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Related Concept Videos

Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Nephrons01:10

Nephrons

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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
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Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Renal Corpuscle01:20

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The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
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Response to the Letter to the Editor Entitled "Integrating Tissue Proteomics and Urinary Analysis to Capture Dynamic Podocyte Injury".

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Related Experiment Video

Updated: Nov 18, 2025

Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
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Advances in Membranous Nephropathy.

Pierre Ronco1,2,3, Emmanuelle Plaisier1,2,4, Hanna Debiec1

  • 1Unité Mixte de Recherche S1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Université Pierre et Marie Curie Paris 06, Hôpital Tenon, 75020 Paris, France.

Journal of Clinical Medicine
|February 10, 2021
PubMed
Summary
This summary is machine-generated.

Recent studies show rituximab is a promising treatment for membranous nephropathy (MN), a kidney disease. New antigen discoveries are paving the way for personalized medicine approaches in managing MN.

Keywords:
KDIGO recommendationsNCAM-1NELL-1PLA2RSemaphorin 3BTHSD7Aexostosins 1/2membranous nephropathyrandomized controlled trialsrituximab

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Area of Science:

  • Nephrology
  • Immunology
  • Autoimmune Diseases

Background:

  • Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults, characterized by auto-antibodies targeting podocyte antigens.
  • It results in immune complex deposition, complement activation, massive proteinuria, and potential kidney failure.
  • Recent advances have focused on therapeutic comparisons and novel antigen identification.

Purpose of the Study:

  • To review recent therapeutic and pathophysiological advances in membranous nephropathy (MN) over the last two years.
  • To compare the efficacy of cyclophosphamide, rituximab, and calcineurin inhibitors in treating MN.
  • To highlight the discovery of new antigens and their implications for personalized medicine.

Main Methods:

  • Analysis of three randomized controlled trials: MENTOR, STARMEN, and RI-CYCLO.
  • Utilizing laser microdissection of glomeruli and mass spectrometry for antigen discovery.
  • Review of recent literature on therapeutic outcomes and pathophysiological mechanisms in MN.

Main Results:

  • Calcineurin inhibitor-based regimens show slower immunologic response and fewer remissions compared to rituximab or cyclophosphamide.
  • Rituximab and cyclophosphamide remain competitive treatment options for MN.
  • Four new antigens (NELL-1, Semaphorin 3B, exostosins 1/2, NCAM 1) have been identified in primary and lupus MN.
  • NELL-1 is associated with cancer in primary MN; Semaphorin 3B is prominent in childhood MN; exostosins 1/2 and NCAM 1 are found in lupus MN.

Conclusions:

  • Rituximab demonstrates significant therapeutic potential in membranous nephropathy (MN).
  • The identification of novel antigens is crucial for developing personalized diagnostic and therapeutic strategies for MN.
  • Future management of MN will likely involve tailored approaches based on specific antigen targets.