comparison, we also analyzed renal biopsy specimens from patients with idiopathic hematuria who had not received cyclosporine. The atrophic and sclerosing glomerular and tubulointerstitial lesions in the specimens were assessed to derive a chronicity index.

Therapy of anti-glomerular basement membrane antibody disease: analysis of prognostic significance of clinical, pathologic and treatment factors.

We have compared the effect of therapy with immunosuppression alone to immunosuppression plus plasma exchange on the clinical course and rate of disappearance of antibody in 17 patients with anti-glomerular basement membrane (anti-GBM) antibody-induced renal disease. Patients receiving immunosuppression (n = 9) and those receiving plasma exchange (n = 8) were similar in terms of entry clinical characteristics, pulmonary manifestations and complications associated with therapy. Rate of disappearance of anti-GBM antibody as estimated from serial estimates of antibody binding was significantly more rapid in patients receiving plasma exchange, and mean serum creatinine in these patients at end of therapy was half that of the patients receiving immunosuppression alone.

Evolution of membranous nephropathy from a proliferative and exudative glomerulonephritis--a report of three cases studied by serial biopsies.

Three adolescents with clinical nephrotic-nephritic picture were noted to have diffuse proliferative and exudative glomerulonephritis. Although focal membranous changes were noted in two of the initial biopsies, evolution into classical membranous glomerulopathy was seen in subsequent biopsies. This study suggests a relationship between these two different patterns of immune complex-associated glomerular injury, and confirms extrapolations made from experimental models of chronic serum sickness.

Lupus nephritis and other autoimmune features in patients with diabetes mellitus due to autoantibody to insulin receptors.

The frequency of various autoimmune features in 14 patients with insulin-resistant diabetes mellitus (type B) was reviewed. Twelve patients had leukopenia, high titers of antinuclear antibodies (speckled pattern), and hypoalbuminemia; 11 had elevated serum levels of IgG and high erythrocyte sedimentation rates; 7 had proteinuria and high serum levels of antibodies to DNA; and 5 had alopecia and elevated serum levels of IgA. Lupus erythematosus preparations were negative in all patients.

Some unusual features of mesangioproliferative glomerulonephritis in horses.

Seven horses ranging from three to 15 years of age had nephrotic syndrome; at necropsy, renal tissue of all seven horses had the morphologic lesions of mesangioproliferative glomerulonephritis (membranoproliferative glomerulonephritis). Homogeneous eosinophilic material which filled the glomerular capillary lumina was found in five horses. Ultrastructurally, this material primarily consisted of electron-dense deposits with a fibrillar pattern in five horses and in one horse, rhomboid crystalline deposits which resembled deposits seen in human cryoglobulinemia.

Effect of treatment on the evolution of renal abnormalities in lupus nephritis.

We retrospectively studied the evolution of histopathologic features in successive renal biopsies in patients with lupus nephritis, to evaluate the effects of various treatment regimens. Repeat renal biopsies had been performed in 62 patients after more than 18 months of observation (median interval, 44 months) in randomized therapeutic trials comparing prednisone with cytotoxic drugs. Renal histopathologic features were graded individually, and a composite score reflecting the number and severity of irreversible lesions was defined as a chronicity index.