Alteration of anti-PLA₂R reactivity in follow-up samples (n = 10).

<p>Anti-PLA₂R, anti-phospholipase A₂ receptor antibody; uPCR, urine protein-creatinine ratio.</p

Clinical outcomes and general characteristics of patients with idiopathic MN according to anti-PLA₂R reactivity.

<p>The data are expressed as the number (%) or median (25–75% interquartile range) or the mean±SD. MN, membranous nephropathy; Anti-PLA₂R, anti-phospholipase A₂ receptor antibody. eGFR, estimated glomerular filtration rate calculated using the Modification of Diet in Renal Disease formula; uPCR, urine protein-creatinine ratio; RAS blocker, renin angiotensin systemic blocker.</p

Clinical characteristics of patients with idiopathic MN at the time of kidney biopsy according to anti-PLA₂R reactivity.

<p>The data are expressed as the mean±SD or median (25–75% interquartile range). MN, membranous nephropathy; Anti-PLA₂R, anti-phospholipase A2 receptor antibody; eGFR, estimated glomerular filtration rate calculated using the Modification of Diet in Renal Disease formula; uPCR, urine protein-creatinine ratio; RAS blocker, renin angiotensin systemic blocker.</p

Clinical outcomes of patients with idiopathic MN according to anti-PLA₂R levels.

<p>MN, membranous nephropathy; Anti-PLA₂R, anti-phospholipase A₂ receptor antibody; N, number of patients.</p>a<p>Group of patients whose serum samples showed anti-PLA₂R reactivity at dilutions of 1∶25 or 1∶100 with negative results at dilutions over 1∶100; ^bGroup of patients whose serum samples showed anti-PLA₂R reactivity at dilutions of 1∶500 or 1∶2000 with negative results at dilutions over 1∶2000; ^cGroup of patients whose serum samples showed anti-PLA₂R reactivity at dilutions up to 1∶8000.</p

Relationship between anti-PLA₂R levels and clinical parameters in patients with idiopathic MN.

<p>A: Proteinuria was more severe in patients with higher anti-PLA₂R level. *Dunn’s multiple pairwise comparison test after Kruskal-Wallis test. B Severity of hypoalbuminemia was increased depending on the anti-PLA₂R levels. **ANOVA test with polynomial contrast. C: The proportion of patients with nephrotic range proteinuria was increased according to the anti-PLA₂R levels. <i>***</i> Mantel-Haenszel χ² test.</p

Histologic findings of patients with secondary MN.

<p>MN, membranous nephropathy; Anti-PLA₂R, anti-phospholipase A2 receptor antibody; HBV, hepatitis B virus; HCV, hepatitis C virus.</p

Value of perioperative genitourinary screening culture and colonization status in predicting early urinary tract infection after renal transplantation

<div><p>Background</p><p>We aimed to assess whether patients colonized with certain organisms in the genitourinary tract would have greater urinary tract infection (UTI) risk during the post-transplantation period, and whether information on the perioperatively colonized organisms may help identify the causal organisms during early UTI.</p><p>Methods</p><p>We retrospectively reviewed the culture results of preoperative urine, preoperative urethral swab, and postoperative urinary catheter tip specimens of 420 renal transplant recipients. The colonization status was compared to the culture results during the first UTI episode within 6 months after transplantation.</p><p>Results</p><p>Twenty six (6.2%) patients developed early UTI, and the presence of common uropathogens in the perioperative genitourinary specimen was positively associated with a higher early UTI risk odds ratio [OR], 3.23; 95% confidence interval [CI], 1.44 to 7.24; <i>P</i> = 0.003). However, the actual causal organism during UTI was observed perioperatively only in 15 patients (40.5%). Neither perioperative colonization nor early UTI was associated with subsequent acute cellular rejection or graft failure.</p><p>Conclusions</p><p>Renal transplantation patients who were colonized with common uropathogens were more likely to develop early UTI. However, the usefulness of the culture results of perioperative colonizers in predicting the causal organism during early UTI seems limited due to the low concordance rate.</p></div

Early Referral to a Nephrologist Improved Patient Survival: Prospective Cohort Study for End-Stage Renal Disease in Korea

<div><p>The timing of referral to a nephrologist may influence the outcome of chronic kidney disease patients, but its impact has not been evaluated thoroughly. The results of a recent study showing an association between early referral and patient survival are still being debated. A total of 1028 patients newly diagnosed as end-stage renal disease (ESRD) from July 2008 to October 2011 were enrolled. Early referral (ER) was defined as patients meeting with a nephrologist more than a year before dialysis and dialysis education were provided, and all others were considered late referral (LR). The relationship of referral pattern with mortality in ESRD patients was explored using a Cox proportional hazards regression models. Time from referral to dialysis was significantly longer in 599 ER patients than in 429 LR patients (62.3±58.9 versus 2.9±3.4 months, P<0.001). Emergency HD using a temporary vascular catheter was required in 485 (47.2%) out of all patients and in 262 (43.7%) of ER compared with 223 (52.0%) of LR (P = 0.009). After 2 years of follow-up, the survival rate in ER was better than that in LR (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.27–4.45, P = 0.007). In patients with diabetes nephropathy, patient survival was also significantly higher in ER than in LR (HR 4.74, 95% CI 1.73–13.00, P = 0.002). With increasing age, HR also increased. Timely referral to a nephrologist in the predialytic stage is associated with reduced mortality.</p> </div

Factors associated with early urinary tract infection.

<p>Factors associated with early urinary tract infection.</p

Thirty-eight causative microorganisms isolated from urine during the first early urinary tract infection episodes in 37 cases after renal transplantation.

<p>Thirty-eight causative microorganisms isolated from urine during the first early urinary tract infection episodes in 37 cases after renal transplantation.</p