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Related Concept Videos

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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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Renal Corpuscle01:20

Renal Corpuscle

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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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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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Dialysis01:27

Dialysis

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
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IgA Nephropathy: Beyond the Half-Century.

Yoshio Shimizu1,2, Yasuhiko Tomino3, Yusuke Suzuki4

  • 1Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni 410-2295, Shizuoka, Japan.

Medicina (Kaunas, Lithuania)
|January 23, 2024
PubMed
Summary

IgA nephropathy (IgAN) pathogenesis remains unclear, but new targeted therapies are emerging. These novel treatments, developed over 55 years, show promise for patients with this kidney disease.

Keywords:
IgA nephropathyRASS-IsRCTglucocorticoidnovel therapeutic targetstonsillectomy

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Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • IgA nephropathy (IgAN) was first described in 1968, with pathogenesis still under investigation.
  • Current treatments include RAAS inhibitors, tonsillectomies, and glucocorticoids.
  • Recent discoveries include mucosal immunity dysregulation and galactose-deficient IgA1 (Gd-IgA1) in IgAN patients.

Purpose of the Study:

  • To review the current understanding of IgAN pathogenesis.
  • To highlight the development of novel therapeutic targets and agents.
  • To discuss the potential clinical availability of new IgAN treatments.

Main Methods:

  • Review of scientific literature on IgA nephropathy.
  • Analysis of recent discoveries in IgAN pathogenesis.
  • Examination of ongoing clinical trials for novel IgAN therapies.

Main Results:

  • The multi-hit hypothesis for IgAN pathogenesis has been established.
  • Several novel therapeutic targets, including APRIL, plasma cells, complement, and endothelin, have been identified.
  • Candidate drugs targeting these pathways are showing efficacy with minimal side effects in clinical trials.

Conclusions:

  • Over 55 years after its discovery, IgAN pathogenesis is better understood.
  • Novel molecularly targeted therapies are nearing clinical availability.
  • These advancements offer new hope for IgAN patients worldwide.