Core Concepts in Parenchymal Kidney Disease by David Philibert M.D., F.R.C.P.C. (auth.), Fernando C.

By David Philibert M.D., F.R.C.P.C. (auth.), Fernando C. Fervenza, Julie Lin, Sanjeev Sethi, Ajay K. Singh (eds.)

Core strategies in Parenchymal Kidney Disease presents finished and state of the art details at the analysis, therapy, type and pathogenesis of glomerular and tubulointerstitial illnesses. Chapters function quite a few medical eventualities and are authored by way of a crew of well known specialists within the box. skilled clinicians and trainees alike will locate this authoritative connection with be a priceless source and contribution to the literature.

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Mutations in the transcription factor WT1 are an important monogenic cause of isolated SRNS while also resulting in syndromic forms of SRNS such as Denys-Drash or Frasier syndrome [36]. Reviewing the results of studies from around the world that sequence NS-associated genes in subjects with NS illustrates the genetic complexity underlying this disease. NS displays both significant genetic and phenotypic heterogeneity. Mutations in NPHS2, NPHS1, WT1, and PLCE1 have all been shown to cause SRNS/FSGS [37].

In addition to the Finnish study of CNS noted above, a recent study reported that 80 % of non-Finnish infants with CNS had a genetic cause of their disease, with 60 % having rare, causal variants in NPHS1, 15 % in NPHS2, and the rest in WT1, PLCE1, and LAMB2 [8]. A study of infants of non-Scandinavian European and Turkish ancestry demonstrated that 66 % of cases of NS occurring in the first year of life are caused by rare variants in NPHS1, NPHS2, WT1, or LAMB2 [6, 32]. Across ethnicities, the most commonly found rare variants in children with nonsyndromic SRNS are in NPHS1, NPHS2, and WT1 [36, 41, 47–52], while those in PLCE1 [53], LAMB2 [54], INF2 [55], and TRPC6 [56] have been found much less frequently.

Infection is a frequent complication with serious morbidity in children with nephrotic syndrome [80]. Spontaneous bacterial peritonitis and cellulitis as well as meningitis and pneumonia are well described. The rate of spontaneous bacterial peritonitis is 2–6 % [81]. Children with nephrotic syndrome are susceptible to bacterial and viral infections due to a combination of low IgG levels, low factor B (complement pathway), edematous tissue, immunosuppressive drugs, and impaired lymphocyte function.

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