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  1. Article ; Online: Cholemic Nephropathy: Role in Acute Kidney Injury in Cholestasis and Cirrhosis.

    Pinter, Klemens / Rosenkranz, Alexander

    Advances in kidney disease and health

    2024  Volume 31, Issue 2, Page(s) 111–126

    Abstract: The concept of structural kidney damage and renal dysfunction as a result of jaundice attracted attention in the medical community in the early and mid-20th century. The postulated doctrine of the time was that the excretion of elevated concentrations of ...

    Abstract The concept of structural kidney damage and renal dysfunction as a result of jaundice attracted attention in the medical community in the early and mid-20th century. The postulated doctrine of the time was that the excretion of elevated concentrations of bile results in bile-stained casts occupying collecting and distal convoluted tubules, degeneration of tubular epithelium, and decreased renal function. Compared to the hepatorenal syndrome, the poster child of hepatology and nephrology collaboration, the notion of structural kidney damage and renal dysfunction as a result of cholemia lost its traction and has almost disappeared from modern textbooks. Today, cholemic nephropathy is experiencing a renaissance, with multiple case reports and case series of jaundiced patients with kidney dysfunction and evidence of bile acid casts upon histologic examination. Published cases include acute hepatitis, chronic liver injury, cirrhosis, and obstructive etiologies. Diagnosis of cholemic nephropathy is based on histological examination, typically showing intraluminal bile casts predominantly located in the distal tubules. In common bile duct-ligated mice, the histomorphological and functional alterations of cholemic nephropathy mimic those seen in humans. Some argue against the concept of cholemic nephropathy and postulate that bile casts are a secondary phenomenon. What we need are carefully designed trials to establish diagnostic criteria and subsequently translate this knowledge into evidence-based therapies.
    MeSH term(s) Humans ; Acute Kidney Injury/pathology ; Acute Kidney Injury/etiology ; Cholestasis/pathology ; Cholestasis/complications ; Liver Cirrhosis/complications ; Liver Cirrhosis/pathology ; Animals ; Bile Acids and Salts/metabolism
    Chemical Substances Bile Acids and Salts
    Language English
    Publishing date 2024-04-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 3156601-7
    ISSN 2949-8139
    ISSN (online) 2949-8139
    DOI 10.1053/j.akdh.2023.07.001
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  2. Article ; Online: Bile Acids Are Important Contributors to AKI Associated with Liver Disease: PRO.

    Fickert, Peter / Rosenkranz, Alexander R

    Kidney360

    2021  Volume 3, Issue 1, Page(s) 17–20

    MeSH term(s) Acute Kidney Injury/etiology ; Bile Acids and Salts ; Hepatorenal Syndrome/complications ; Humans ; Liver Diseases/complications
    Chemical Substances Bile Acids and Salts
    Language English
    Publishing date 2021-05-03
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0005932020
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  3. Article ; Online: Lupus nephritis and ANCA-associated vasculitis: towards precision medicine?

    Rosenkranz, Alexander R / Tesar, Vladimir

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2021  Volume 36, Issue Suppl 2, Page(s) 37–43

    Abstract: Historically the treatment of lupus nephritis (LN) and anti-neutrophil cytoplasmic antibody (ANCA) vasculitis was 'one size fits all'; however, with the emergence of precision medicine initiatives, the field is moving towards more personalized treatment ... ...

    Abstract Historically the treatment of lupus nephritis (LN) and anti-neutrophil cytoplasmic antibody (ANCA) vasculitis was 'one size fits all'; however, with the emergence of precision medicine initiatives, the field is moving towards more personalized treatment approaches. The recent development of a more accurate and reproducible histopathological classification system for LN could lead to better disease categorization and therefore more targeted therapies. A better understanding of the pathophysiology of LN has provided evidence that not only T but also B cells play an important role, opening new opportunities for individualized treatment approaches. Recent trials have shown calcineurin inhibitors and the anti-CD20 antibodies rituximab and ofatumumab to be effective in the treatment of LN, adding new treatment options. State-of-the-art targeted therapy in ANCA-associated vasculitis (AAV) takes interindividual heterogeneity in disease severity, type of ANCA antibody [myeloperoxidase versus proteinase 3 (PR3)] and the risk for side effects of therapy into consideration. In addition, within an individual, induction therapy differs from maintenance therapy, the same holding true in incident and relapsing disease. Rituximab is now widely used in AAV and it has become clear that prolonged B cell depletion, as in LN, must be achieved to obtain a long-lasting clinical response, especially in anti-PR3-associated disease. Still, despite these advances, molecular and genetic markers are rarely incorporated into diagnostic and treatment algorithms and true precision medicine remains an aspiration that hopefully can be achieved.
    MeSH term(s) Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Antibodies, Antineutrophil Cytoplasmic ; Humans ; Lupus Nephritis/diagnosis ; Lupus Nephritis/drug therapy ; Lupus Nephritis/etiology ; Myeloblastin ; Precision Medicine ; Rituximab/therapeutic use
    Chemical Substances Antibodies, Antineutrophil Cytoplasmic ; Rituximab (4F4X42SYQ6) ; Myeloblastin (EC 3.4.21.76)
    Language English
    Publishing date 2021-06-18
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfab166
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  4. Article ; Online: Cholemic Nephropathy Reloaded.

    Fickert, Peter / Rosenkranz, Alexander R

    Seminars in liver disease

    2019  Volume 40, Issue 1, Page(s) 91–100

    Abstract: Acute kidney injury (AKI) is a dreaded complication in patients with liver disease and jaundice, since it is associated with significant morbidity and mortality. Cholemic nephropathy (CN) is thought to represent a widely underestimated important cause of ...

    Abstract Acute kidney injury (AKI) is a dreaded complication in patients with liver disease and jaundice, since it is associated with significant morbidity and mortality. Cholemic nephropathy (CN) is thought to represent a widely underestimated important cause of AKI in advanced liver diseases with jaundice. The umbrella term CN describes impaired renal function along with histomorphological changes consisting of intratubular cast formation and tubular epithelial cell injury directed primarily toward distal nephron segments. In cholestasis, biliary constituents may be excreted via the kidney and bilirubin or bile acids may trigger tubular injury and cast formation, but as we begin to understand the underlying pathophysiologic mechanisms, we become increasingly aware of the urgent need for clearly defined diagnostic criteria. In the following, we aim to summarize current knowledge of clinical and morphological characteristics of CN, discuss potential pathomechanisms, and raise key questions to stimulate evolution of a research strategy for CN.
    MeSH term(s) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Animals ; Bile Acids and Salts/adverse effects ; Bilirubin/blood ; Cholestasis/complications ; Disease Models, Animal ; Humans ; Jaundice, Obstructive/etiology ; Liver Diseases/complications
    Chemical Substances Bile Acids and Salts ; Bilirubin (RFM9X3LJ49)
    Language English
    Publishing date 2019-10-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0039-1698826
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  5. Article ; Online: Update: Immunsuppression bei Organtransplantationen.

    Kniepeiss, Daniela / Rosenkranz, Alexander R / Fickert, Peter / Schemmer, Peter

    Deutsche medizinische Wochenschrift (1946)

    2022  Volume 147, Issue 18, Page(s) 1199–1212

    Abstract: Immunosuppression is an essential prerequisite for successful transplantation. In order to reduce the sometimes-considerable side effects, combination therapies with different agents are used. This article aims to provide an up-to-date overview of ... ...

    Title translation Update: Immunosuppression in organ transplantation.
    Abstract Immunosuppression is an essential prerequisite for successful transplantation. In order to reduce the sometimes-considerable side effects, combination therapies with different agents are used. This article aims to provide an up-to-date overview of immunosuppression after liver and kidney transplantation.
    MeSH term(s) Humans ; Immunosuppression Therapy ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation ; Organ Transplantation/adverse effects
    Chemical Substances Immunosuppressive Agents
    Language German
    Publishing date 2022-09-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1716-8031
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  6. Article ; Online: Comment on: Association between intrarenal venous flow from Doppler ultrasonography and acute kidney injury in patients with sepsis in critical care: a prospective, exploratory observational study.

    Schreiber, Nikolaus / Kolland, Michael / Eller, Philipp / Rosenkranz, Alexander R / Kirsch, Alexander H

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 335

    MeSH term(s) Humans ; Prospective Studies ; Acute Kidney Injury/diagnostic imaging ; Sepsis/complications ; Sepsis/diagnostic imaging ; Critical Care ; Ultrasonography, Doppler
    Language English
    Publishing date 2023-08-29
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04625-0
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  7. Article ; Online: Atypical chemokine receptors-"chemokine PACMANs" as new therapeutic targets in glomerulonephritis.

    Eller, Kathrin / Rosenkranz, Alexander R

    Kidney international

    2018  Volume 93, Issue 4, Page(s) 774–775

    Abstract: Inflammatory cells are recruited to sites of inflammation by chemokines. Atypical chemokine receptors regulate chemokine gradients, thereby limiting inflammation. In this issue of Kidney International, atypical chemokine receptor 2 knockouts were ... ...

    Abstract Inflammatory cells are recruited to sites of inflammation by chemokines. Atypical chemokine receptors regulate chemokine gradients, thereby limiting inflammation. In this issue of Kidney International, atypical chemokine receptor 2 knockouts were described to be increasingly susceptible to immune complex-mediated glomerulonephritis. By degrading CCL2, atypical chemokine receptor 2 limited the recruitment of immune cells and myofibroblasts to the renal interstitial compartment. Therefore, not only inflammation, but also fibrosis, was effectively inhibited, making atypical chemokine receptor 2 an attractive therapeutic target in glomerulonephritis.
    MeSH term(s) Chemokine CCL2 ; Chemokines ; Fibrosis ; Glomerulonephritis ; Humans ; Kidney ; Receptors, Chemokine
    Chemical Substances Chemokine CCL2 ; Chemokines ; Receptors, Chemokine
    Language English
    Publishing date 2018-03-23
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 120573-0
    ISSN 1523-1755 ; 0085-2538
    ISSN (online) 1523-1755
    ISSN 0085-2538
    DOI 10.1016/j.kint.2017.12.021
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  8. Book ; Thesis: Das Profil der an primärer Osteoporose erkrankten Patientinnen aus der Sicht des Orthopäden

    Rosenkranz, Alexander M.

    eine vergleichende Studie

    1991  

    Author's details vorgelegt von Alexander Michael Rosenkranz
    Size 1 Mikrofiche
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Bochum, Univ., Diss., 1991
    Note Mikroreprod. e. Ms.: 207 Bl. : Ill., graph. Darst.
    HBZ-ID HT003941440
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    1992 MB 1056 order for loan Magazin

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  9. Article ; Online: Value of SGLT-2 inhibitors in the treatment of chronic kidney disease : Clinical and practical implications.

    Säemann, Marcus / Cejka, Daniel / Schmaldienst, Sabine / Rosenkranz, Alexander R / Mayer, Gert

    Wiener klinische Wochenschrift

    2022  Volume 135, Issue 3-4, Page(s) 97–109

    Abstract: Chronic kidney disease (CKD) drastically increases the risk for cardiovascular morbidity and mortality and its worldwide prevalence is still rising. Effective treatment slows CKD progression, prevents development of end-stage kidney disease and ... ...

    Abstract Chronic kidney disease (CKD) drastically increases the risk for cardiovascular morbidity and mortality and its worldwide prevalence is still rising. Effective treatment slows CKD progression, prevents development of end-stage kidney disease and cardiovascular disease thereby prolonging survival of patients. Recently, several large-scale studies with sodium-glucose cotransport‑2 inhibitors (SGLT-2i) have demonstrated profound nephroprotective and cardioprotective properties in patients with type 2 diabetes mellitus with both CKD and heart failure. Recently, the dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial demonstrated that the selective SGLT-2i dapagliflozin reduced the hazard ratio for a composite renal and cardiovascular death endpoint in patients with CKD with or without type 2 diabetes. Furthermore, dapagliflozin exerted strong nephroprotection in CKD patients with diverse etiologies like IgA nephropathy. Furthermore, other promising CKD trials such as with empagliflozin are underway. Hence, individualized treatment with SGLT2i represents a promising therapeutic option for patients with both diabetic and non-diabetic CKD. Here we summarize the current knowledge on the treatment with SGLT-2i in CKD patients underscoring a strong rationale for SGLT2 inhibition to be incorporated into standard of care for most CKD patients also with non-diabetic kidney disease. Finally, we aim to translate the current evidence into recommendations for the clinical practice in the management of patients with CKD.
    MeSH term(s) Humans ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/drug therapy ; Kidney
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors ; dapagliflozin (1ULL0QJ8UC)
    Language English
    Publishing date 2022-10-17
    Publishing country Austria
    Document type Journal Article ; Review
    ZDB-ID 200462-8
    ISSN 1613-7671 ; 0043-5325 ; 0300-5178
    ISSN (online) 1613-7671
    ISSN 0043-5325 ; 0300-5178
    DOI 10.1007/s00508-022-02096-x
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  10. Article: Cholemic Nephropathy Reloaded

    Fickert, Peter / Rosenkranz, Alexander R.

    Seminars in Liver Disease

    2019  Volume 40, Issue 01, Page(s) 91–100

    Abstract: Acute kidney injury (AKI) is a dreaded complication in patients with liver disease and jaundice, since it is associated with significant morbidity and mortality. Cholemic nephropathy (CN) is thought to represent a widely underestimated important cause of ...

    Abstract Acute kidney injury (AKI) is a dreaded complication in patients with liver disease and jaundice, since it is associated with significant morbidity and mortality. Cholemic nephropathy (CN) is thought to represent a widely underestimated important cause of AKI in advanced liver diseases with jaundice. The umbrella term CN describes impaired renal function along with histomorphological changes consisting of intratubular cast formation and tubular epithelial cell injury directed primarily toward distal nephron segments. In cholestasis, biliary constituents may be excreted via the kidney and bilirubin or bile acids may trigger tubular injury and cast formation, but as we begin to understand the underlying pathophysiologic mechanisms, we become increasingly aware of the urgent need for clearly defined diagnostic criteria. In the following, we aim to summarize current knowledge of clinical and morphological characteristics of CN, discuss potential pathomechanisms, and raise key questions to stimulate evolution of a research strategy for CN.
    Keywords acute kidney injury ; cholestasis ; hepatorenal syndrome ; advanced liver disease ; jaundice
    Language English
    Publishing date 2019-10-18
    Publisher Thieme Medical Publishers
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0039-1698826
    Database Thieme publisher's database

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