By David Philibert M.D., F.R.C.P.C. (auth.), Fernando C. Fervenza, Julie Lin, Sanjeev Sethi, Ajay K. Singh (eds.)
Core thoughts in Parenchymal Kidney Disease presents finished and state of the art details at the analysis, therapy, type and pathogenesis of glomerular and tubulointerstitial ailments. Chapters function numerous medical eventualities and are authored via a crew of popular specialists within the box. skilled clinicians and trainees alike will locate this authoritative connection with be a necessary source and contribution to the literature.
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Additional resources for Core Concepts in Parenchymal Kidney Disease
26. Radhakrishnan J, Appel AS, Valeri A, Appel GB. The nephrotic syndrome, lipids, and risk factors for cardiovascular disease. Am J Kidney Dis. 1993;22:135–42. 27. McIntyre P, Craig JC. Prevention of serious bacterial infection in children with nephrotic syndrome. J Paediatr Child Health. 1998;34:314–7. 28. Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L, et al. High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study.
The use of antihyperlipidemic agents and RAAS blockers may be considered on a case-by-case basis in FR/SD MCD adults. Mycophenolate In children with MCD, mycophenolate (MMF) has been used as a steroid-sparing agent. The experience with MMF in adults has been limited to case reports [43–45]. Rituximab Rituximab has been used in small uncontrolled case series in both adults and children with immunosuppression-dependent MCD with varying degrees of success [46, 47]. Corticosteroids-Resistant MCD An estimated 10 % of adult MCD patients are steroid-resistant, defined as failing 16 weeks of daily or alternate day corticosteroids as outlined previously.
However, more than 25 % of patients with MCNS who were treated with cyclophosphamide were not in sustained remission after puberty and required prolonged immunosuppressive treatment [90–92]. Thus, because of the serious toxicity associated with the alkylating agents, reluctance to prescribe a second course, and the guarded long-term effect, there has been greater reliance on alternative medications for frequently relapsing or steroid-dependent patients with MCNS. Antimetabolites such as azathioprine and mycophenolate mofetil have been evaluated in a number of open-label studies.