| Outcome of the acute glomerular injury in proliferative lupus nephritis. | |
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MedLine Citation:
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PMID: 2760219 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Treatment with total lymphoid irradiation (TLI) and corticosteroids markedly reduced activity of systemic lupus erythematosis in 10 patients with diffuse proliferative lupus nephritis (DPLN) complicated by a nephrotic syndrome. Physiologic and morphometric techniques were used serially before, and 12 and 36 mo post-TLI to characterize the course of glomerular injury. Judged by a progressive reduction in the density of glomerular cells and immune deposits, glomerular inflammation subsided. A sustained reduction in the fractional clearance of albumin, IgG and uncharged dextrans of radius greater than 50 A, pointed to a parallel improvement in glomerular barrier size-selectivity. Corresponding changes in GFR were modest, however. A trend towards higher GFR at 12 mo was associated with a marked increase in the fraction of glomerular tuft area occupied by patent capillary loops as inflammatory changes receded. A late trend toward declining GFR beyond 12 mo was associated with progressive glomerulosclerosis, which affected 57% of all glomeruli globally by 36 mo post-TLI. Judged by a parallel increase in volume by 59%, remaining, patent glomeruli had undergone a process of adaptive enlargement. We propose that an increasing fraction of glomeruli continues to undergo progressive sclerosis after DPLN has become quiescent, and that the prevailing GFR depends on the extent to which hypertrophied remnant glomeruli can compensate for the ensuing loss of filtration surface area. |
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Authors:
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A Chagnac; B A Kiberd; M C Fariñas; S Strober; R K Sibley; R Hoppe; B D Myers |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Journal of clinical investigation Volume: 84 ISSN: 0021-9738 ISO Abbreviation: J. Clin. Invest. Publication Date: 1989 Sep |
Date Detail:
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Created Date: 1989-09-21 Completed Date: 1989-09-21 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 7802877 Medline TA: J Clin Invest Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 922-30 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Stanford University Medical Center, California 94305-5114. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Capillary Permeability / radiation effects Female Glomerular Filtration Rate / radiation effects Hemodynamics / radiation effects Humans Kidney Failure, Chronic / pathology, physiopathology Kidney Glomerulus / pathology*, physiopathology, radiation effects Longitudinal Studies Lupus Nephritis / pathology*, physiopathology, radiotherapy Lymphatic Irradiation Male |
| Grant Support | |
ID/Acronym/Agency:
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AM-29985/AM/NIADDK NIH HHS; DK-33340/DK/NIDDK NIH HHS; M01-R00070//PHS HHS |
| Comments/Corrections | |
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