Kidney Medicine最新文献

{"title":"Daratumumab for Bortezomib-Refractory Proliferative Glomerulonephritis With Monoclonal Immunoglobulin Deposits in Kidney Allograft: A Case Report","authors":"Zewei Chen ,&nbsp;Shangxi Fu ,&nbsp;Jun Wu ,&nbsp;Xiaoling Luo ,&nbsp;Zhiguo Mao ,&nbsp;Dechao Xu ,&nbsp;Xiang Gao","doi":"10.1016/j.xkme.2024.100945","DOIUrl":"10.1016/j.xkme.2024.100945","url":null,"abstract":"<div><div>Despite treatment with immunosuppressive or clone-targeted chemotherapy, patients with proliferative glomerulonephritis with monoclonal immunoglobulin deposit (PGNMID) frequently progress into end-stage kidney failure, and early recurrence of PGNMID after kidney transplantation is common. The standard management of PGNMID has been unclear, currently based on data from small cohorts, which requires a need for additional therapeutic regimens in this disease. A human IgG monoclonal antibody that targets CD38 (daratumumab) was recently identified as a potential therapeutic option for treating PGNMID. To date, rare data on the application of daratumumab in patients with PGNMID after kidney transplantation have been reported. Herein, we first described a unique patient with recurrent PGNMID in kidney allograft who was treated with daratumumab after not responding to bortezomib-based regimens. Daratumumab was shown to successfully reduce proteinuria with stabilizing kidney function and was well-tolerated in this patient, which supports that daratumumab appears to be a viable option for treatment-resistant PGNMID.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100945"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Dialysis Prediction Using Artificial Intelligence","authors":"Caitlin K. Monaghan PhD ,&nbsp;Joanna Willetts MS ,&nbsp;Hao Han MS ,&nbsp;Sheetal Chaudhuri PhD ,&nbsp;Linda H. Ficociello DSc ,&nbsp;Michael A. Kraus MD ,&nbsp;Harold E. Giles MD ,&nbsp;Len Usvyat PhD ,&nbsp;Joseph Turk MBA","doi":"10.1016/j.xkme.2024.100949","DOIUrl":"10.1016/j.xkme.2024.100949","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100949"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron Deficiency, Cadmium Levels, and Kidney Transplant Outcomes in Prevalent Kidney Transplant Recipients","authors":"Pien Rawee MSc ,&nbsp;Daan Kremer MD, PhD ,&nbsp;Ilja M. Nolte PhD ,&nbsp;Mark R. Hanudel MD, MS ,&nbsp;Daan J. Touw PharmD, PhD ,&nbsp;Martin H. De Borst MD, PhD ,&nbsp;Stephan J.L. Bakker MD, PhD ,&nbsp;Michele F. Eisenga MD, PhD","doi":"10.1016/j.xkme.2024.100942","DOIUrl":"10.1016/j.xkme.2024.100942","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100942"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Urinary Tract Infections in Kidney Transplant Recipients With Initially Asymptomatic Bacteriuria: A Single-Center Retrospective Cohort Study","authors":"Samar Medani ,&nbsp;Marc Dorais ,&nbsp;Aurélie Poulin ,&nbsp;Alexandre Tavares-Brum ,&nbsp;Habib Mawad ,&nbsp;Alain Duclos ,&nbsp;Azemi Barama ,&nbsp;Héloïse Cardinal","doi":"10.1016/j.xkme.2024.100946","DOIUrl":"10.1016/j.xkme.2024.100946","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Management of asymptomatic bacteriuria in kidney transplant recipients remains uncertain. Our main objective was to evaluate whether patient- or episode-related factors could help identify episodes of asymptomatic bacteriuria associated with a higher risk of being followed by a symptomatic urinary tract infection.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A single-center, retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings &amp; Participants&lt;/h3&gt;&lt;div&gt;Consecutive patients who received a kidney transplantation between January 1, 2008, and April 26, 2016, and experienced&lt;!--&gt; &lt;!--&gt;≥1 episode of asymptomatic bacteriuria during the first 3 years posttransplantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;Recipient age, sex, diabetes, donor type, retransplant, urological abnormalities, thymoglobulin for induction, time since transplant, presence of ureteral stent, prior acute rejection, leukocyturia, hematuria, urinary nitrites, bacterial strain, prior urinary tract infection, resistance to antibiotics, antibiotic treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;The primary outcome was the occurrence of symptomatic urinary tract infection. The secondary outcome was antibiotic treatment of asymptomatic bacteriuria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;A Cox regression survival analysis model accounting for recurrent events and a logistic regression model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From a cohort of 508 patients, we included 597 episodes of asymptomatic bacteriuria detected in 119 outpatients. Antibiotics were prescribed in 26% of these episodes. Overall, 56 (9%) of episodes were followed by a symptomatic urinary tract infection. Pretransplant diabetes (hazard ratio [HR], 4.28; 95% confidence intervals [CI], 2.40-7.61), leukocyturia or hematuria (HR, 2.24; 95% CI, 1.27-3.96), and the presence of a ureteral stent (HR, 3.40; 95% CI, 1.33-8.70) were associated with development of a clinical urinary tract infection in patients with asymptomatic bacteriuria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The small number of events limits complete multivariable adjustment. It also prevents us from drawing a definite conclusion about the importance of a number of independent variables as risk factors for the outcome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The benefit of treating episodes of asymptomatic bacteriuria with high-risk characteristics should be investigated in future trials.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain Language Summary&lt;/h3&gt;&lt;div&gt;Urine infections are very frequent in patients who have received a kidney transplant. Bacteria are sometimes found in the urine of patients who report no symptoms. This is called asymptomatic bacteriuria. Asymptomatic bacteriuria is a risk factor for having an overt symptomatic urine infection, but previous small studies did not show any benefit of treatment. However, this may be different if only patients with asymptomatic bacteriuria at high risk of developing a","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100946"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Mineralocorticoid Receptor Antagonists on Kidney and Cardiovascular Outcomes in Patients With Chronic Kidney Disease: An Umbrella Review","authors":"Porntep Amornritvanich ,&nbsp;Thunyarat Anothaisintawee ,&nbsp;John Attia ,&nbsp;Gareth J. McKay ,&nbsp;Ammarin Thakkinstian","doi":"10.1016/j.xkme.2024.100943","DOIUrl":"10.1016/j.xkme.2024.100943","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;To comprehensively summarize the efficacy of mineralocorticoid receptor antagonists (MRAs) to improve kidney and cardiovascular (CV) outcomes in patients with chronic kidney disease (CKD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Relevant studies were identified from Medline and Scopus databases from their inception up to August 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Study Populations&lt;/h3&gt;&lt;div&gt;Patients with nondialysis or dialysis CKD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Selection Criteria for Studies&lt;/h3&gt;&lt;div&gt;Systematic reviews and meta-analyses (SR-MAs) of randomized controlled trials (RCTs) that investigated the efficacy of MRAs on kidney and CV outcomes in patients with nondialysis or dialysis CKD were included in this study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Extraction&lt;/h3&gt;&lt;div&gt;Characteristics of studies and participants, and treatment effects were extracted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytic Approach&lt;/h3&gt;&lt;div&gt;Efficacy of MRAs was qualitatively summarized according to types of patients and MRAs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Forty SR-MAs were included. When compared with placebo/usual care, steroidal MRAs (sMRAs) provided significant benefit in decreasing all-cause (pooled RRs of 0.38 [0.22-0.65] to 0.87 [0.77-0.98]) and CV mortality (pooled RRs of 0.34 [0.15-0.75] to 0.46 [0.28-0.76]) only in patients treated with dialysis, when compared with placebo. Nonsteroidal MRAs (nsMRAs) significantly lowered composite CV events in both nondialysis CKD (pooled RRs of 0.86 [0.79-0.94] to 0.92 [0.85-0.99]) and patients with diabetic kidney disease (DKD) (pooled RRs of 0.86 [0.78-0.95] to 0.88 [0.81-0.96]). In addition, nsMRAs showed significant benefit in reducing composite kidney outcomes in patients with either nondialysis CKD or DKD when compared with placebo. However, this efficacy was lower than sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with DKD. Moreover, both sMRAs and nsMRAs significantly increased the risk of hyperkalemia in patients with nondialysis CKD and DKD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The comparison between nsMRAs and SGLT2i is based on network meta-analyses. Consequently, additional head-to-head RCTs are necessary to confirm the advantages of SGLT2i over nsMRAs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;sMRAs offer benefits in reducing all-cause and cardiovascular mortality and composite CV events in patients treated with dialysis. nsMRAs improve kidney outcomes in patients with nondialysis CKD and DKD but increase hyperkalemia risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain Language Summary&lt;/h3&gt;&lt;div&gt;Chronic kidney disease (CKD) can increase the risk of severe kidney problems and heart disease. A key factor in kidney decline and heart disease risk is the overactivation of mineralocorticoid receptors (MR). Medications called MR antagonists (MRAs) may lower heart disease risk. We performed a thorough review of all existing studies on both steroidal MRAs (sMRAs) and nonsteroidal MR antagonists (nsMRA","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100943"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Dialysis for Undocumented Individuals: A Five-Year Single Center Experience","authors":"Laurene M. Asare MD ,&nbsp;Dia R. Waguespack MD ,&nbsp;Jose J. Perez MD ,&nbsp;Jade M. Teakell MD, PhD","doi":"10.1016/j.xkme.2024.100929","DOIUrl":"10.1016/j.xkme.2024.100929","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100929"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident Heart Failure in Atherosclerotic Renal Artery Stenosis: A Post Hoc Analysis of the CORAL Trial","authors":"Rajesh Gupta ,&nbsp;Michelle M. Estrella ,&nbsp;Rebecca Scherzer ,&nbsp;Pamela S. Brewster ,&nbsp;Lance D. Dworkin ,&nbsp;Hanh T. Nguyen ,&nbsp;Yanmei Xie ,&nbsp;Joachim H. Ix ,&nbsp;Michael G. Shlipak ,&nbsp;Timothy P. Murphy ,&nbsp;Donald E. Cutlip ,&nbsp;Eldrin F. Lewis ,&nbsp;Christopher J. Cooper","doi":"10.1016/j.xkme.2024.100948","DOIUrl":"10.1016/j.xkme.2024.100948","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><div>Although renal artery stenosis (RAS) and heart failure (HF) have been linked, the incidence and predictors of HF among patients with RAS are not well described.</div></div><div><h3>Study Design</h3><div>Post hoc analysis of the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) multicenter, open-label, randomized controlled trial (RCT).</div></div><div><h3>Settings and Participants</h3><div>Patients with atherosclerotic RAS and elevated blood pressure, chronic kidney disease, or both, and without a history of HF at enrollment.</div></div><div><h3>Intervention</h3><div>Medical therapy alone versus medical therapy plus renal artery stenting.</div></div><div><h3>Outcomes</h3><div>Incident HF events.</div></div><div><h3>Results</h3><div>This analysis included 808 participants enrolled in the CORAL trial without evidence of baseline HF. During a median follow-up of 4.8 years, 54 participants (6.7%) developed incident HF. HF incidence rates did not differ by randomized intervention (HR, 0.84; 95% confidence interval [CI], 0.49-1.43 for stent arm with medical arm as reference). Baseline diabetes (subdistribution hazard ratio (sHR), 2.07; 95% CI, 1.20-3.58), albuminuria (sHR, 1.12 per doubling of urinary albumin-creatinine ratio, 95% CI, 1.02-1.24), lower eGFR (sHR, 0.78 per 10<!--> <!-->mL/min/1.73<!--> <!-->m² estimated glomerular filtration rate calculated with cystatin C and creatinine, 95% CI, 0.69-0.88), and peripheral vascular disease (PVD) (sHR, 2.18, 95% CI, 1.21-3.91) were independent predictors of incident HF. Participants who experienced incident HF had greater kidney function decline before HF events.</div></div><div><h3>Limitations</h3><div>This is a post hoc analysis of a RCT. The number of HF events is small.</div></div><div><h3>Conclusions</h3><div>In patients with RAS, rates of incident HF did not differ between participants randomized to optimal medical therapy alone versus optimal medical therapy plus renal artery stenting. The presence of diabetes, PVD, and worse kidney health at baseline were associated with future HF events.</div></div><div><h3>Plain-Language Summary</h3><div>Renal artery stenosis has been linked with heart failure. The CORAL randomized controlled trial has the largest study population of participants with renal artery stenosis. In this analysis, we assessed the incidence and predictors of heart failure in CORAL. We found similar rates of incident heart failure among participants randomized to medical therapy alone vs. medical therapy plus renal artery stent. We identified independent predictors of incident heart failure among people with renal artery stenosis include PAD, diabetes, albuminuria, and lower baseline eGFR. In addition, eGFR declined prior to heart failure events.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100948"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using KeGFR for Vancomycin Dosing When Renal Clearance Is Acutely Changing: A Simulation Study in a Retrospective Cohort","authors":"Manohar Bairy FRCP (London),&nbsp;Benjamin Khoo MRCP (UK),&nbsp;Sock Hoon Tan MSc,&nbsp;Leticia Xyn Yen Peh PharmD,&nbsp;Siow Yu Lim PharmD,&nbsp;Shen Hui Chuang PharmD","doi":"10.1016/j.xkme.2025.100970","DOIUrl":"10.1016/j.xkme.2025.100970","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100970"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Herpes Simplex Virus Associated Peritoneal Dialysis Peritonitis With Novel Use of Intraperitoneal Acyclovir","authors":"Arti Dhoot ,&nbsp;Bourne Auguste ,&nbsp;Jenny Ng ,&nbsp;Helen Genis ,&nbsp;Nisha Andany ,&nbsp;Gemini Tanna","doi":"10.1016/j.xkme.2025.100968","DOIUrl":"10.1016/j.xkme.2025.100968","url":null,"abstract":"<div><div>Viral etiologies, such as herpes simplex virus (HSV), for peritonitis can be misclassified as culture negative peritonitis because of poor accessibility of viral testing in the effluent fluid. Inaccurate diagnosis and subsequent ineffective treatment can lead to unnecessary catheter removal for presumed refractory peritonitis. Here, we report a 73-year-old woman with a history of genital HSV-2 on continuous cyclic peritoneal dialysis who presented with HSV-2 related peritonitis. She initially presented with hypotension, suprapubic pain, and cloudy effluent with an elevated white blood cell count preceded by a 1-week history of genital lesions. Elevated cell counts were primarily lymphocyte and monocyte predominant. Bacterial and fungal cultures were negative, and she had minimal improvement in cell counts after 1 week of empiric antibiotics. Effluent was positive for HSV-2. Acyclovir was reconstituted in a 2.5% Dianeal bag and administered via the intraperitoneal route for local effects and avoidance of neurotoxicity. Her cell counts normalized within a week of starting intraperitoneal antiviral therapy and repeat effluent was negative for HSV at 2 weeks. There is one case report describing HSV-2 related peritonitis; however, to our knowledge, this is the first case of viral peritonitis treated with IP acyclovir successfully.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100968"},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab-Mediated Complete Remission of a PLA2R-Positive Paraneoplastic Membranous Nephropathy: A Case Report","authors":"Rayane Benyahia ,&nbsp;Magali Colombat ,&nbsp;Serigne Gueye ,&nbsp;Julien Mazières ,&nbsp;Julie Belliere","doi":"10.1016/j.xkme.2025.100967","DOIUrl":"10.1016/j.xkme.2025.100967","url":null,"abstract":"<div><div>Management of paraneoplastic membranous nephropathy (MN) is directed toward the underlying malignancy, and prescriptions of immune checkpoint inhibitors (ICIs) are skyrocketing in the field of oncology. However, this drug category is usually discouraged for patients with autoimmune disorders (AIDs) because it might trigger immune-related adverse events (irAEs) in the form of flare-ups or even genesis of AID. Yet, nothing is known about the efficacy and safety of ICIs for cancers associated with paraneoplastic MN. Here, we report a rare case of PLA2R-positive MN related to a PDL1-positive locally advanced lung adenocarcinoma. Antineoplastic treatment with the anti-PD1 pembrolizumab as a first-line, single-drug therapy allowed for both cancer and nephropathy remissions. To date, to our knowledge, this is the first description of a (PLA2R-positive) paraneoplastic MN that was put into remission via an ICI monotherapy successfully targeting the associated neoplasia only, without additional immunosuppressive agents.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100967"},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}