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  1. Article ; Online: Chronic kidney disease with unknown cause across the global spectrum.

    Nast, Cynthia C

    Current opinion in nephrology and hypertension

    2023  Volume 32, Issue 3, Page(s) 223–231

    Abstract: Purpose of review: In the 1990s, a type of chronic kidney disease with unknown cause (CKDu) was identified in Central America and Sri Lanka. Patients lacked hypertension, diabetes, glomerulonephritis, or other usual causes of kidney failure. Affected ... ...

    Abstract Purpose of review: In the 1990s, a type of chronic kidney disease with unknown cause (CKDu) was identified in Central America and Sri Lanka. Patients lacked hypertension, diabetes, glomerulonephritis, or other usual causes of kidney failure. Affected patients are predominantly male agricultural workers aged 20-60 years, living in economically disadvantaged areas with poor access to medical care. Patients typically present late and progress to end-stage kidney disease within 5 years, resulting in social and economic hardship for families, regions, and countries. This review covers the current state of knowledge for this disease.
    Recent findings: The prevalence of CKDu is increasing in known endemic regions and across the globe, reaching epidemic proportions. There is primary tubulointerstitial injury with secondary glomerular and vascular sclerosis. No definitive etiologic factors have been identified, and these may vary or overlap in different geographic locations. The leading hypotheses include exposure to agrochemicals, heavy metals and trace elements, and kidney injury from dehydration/heat stress. Infections and lifestyle factors may play a role, but are likely not key. Genetic and epigenetic factors are beginning to be explored.
    Summary: CKDu is a leading cause of premature death in young-to-middle-aged adults in endemic regions and has become a public health crisis. Studies are underway to investigate clinical, exposome, and omics factors, and hopefully will provide insights into pathogenetic mechanisms resulting in biomarker discovery, preventive measures, and therapeutics.
    MeSH term(s) Adult ; Middle Aged ; Humans ; Male ; Female ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/etiology ; Kidney/pathology ; Kidney Failure, Chronic/complications ; Sri Lanka/epidemiology ; Kidney Glomerulus/pathology
    Language English
    Publishing date 2023-02-09
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000874
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3686: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  2. Article ; Online: Implications of Incomplete Immunostaining in Membranous Lupus Nephritis.

    Miyata, Kana N / Nast, Cynthia C

    Kidney360

    2023  Volume 4, Issue 7, Page(s) 868–869

    MeSH term(s) Humans ; Lupus Nephritis/diagnosis ; Glomerulonephritis, Membranous/diagnosis ; Kidney ; Lupus Erythematosus, Systemic
    Language English
    Publishing date 2023-07-27
    Publishing country United States
    Document type Editorial ; Comment
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0000000000000191
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Kidney Histopathology of Patients with Hepatitis C Infection and Diabetes Mellitus before and after Availability of Direct-Acting Antiviral Therapy.

    Kung, Vanderlene L / Giannini, Gabriel / Nast, Cynthia C

    Glomerular diseases

    2024  Volume 4, Issue 1, Page(s) 74–83

    Abstract: Introduction: Type 2 diabetes mellitus (DM) and diabetic kidney disease are increasing. Hepatitis C infection (HCV) occurs in 1% of the world population and can induce several kidney diseases. DM prevalence is increased in individuals with HCV; however, ...

    Abstract Introduction: Type 2 diabetes mellitus (DM) and diabetic kidney disease are increasing. Hepatitis C infection (HCV) occurs in 1% of the world population and can induce several kidney diseases. DM prevalence is increased in individuals with HCV; however, kidney diseases in those with both DM and HCV have not been assessed. Direct-acting antiviral agents (DAAs) became available for HCV treatment in 2014; it is unknown if DAAs altered the spectrum of kidney disease in patients with DM and HCV.
    Methods: Case review identifying patients with kidney biopsy and clinical history of DM and HCV between 2009-2013 (pre-DAA) and 2016-2020 (post-DAA), excluding kidney transplant, hepatitis B, HIV, and inadequate biopsy, identified 245 biopsies. Biopsies were evaluated for diabetic glomerulosclerosis (DGS) class, global and focal segmental glomerulosclerosis (FSGS), other glomerular diseases, interstitial fibrosis/tubular atrophy (IFTA), interstitial nephritis, acute tubular injury and degree of arterial and arteriolar sclerosis. Kidney disease differences in pre-DAA versus post-DAA eras and in mild versus severe DGS were assessed by χ
    Results: The most common non-DGS lesions were non-collapsing FSGS (41%), HCV-related IgM dominant immune complex glomerulonephritis (IgM-ICGN, 18%), IgA nephropathy (9%), and membranoproliferative glomerulonephritis (MPGN, 7%). Collapsing FSGS was more common pre-DAA versus post-DAA (8% vs. 1%,
    Conclusion: Post-DAA there were reduced biopsies and MPGN, with more severe DGS class, non-collapsing FSGS, IFTA, and chronic vascular changes. This suggests a modulating effect of DAAs on HCV-related kidney pathology with DM and chronic changes driving indications for kidney biopsy.
    Language English
    Publishing date 2024-03-15
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-3633
    ISSN (online) 2673-3633
    DOI 10.1159/000537977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Antigens in Membranous Nephropathy: Progress Toward Precision.

    Nast, Cynthia C

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2020  Volume 76, Issue 5, Page(s) 610–612

    MeSH term(s) Cohort Studies ; Glomerulonephritis, Membranous/diagnosis ; Humans ; Phenotype ; Podocytes ; Receptors, Phospholipase A2 ; Retrospective Studies ; Staining and Labeling
    Chemical Substances Receptors, Phospholipase A2
    Language English
    Publishing date 2020-09-18
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2020.06.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1669: Show issues Location:
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    Zs.MO 468: Show issues

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  5. Article ; Online: Gaining Ground in Glomerular Diseases.

    Adler, Sharon G / Nast, Cynthia C

    Glomerular diseases

    2021  Volume 1, Issue 1, Page(s) 1–2

    Language English
    Publishing date 2021-03-09
    Publishing country Switzerland
    Document type Editorial
    ISSN 2673-3633
    ISSN (online) 2673-3633
    DOI 10.1159/000515389
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Medication-Induced Interstitial Nephritis in the 21st Century.

    Nast, Cynthia C

    Advances in chronic kidney disease

    2017  Volume 24, Issue 2, Page(s) 72–79

    Abstract: Interstitial nephritis is an immune mediated form of tubulointerstitial kidney injury that may occur secondary to drugs, autoimmune disease, infections, and hematologic disorders or as a reactive process. Drug-induced acute interstitial nephritis (DI-AIN) ...

    Abstract Interstitial nephritis is an immune mediated form of tubulointerstitial kidney injury that may occur secondary to drugs, autoimmune disease, infections, and hematologic disorders or as a reactive process. Drug-induced acute interstitial nephritis (DI-AIN) occurs in 0.5%-3% of all kidney biopsies and in 5%-27% of biopsies performed for acute kidney injury. Drugs are implicated in 70%-90% of biopsy-proved IN with a prevalence of 50% in less developed to 78% in more developed countries. DI-AIN typically is idiosyncratic because of a delayed hypersensitivity reaction, although some chemotherapeutic agents are permissive for immune upregulation and injure the kidney in a dose-related manner. Antibiotics are the most implicated class of medication in DI-AIN, followed by proton pump inhibitors, nonsteroidal anti-inflammatory agents, and 5-aminosalicylates. Diuretics, allopurinol, phenytoin and other anti-seizure medications, and H2 receptor antagonists are known offenders while chemotherapeutic agents are an under-recognized cause. The symptoms of DI-AIN are variable and often not specific; thus, kidney biopsy is required to make a firm diagnosis. The incidence of DI-AIN appears to be increasing, particularly in the elderly in whom kidney biopsy is underused, and identification of the offending agent may be complicated by polypharmacy. As rapid drug discontinuation may improve prognosis, the possibility of DI-AIN should always be considered in a patient with acute kidney injury.
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2016.11.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4627: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  7. Article ; Online: The Renal Tubulointerstitium.

    Nast, Cynthia C

    Advances in chronic kidney disease

    2017  Volume 24, Issue 2, Page(s) 55–56

    Language English
    Publishing date 2017
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2016.11.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4627: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  8. Article ; Online: Artificial Intelligence: The Next Frontier in Kidney Biopsy Evaluation.

    Hou, Jean / Nast, Cynthia C

    Clinical journal of the American Society of Nephrology : CJASN

    2020  Volume 15, Issue 10, Page(s) 1389–1391

    MeSH term(s) Artificial Intelligence ; Biopsy ; Fluorescent Antibody Technique, Direct ; Humans ; Kidney ; Nephrology ; Neural Networks, Computer
    Keywords covid19
    Language English
    Publishing date 2020-09-16
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.13450820
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6584: Show issues Location:
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  9. Article ; Online: Fibronectin glomerulopathy in a kidney allograft biopsy.

    Klair, Nathaniel / Mahmood, Salman B / El-Rifai, Rasha / Nast, Cynthia C / Bu, Lihong / Bregman, Adam

    BMC nephrology

    2023  Volume 24, Issue 1, Page(s) 359

    Abstract: Background: Fibronectin glomerulopathy is a rare genetic nephropathy with only a few cases of post-transplant recurrence being reported previously. We highlight a case that was initially misdiagnosed and emphasize the importance of full ... ...

    Abstract Background: Fibronectin glomerulopathy is a rare genetic nephropathy with only a few cases of post-transplant recurrence being reported previously. We highlight a case that was initially misdiagnosed and emphasize the importance of full immunofluorescence and electron microscopy evaluation in allograft biopsies.
    Case presentation: A 36-year-old male with a history of end-stage kidney disease secondary to biopsy-proven type 1 membranoproliferative glomerulonephritis (MPGN) status-post living unrelated donor kidney transplant 12 years prior, presented with increasing creatinine and proteinuria. Biopsy was performed and was consistent with fibronectin glomerulopathy. Subsequent genetic testing revealed an FN1 mutation, the primary gene associated with this condition.
    Conclusions: Full histologic evaluation of the allograft biopsy corrected the diagnosis and additionally suggested that the patient's mother, who had expired in her 30s and had received a diagnosis of type 1 MPGN on autopsy, likely also had fibronectin glomerulopathy, enabling appropriate genetic counseling for the family.
    MeSH term(s) Humans ; Male ; Female ; Adult ; Glomerulonephritis, Membranoproliferative/pathology ; Neoplasm Recurrence, Local/complications ; Biopsy ; Kidney/pathology ; Allografts/pathology
    Language English
    Publishing date 2023-12-05
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-023-03403-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: An Organ System-Based Approach to Differential Diagnosis of Amyloid Type in Surgical Pathology.

    Giannini, Gabriel / Nast, Cynthia C

    Archives of pathology & laboratory medicine

    2019  Volume 144, Issue 3, Page(s) 379–387

    Abstract: Context.—: Amyloidosis is an uncommon but important entity. A protein-based classification of amyloidosis defines the underlying disease process, directing clinical management and providing prognostic information. However, in routine surgical pathology ... ...

    Abstract Context.—: Amyloidosis is an uncommon but important entity. A protein-based classification of amyloidosis defines the underlying disease process, directing clinical management and providing prognostic information. However, in routine surgical pathology there often is no attempt to classify amyloid other than staining to determine light chain-associated amyloidosis. Systemic and localized amyloidosis vary with respect to frequency of organ involvement by different amyloid types, and most amyloid proteins have commercial antibodies available for identification.
    Objective.—: To provide a guide for the likelihood of amyloid type by organ system.
    Data sources.—: Literature review based on PubMed searches containing the word
    Conclusions.—: In patients with amyloidosis, determination of the responsible protein is critical for appropriate patient care. In large subspecialty practices and reference laboratories with experience in using and analyzing relevant immunohistochemistry, most amyloid proteins can be identified with an organ-specific algorithm. Referring to an organ-based algorithm may be helpful in providing clinicians with a more specific differential diagnosis regarding amyloid type to help guide clinical evaluation and treatment. When the protein cannot be characterized, mass spectrometry can be performed to definitively classify the amyloid type.
    MeSH term(s) Amyloid/biosynthesis ; Amyloid/classification ; Amyloidosis/diagnosis ; Amyloidosis/metabolism ; Bone and Bones/metabolism ; Diagnosis, Differential ; Gastrointestinal Tract/metabolism ; Humans ; Immunohistochemistry/methods ; Kidney/metabolism ; Liver/metabolism ; Lung/metabolism ; Myocardium/metabolism ; Organ Specificity ; Pathology, Surgical/methods ; Peripheral Nervous System/metabolism
    Chemical Substances Amyloid
    Language English
    Publishing date 2019-11-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 194119-7
    ISSN 1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
    ISSN (online) 1543-2165
    ISSN 0363-0153 ; 0096-8528 ; 0003-9985
    DOI 10.5858/arpa.2018-0509-RA
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ud II Zs.36: Show issues Location:
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