Dialysis Outcomes for Children With Lupus Nephritis Compared to Children With Other Forms of Nephritis: A Retrospective Cohort Study

Wasik, Heather L.; Chadha, Vimal; Galbiati, Shirley; Warady, Bradley A.; Atkinson, Meredith A.

doi:10.1053/j.ajkd.2021.07.013

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…Importantly, it remains consistent that renal survival is significantly worse in African American patients compared with Caucasians, independent of age, duration of lupus, history of hypertension (HTN), HTN control during therapy, and activity or chronicity indices on renal biopsy [15 ▪ ]. This is consistent with literature that demonstrates racial disparities in survival on dialysis and following kidney transplantation [9,13 ▪▪ ,20].…”

Section: Lupus Nephritissupporting

confidence: 81%

“…So long as this can be achieved, preemptive transplantation is preferred because of evidence that increased wait time on dialysis is associated with a higher rate of graft loss following transplantation [9]. Unfortunately, children with lupus nephritis remain less likely to receive a transplant within 1 year of starting dialysis compared with patients with IgAN, dysplasia or hypoplasia, so early referral for evaluation is important [2,13 ▪▪ ].…”

Section: Lupus Nephritismentioning

confidence: 99%

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Kidney transplantation in pediatric patients with rheumatologic disorders

Cody

Hooper

2021

Current Opinion in Pediatrics

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Purpose of reviewProviders caring for children with end-stage kidney disease from rheumatologic conditions face questions such as when to proceed with kidney transplantation, how common is disease recurrence posttransplant, how does recurrent disease impact patient and allograft outcomes, and what approaches are available to prevent and treat recurrent disease. We discuss recent developments and relevant literature that address these questions for the most common rheumatologic disorders that lead to end-stage kidney disease in childhood namely, systemic lupus erythematosus, IgA nephropathy, IgA Vasculitis/Henoch Schoenlein Purpura, and Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis.Recent findingsRecent data suggest that children with IgA nephropathy, IgA vasculitis, and ANCA-associated vasculitis have similar patient and allograft survival to other conditions despite the risk of recurrent disease, yet those with lupus have worse posttransplant patient and allograft outcomes. A period of disease quiescence may be prudent prior to transplantation to decrease the risk of recurrence, which is associated with decreased allograft survival. Data on preventive strategies and treatment options are limited.SummaryIt is recommended that patients with systemic rheumatologic conditions not be excluded from kidney transplantation but that patients be counseled on the risk of potential recurrent disease with its impact on transplant outcomes.

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Section: Lupus Nephritissupporting

confidence: 81%

Section: Lupus Nephritismentioning

confidence: 99%

Kidney transplantation in pediatric patients with rheumatologic disorders

Cody

Hooper

2021

Current Opinion in Pediatrics

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“…The rate of post-transplant recurrence varies broadly from 0 to 30% [211]. Children with LN on maintenance dialysis mainly die after cardiovascular events or infections [212].…”

Section: Follow-up and Prognosismentioning

confidence: 99%

Lupus Nephritis in Children: Novel Perspectives

Pennesi,

Benvenuto

2023

Medicina

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Childhood-onset systemic lupus erythematosus is an inflammatory and autoimmune condition characterized by heterogeneous multisystem involvement and a chronic course with unpredictable flares. Kidney involvement, commonly called lupus nephritis, mainly presents with immune complex-mediated glomerulonephritis and is more frequent and severe in adults. Despite a considerable improvement in long-term renal prognosis, children and adolescents with lupus nephritis still experience significant morbidity and mortality. Moreover, current literature often lacks pediatric-specific data, leading clinicians to rely exclusively on adult therapeutic approaches. This review aims to describe pediatric lupus nephritis and provide an overview of the novel perspectives on the pathogenetic mechanisms, histopathological classification, therapeutic approach, novel biomarkers, and follow-up targets in children and adolescents with lupus nephritis.

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“…It is worth noting that structural and functional anomalies in the GBM may contribute to the pathogenesis of both IgAN and IgAVN, although the precise mechanisms are still undefined [ 20 , 22 ]. Furthermore, alongside these aforementioned conditions, systemic lupus erythematosus (SLE), an autoimmune disease, often causes immune-related inflammation and damage to the GBM, particularly affecting the kidneys through LN [ 23 , 24 ]. However, the significance of molecular changes in the GBM and the underlying processes contributing to the progressive decline in renal function in pediatric glomerular diseases are still not well understood.…”

Section: Introductionmentioning

confidence: 99%

Characterization of glomerular basement membrane components within pediatric glomerular diseases

Chen,

Zhou,

Gan

et al. 2024

Clinical Kidney Journal

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Background Disruptions in gene expression associated with the glomerular basement membrane (GBM) could precipitate glomerular dysfunction. Nevertheless, a comprehensive understanding of the characterization of GBM components within pediatric glomerular diseases and their potential association with glomerular function necessitates further systematic investigation. Methods We conducted a systematic analysis focusing on the pathological transformations and molecular attributes of key constituents within the GBM, specifically Collagen IV α3α4α5, Laminin α5β2γ1, and Integrin α3β1, across prevalent pediatric glomerular diseases. Results We observed upregulation of linear expression levels of COL4A3/4/5 and Laminin 5α proteins, along with a partial reduction in the linear structural expression of Podocin in idiopathic nephrotic syndrome (INS), encompassing minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), but showing a reduction in IgA nephropathy (IgAN), IgA vasculitis nephritis (IgAVN) and lupus nephritis (LN). Furthermore, our study revealed reductions in Laminin β2γ1 and Integrin α3β1 in both primary and secondary childhood glomerular diseases. Conclusion In INS, notably MCD and FSGS, there is a notable increase in the linear expression levels of COL4A3/4/5 and Laminin 5α proteins. In contrast, in IgAN, IgAVN, and LN, there is a consistent reduction in the expression of these markers. Furthermore, the persistent reduction of Laminin β2γ1 and Integrin α3β1 in both primary and secondary childhood glomerular diseases suggests a shared characteristic of structural alterations within the GBM across these conditions.

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Dialysis Outcomes for Children With Lupus Nephritis Compared to Children With Other Forms of Nephritis: A Retrospective Cohort Study

Cited by 11 publications

References 31 publications

Kidney transplantation in pediatric patients with rheumatologic disorders

Kidney transplantation in pediatric patients with rheumatologic disorders

Lupus Nephritis in Children: Novel Perspectives

Characterization of glomerular basement membrane components within pediatric glomerular diseases

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