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  1. Article ; Online: Emerging drugs for treatment of focal segmental glomerulosclerosis.

    Trachtman, Howard

    Expert opinion on emerging drugs

    2020  Volume 25, Issue 3, Page(s) 367–375

    Abstract: Background: Glomerulosclerosis represents the final stage of glomerular injury during the course of kidney disease and can result from a primary disturbance in disorders like focal segmental glomerulosclerosis or a secondary response to ... ...

    Abstract Background: Glomerulosclerosis represents the final stage of glomerular injury during the course of kidney disease and can result from a primary disturbance in disorders like focal segmental glomerulosclerosis or a secondary response to tubulointerstitial disease. Overall, primary focal glomerulosclerosis (FSGS), the focus of this review, accounts for 10-20% of patients of all ages who progress to end stage kidney disease. There are no FDA approved therapeutic options that effectively prevent or delay the onset of kidney failure.
    Areas covered: Current immunosuppressive therapy and conservative management including inhibitors of the renin-angiotensin-aldosterone axis and sodium-glucose cotransporter are reviewed. FSGS is now recognized to represent a heterogeneous entity with multiple underlying disease mechanisms. Therefore, novel approaches targeting the podocyte cytoskeleton, immunological, inflammatory, hemodynamic and metabolic pathways are highlighted.
    Expert opinion: A number of factors are driving the development of drugs to treat focal segmental glomerulosclerosis in particular and glomerulosclerosis in general including growing awareness of the burden of chronic kidney disease, improved scientific understanding of the mechanism of injury, and the development of noninvasive profiles to identify subgroups of patients with discrete mechanisms of glomerular injury.
    MeSH term(s) Animals ; Disease Progression ; Drug Development ; Glomerulosclerosis, Focal Segmental/complications ; Glomerulosclerosis, Focal Segmental/drug therapy ; Glomerulosclerosis, Focal Segmental/physiopathology ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/pharmacology ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/prevention & control ; Renin-Angiotensin System/drug effects ; Sodium-Glucose Transport Proteins/drug effects ; Sodium-Glucose Transport Proteins/metabolism
    Chemical Substances Immunosuppressive Agents ; Sodium-Glucose Transport Proteins
    Language English
    Publishing date 2020-08-12
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2061369-6
    ISSN 1744-7623 ; 1472-8214
    ISSN (online) 1744-7623
    ISSN 1472-8214
    DOI 10.1080/14728214.2020.1803276
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book: Glomerulonephritis

    Trachtman, Howard / Herlitz, Leal / Lerma, Edgar V. / Hogan, Jonathan J.

    2019  

    Author's details Howard Trachtman, Leal C. Herlitz, Edgar V. Lerma, Jonathan J. Hogan editors
    Keywords Chronic Kidney Disease ; Glomerulonephritis ; Glomerulopathy ; Parenchymal Kidney Disease ; Renal Pathology
    Subject code 610
    Language English
    Size xxv, 888 Seiten, llustrationen, 23.5 cm x 15.5 cm, 0 g
    Publisher Springer
    Publishing place Cham
    Publishing country Switzerland
    Document type Book
    HBZ-ID HT020038601
    ISBN 978-3-319-49378-7 ; 3-319-49378-7 ; 9783319493794 ; 9783319493800 ; 3319493795 ; 3319493809
    Database Catalogue ZB MED Medicine, Health

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    2019 A 768 available for loan (reading room) Lesesaal EG

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  3. Article ; Online: Tonsillectomy for the Management of Immunoglobulin A Nephropathy.

    Trachtman, Howard

    JAMA network open

    2019  Volume 2, Issue 5, Page(s) e194755

    MeSH term(s) Glomerulonephritis, IGA ; Humans ; Tonsillectomy
    Language English
    Publishing date 2019-05-03
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2019.4755
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Research imperative.

    Trachtman, Howard

    Contemporary clinical trials communications

    2019  Volume 14, Page(s) 100350

    Abstract: There is a note of caution expressed when clinical care providers enroll their own patients into investigational trials, a concern expressed in the called dual-role consent. There is concern that this circumstance may create a conflict of interest for ... ...

    Abstract There is a note of caution expressed when clinical care providers enroll their own patients into investigational trials, a concern expressed in the called dual-role consent. There is concern that this circumstance may create a conflict of interest for the physician-investigator, lead to loss of patient voluntarism, and promote the therapeutic misconceptions. In this opinion paper, I review the circumstances surrounding participation in clinical research and the conduct of standard patient care. I propose that when a patient is eligible for an institutional review board-approved clinical trial, instead of representing a potential ethical lapse, soliciting enrollment by the clinician-researcher may represent optimal care for the patient.
    Language English
    Publishing date 2019-03-24
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2451-8654
    ISSN (online) 2451-8654
    DOI 10.1016/j.conctc.2019.100350
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Age-Dependent Definition of CKD.

    Trachtman, Howard

    Journal of the American Society of Nephrology : JASN

    2019  Volume 31, Issue 2, Page(s) 447

    MeSH term(s) Creatinine ; Glomerular Filtration Rate ; Humans ; Renal Insufficiency, Chronic
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2019-12-23
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2019090914
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  6. Article ; Online: Sparsentan: the first and only non-immunosuppressive therapy for the reduction of proteinuria in IgA nephropathy.

    Trachtman, Howard / Komers, Radko / Inrig, Jula

    Expert review of clinical immunology

    2024  , Page(s) 1–6

    Abstract: Introduction: IgA nephropathy is one of the most common forms of glomerular disease. Patients with persistent proteinuria are at increased risk of progression to kidney failure. There is a significant need for safe and effective therapies to lower ... ...

    Abstract Introduction: IgA nephropathy is one of the most common forms of glomerular disease. Patients with persistent proteinuria are at increased risk of progression to kidney failure. There is a significant need for safe and effective therapies to lower proteinuria in these patients. Sparsentan is a non-immunosuppressive agent that acts as a dual angiotensin and endothelin receptor antagonist. It lowers proteinuria in experimental models of glomerular disease and in affected patients.
    Areas covered: This review covers the immunological and non-immunological actions of sparsentan in glomerular disease. It reviews the clinical trials that evaluated the impact of the drug in pediatric and adult patients with IgA nephropathy. It places the use of sparsentan in an overall treatment paradigm for the full spectrum of patients with IgA nephropathy including nonspecific renoprotective agents such as inhibitors of the renin-angiotensin-aldosterone axis and SGLT2 transporter and immunosuppressive drugs. The review represents a search of the current literature about the effect of the drug on normal physiology and the pathogenesis of IgA nephropathy.
    Expert opinion: The safety, tolerability, and therapeutic efficacy of sparsentan have been demonstrated in long-term studies of patients with primary glomerular diseases extending over 5 years. The evidence in support of a beneficial treatment effect of sparsentan is stronger in IgAN than in FSGS. It is anticipated that sparsentan will supplant the use of ACEI or ARB as the first-line therapy to reduce proteinuria prior to the implementation of immunosuppressive agents in patients with IgA nephropathy. It may be combined with other renoprotective drugs like SGLT2 inhibitors. Practice guidelines are needed to promote safe and effective use of this new drug by nephrologists caring for patients with IgAN in all clinical settings.
    Language English
    Publishing date 2024-02-26
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2024.2319132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Sparsentan versus Irbesartan in Focal Segmental Glomerulosclerosis. Reply.

    Trachtman, Howard / Rheault, Michelle N / Komers, Radko

    The New England journal of medicine

    2024  Volume 390, Issue 12, Page(s) 1154–1155

    MeSH term(s) Humans ; Glomerulosclerosis, Focal Segmental/drug therapy ; Irbesartan/therapeutic use ; Spiro Compounds ; Sulfonamides
    Chemical Substances Irbesartan (J0E2756Z7N) ; sparsentan (9242RO5URM) ; Spiro Compounds ; Sulfonamides
    Language English
    Publishing date 2024-03-07
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2401126
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  8. Book: Pediatric nephrology

    Trachtman, Howard

    (Monographs in clinical pediatrics ; 10)

    1998  

    Author's details ed. by Howard Trachtman
    Series title Monographs in clinical pediatrics ; 10
    Collection
    Language English
    Size XIV, 405 S. : Ill.
    Publisher Harwood Academic
    Publishing place Amsterdam u.a.
    Publishing country Netherlands
    Document type Book
    Note Includes index.
    HBZ-ID HT009238819
    ISBN 90-5702-273-7 ; 978-90-5702-273-9
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2000 A 3313 order for loan Magazin

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  9. Article ; Online: Does What Goes Around Always Come Around?

    Trachtman, Howard

    Clinical journal of the American Society of Nephrology : CJASN

    2018  Volume 13, Issue 12, Page(s) 1788–1790

    MeSH term(s) Adrenocorticotropic Hormone ; Child ; Humans ; Nephrosis ; Nephrosis, Lipoid ; Nephrotic Syndrome
    Chemical Substances Adrenocorticotropic Hormone (9002-60-2)
    Language English
    Publishing date 2018-11-15
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.12291018
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  10. Article ; Online: Genetic Spectrum of Nephrotic Syndrome: Impact of Podocytopathy in Adult Life.

    Massengill, Susan / Trachtman, Howard

    Advances in chronic kidney disease

    2022  Volume 29, Issue 3, Page(s) 221–224

    Abstract: A substantial number of patients with focal segmental glomerulosclerosis (FSGS) have a pathogenic genetic mutation in a podocyte protein as the cause of their disease. The mutations can affect a wide range of cell functions including the actin ... ...

    Abstract A substantial number of patients with focal segmental glomerulosclerosis (FSGS) have a pathogenic genetic mutation in a podocyte protein as the cause of their disease. The mutations can affect a wide range of cell functions including the actin cytoskeleton, cell adhesion and motility, mitochondrial function, and nuclear pore proteins. The likelihood of a genetic cause declines with age, from approximately 30% in children and adolescents to 10% in adulthood, and the specific proteins involved and the pattern of inheritance differ in the 2 age groups. The presence of a genetic cause for FSGS can have important clinical ramifications including the need for a diagnostic kidney biopsy, medical management, and the risk of recurrent disease after kidney transplantation. This review summarizes the spectrum of genetic causes of nephrotic syndrome, primarily FSGS, in adults with a focus on diagnosis, presentation, and management.
    MeSH term(s) Adolescent ; Adult ; Child ; Glomerulosclerosis, Focal Segmental/genetics ; Humans ; Kidney Transplantation/adverse effects ; Mutation ; Nephrotic Syndrome/complications ; Nephrotic Syndrome/genetics ; Podocytes/pathology
    Language English
    Publishing date 2022-09-09
    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.2022.04.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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