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  1. Article ; Online: Lupus nephritis - An update on disparities affecting african americans.

    Portalatin, Gilda M / Gebreselassie, Surafel K / Bobart, Shane A

    Journal of the National Medical Association

    2022  Volume 114, Issue 3S2, Page(s) S34–S42

    Abstract: Lupus Nephritis is a complex clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. It disproportionately affects minorities, especially African Americans (AA) with higher rates of progression to ...

    Abstract Lupus Nephritis is a complex clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. It disproportionately affects minorities, especially African Americans (AA) with higher rates of progression to end stage kidney disease. Several factors are implicated including genetic predisposition to both SLE and chronic kidney disease, social determinants of health such as income inequality, education disparities, social isolation/lack of support, health care access and affordability. Clinically, AA may have higher auto-antibody titers, including several antibodies occurring simultaneously. AA are more prone to severe disease such as Class III and IV lupus nephritis. Fortunately, clinical trials have shown a favorable benefit/response among African Americans to mycophenolate mofetil. However, newer and alternative agents such as Rituximab, Belimumab and Voclosporin are widely unaffordable, and AA remain underrepresented in these clinical trials. The current state of disparities affecting LN patients of AA ancestry is a call for better access to healthcare and social support systems, greater inclusion/representation in clinical trials, and making new and alternative regimens more affordable and cost effective.
    MeSH term(s) African Americans/genetics ; Genetic Predisposition to Disease ; Humans ; Kidney Failure, Chronic ; Lupus Erythematosus, Systemic ; Lupus Nephritis/complications ; Lupus Nephritis/drug therapy ; Lupus Nephritis/genetics
    Language English
    Publishing date 2022-05-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 419737-9
    ISSN 1943-4693 ; 0027-9684
    ISSN (online) 1943-4693
    ISSN 0027-9684
    DOI 10.1016/j.jnma.2022.05.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Kidney Biopsy Is Required for Nephrotic Syndrome with PLA2R+ and Normal Kidney Function: The Con View.

    Bobart, Shane A / Fervenza, Fernando C

    Kidney360

    2020  Volume 1, Issue 9, Page(s) 890–893

    MeSH term(s) Biopsy ; Glomerulonephritis, Membranous/pathology ; Humans ; Kidney/pathology ; Nephrotic Syndrome/diagnosis
    Language English
    Publishing date 2020-07-13
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0003262020
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  3. Article: Recurrent Glomerulonephritis in the Kidney Allograft.

    Bobart, Shane A / Alexander, Mariam P / Bentall, Andrew

    Indian journal of nephrology

    2020  Volume 30, Issue 6, Page(s) 359–369

    Abstract: Renal transplantation is the preferred form of renal replacement therapy in patients who develop end-stage kidney disease (ESKD). Among the diverse etiologies of ESKD, glomerulonephritis is the third most common cause, behind hypertensive and diabetic ... ...

    Abstract Renal transplantation is the preferred form of renal replacement therapy in patients who develop end-stage kidney disease (ESKD). Among the diverse etiologies of ESKD, glomerulonephritis is the third most common cause, behind hypertensive and diabetic kidney disease. Although efforts to prolong graft survival have improved over time with the advent of novel immunosuppression, recurrent glomerulonephritis remains a major threat to renal allograft survival despite concomitant immunosuppression. As a result, clinical expertise, early diagnosis and intervention will help identify recurrent disease and facilitate prompt treatment, thus minimizing graft loss, resulting in improved outcomes. In this review, we highlight the clinicopathologcal characteristics of certain glomerular diseases that recur in the renal allograft.
    Language English
    Publishing date 2020-11-30
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2134388-3
    ISSN 1998-3662 ; 0971-4065
    ISSN (online) 1998-3662
    ISSN 0971-4065
    DOI 10.4103/ijn.IJN_193_19
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  4. Article ; Online: The Clinical and Pathological Characteristics of Patients with Oxalate Nephropathy.

    Llanos, Maria / Kwon, Alvin / Herlitz, Leal / Shafi, Tariq / Cohen, Scott / Gebreselassie, Surafel K / Sawaf, Hanny / Bobart, Shane A

    Kidney360

    2023  Volume 5, Issue 1, Page(s) 65–72

    MeSH term(s) Humans ; Hyperoxaluria/complications ; Hyperoxaluria/pathology ; Renal Insufficiency ; Oxalates
    Chemical Substances Oxalates
    Language English
    Publishing date 2023-12-14
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0000000000000340
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  5. Article ; Online: C3 Glomerulonephritis: A Rare Etiology of the Pulmonary Renal Syndrome.

    Bobart, Shane A / Sethi, Sanjeev / Fervenza, Fernando C

    Kidney medicine

    2019  Volume 1, Issue 1, Page(s) 36–39

    Abstract: C3 Glomerulopathy is a rare form of kidney disease due to dysregulation of the alternative complement pathway. We report a case of a college-aged woman with C3 glomerulonephritis (C3GN), presenting with the unexpected extrarenal manifestation of ... ...

    Abstract C3 Glomerulopathy is a rare form of kidney disease due to dysregulation of the alternative complement pathway. We report a case of a college-aged woman with C3 glomerulonephritis (C3GN), presenting with the unexpected extrarenal manifestation of pulmonary hemorrhage. The patient presented with a nephritic urinary sediment and acute kidney injury after a recent infection. Kidney biopsy demonstrated focal endocapillary proliferative, crescentic, and necrotizing glomerulonephritis with bright glomerular C3 staining only. Electron microscopy revealed mesangial, intramembranous, and subendothelial deposits. After 2 doses of intravenous methylprednisolone, the patient developed spontaneous hemoptysis and respiratory compromise requiring emergent intubation. Bronchoscopy and computed tomography findings were consistent with diffuse alveolar hemorrhage. Notable laboratory results included C3, 40 (reference range, 75-175) mg/dL, and negative antinuclear antibody, antineutrophil cytoplasmic antibody, and anti-glomerular basement membrane serology results. As an outpatient, genetic testing revealed the presence of C3 glomerulopathy risk alleles. A diagnosis of C3GN complicated by pulmonary hemorrhage was made. There was initial response to treatment with steroids and mycophenolate mofetil; however, after repeated relapses of proteinuria and hematuria, treatment with eculizumab showed an initial response, but the patient subsequently became hemodialysis dependent. Our case highlights that C3GN can present with crescents and have other extrarenal manifestations such as pulmonary hemorrhage and should also be considered part of the differential diagnosis in patients presenting with pulmonary renal syndrome.
    Language English
    Publishing date 2019-01-14
    Publishing country United States
    Document type Case Reports
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2018.12.002
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  6. Article: Ketogenic-Diet Shake Containing

    Portalatin, Gilda / Shettigar, Shruti / Carrion-Rodriguez, Astrid / Medikayala, Sushma / Herlitz, Leal / Sandy, Dianne / Gebreselassie, Surafel K / Bobart, Shane A

    Case reports in nephrology and dialysis

    2022  Volume 12, Issue 3, Page(s) 219–225

    Abstract: ... Uncaria ... ...

    Abstract Uncaria tomentosa
    Language English
    Publishing date 2022-10-27
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2809879-1
    ISSN 2296-9705
    ISSN 2296-9705
    DOI 10.1159/000526391
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  7. Article ; Online: Immune Check Point Inhibitor-Associated Endothelialitis.

    Bobart, Shane A / Owoyemi, Itunu / Grande, Joseph / Leung, Nelson / Herrmann, Sandra M

    Kidney international reports

    2020  Volume 5, Issue 8, Page(s) 1371–1374

    Language English
    Publishing date 2020-06-03
    Publishing country United States
    Document type Case Reports
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2020.05.027
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  8. Article ; Online: Proptosis and vision loss as grave complications of allergic fungal sinusitis and polyposis.

    Bobart, Shane A / Dimov, Ves / Sider, Darby / Gallego, Esteban

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2017  Volume 118, Issue 6, Page(s) 728–729

    Language English
    Publishing date 2017-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2017.03.008
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  9. Article ; Online: Maintenance of Remission and Risk of Relapse in Myeloperoxidase-Positive ANCA-Associated Vasculitis with Kidney Involvement.

    Casal Moura, Marta / Specks, Ulrich / Tehranian, Shahrzad / Sethi, Sanjeev / Zubidat, Dalia / Nardelli, Luca / Dos Santos, Fernanda G / Sousa, Ciria / León-Róman, Juan / Bobart, Shane A / Greene, Eddie / Zand, Ladan / Fervenza, Fernando C

    Clinical journal of the American Society of Nephrology : CJASN

    2022  Volume 18, Issue 1, Page(s) 47–59

    Abstract: Background: The optimal strategy for remission-maintenance therapy in patients with myeloperoxidase-ANCA (MPO-ANCA)-associated vasculitis is not established. Defining parameters to guide maintenance therapy is required.: Methods: This was a ... ...

    Abstract Background: The optimal strategy for remission-maintenance therapy in patients with myeloperoxidase-ANCA (MPO-ANCA)-associated vasculitis is not established. Defining parameters to guide maintenance therapy is required.
    Methods: This was a retrospective cohort study of all patients with MPO-ANCA-associated vasculitis (microscopic with polyangiitis and granulomatosis with polyangiitis) and GN followed at the Mayo Clinic between 1996 and 2015. Relapse rate, MPO-ANCA status, and remission-maintenance therapies were reviewed. Logistic regression models, Kaplan-Meier method, and Cox proportional hazards regression models were applied.
    Results: We analyzed 159 patients with active MPO-ANCA-associated vasculitis with GN. Sixty-six (42%) patients had at least one relapse, and 52 (33%) relapsed before 60 months. Patients with MPO-ANCA who became persistently negative did not relapse (hazard ratio [HR], 0.03; 95% confidence interval [95% CI], 0.002 to 0.431; P =0.01). The reappearance of MPO-ANCA was associated with a higher risk of relapse (HR, 1.91; 95% CI, 1.109 to 3.293; P =0.02). Immunosuppression was withdrawn in 80 (50%) patients, and this was less likely in those who received cyclophosphamide for remission induction or in patients with persistently positive MPO-ANCA (odds ratio [OR], 0.44; 95% CI, 0.228 to 0.861; P =0.02 and OR, 0.42; 95% CI, 0.213 to 0.820; P =0.01, respectively). Relapse frequency was not different between patients with persistently positive MPO-ANCA and patients with MPO-ANCA reappearance (44% versus 39%, P =0.49), irrespective of remission-maintenance treatment. Ear, nose, and throat involvement (OR, 6.10; 95% CI, 1.280 to 29.010; P =0.02) and MPO-ANCA reappearance (OR, 9.25; 95% CI, 3.126 to 27.361; P <0.001) were independently associated with relapse after treatment withdrawal.
    Conclusions: Patients persistently MPO-ANCA negative are at low risk for relapse even without remission-maintenance therapy. Persistence or subsequent reappearance of MPO-ANCA is associated with a higher risk of relapse.
    Podcast: This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast.aspx?p=CJASN&e=2023_01_10_CJN06460622.mp3.
    MeSH term(s) Humans ; Granulomatosis with Polyangiitis/drug therapy ; Granulomatosis with Polyangiitis/complications ; Antibodies, Antineutrophil Cytoplasmic ; Retrospective Studies ; Peroxidase ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Chronic Disease ; Kidney ; Recurrence
    Chemical Substances Antibodies, Antineutrophil Cytoplasmic ; Peroxidase (EC 1.11.1.7)
    Language English
    Publishing date 2022-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.06460622
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: New-onset atrial fibrillation in patients with acute kidney injury on continuous renal replacement therapy.

    Shawwa, Khaled / Kompotiatis, Panagiotis / Bobart, Shane A / Mara, Kristin C / Wiley, Brandon M / Jentzer, Jacob C / Kashani, Kianoush B

    Journal of critical care

    2020  Volume 62, Page(s) 157–163

    Abstract: Purpose: The mortality of critically ill patients with acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT) remains high. We assessed the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population ... ...

    Abstract Purpose: The mortality of critically ill patients with acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT) remains high. We assessed the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population and its impact on outcomes.
    Materials and methods: This is a retrospective cohort study of adult intensive care units (ICU) patients who had AKI and received CRRT from December 2006 through November 2015 in a tertiary academic medical center. Cox proportional hazard model was used to evaluate the impact of NOAF on overall mortality.
    Results: Out of 1398 screened patients, NOAF occurred in 193 (14%) cases. NOAF occurring on CRRT was independently associated with an increased hazard of death at follow-up (HR: 1.26; 95% CI: 1.03-1.56), compared to the group who did not have NOAF. In the multivariable analysis using time-dependent covariates, higher potassium (HR 1.24, 95%CI: 1.01-1.54) and bicarbonate (HR 0.95, 95%CI: 0.92-0.98) levels were associated with increased and decreased risk of NOAF on CRRT, respectively.
    Conclusions: NOAF in critically ill patients with AKI receiving CRRT is common and carries an unfavorable prognosis. Prospective studies are required to elucidate modifiable risk factors for NOAF occurring on CRRT.
    MeSH term(s) Acute Kidney Injury/epidemiology ; Acute Kidney Injury/therapy ; Adult ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/therapy ; Continuous Renal Replacement Therapy ; Critical Illness ; Humans ; Intensive Care Units ; Renal Replacement Therapy ; Retrospective Studies
    Language English
    Publishing date 2020-12-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2020.12.010
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