Nephrology Commons^™

Resistant Hypertension Secondary To Renal Arteriovenous Malformation: A Case Of Cure After Nephrectomy, Alexis Garza, Maximo A. Alvarez, Paul Kim, David Alonzo

School of Medicine Publications

BACKGROUND: Evaluation of multidrug-resistant hypertension in young adults requires consideration of uncommon secondary etiologies, including renovascular disease and congenital renal vascular anomalies. Renal arteriovenous malformations (rAVMs) represent a rare cause of secondary hypertension, accounting for less than 0.1% of renal vascular abnormalities. They most commonly present with hematuria, flank pain, or, in high-flow lesions, high output cardiac failure. Hypertension as the principal manifestation is uncommon.

CASE REPORT: We describe a 33-year-old woman with longstanding uncontrolled hypertension requiring 5 antihypertensive agents who presented for evaluation of refractory blood pressure control. Initial duplex ultrasound and angiography identified a large complex left renal …

Maternal Sjögren's Disease And Its Long Shadow: Adult-Onset Seronegative Lupus Nephritis Following Congenital Heart Block, Tatiana Dacak, Abelardo Rodriguez, Luisa Fernanda Gomez, Corey Haines, Nida Asif

School of Medicine Publications

Congenital complete atrioventricular block (CCAVB) is a well-recognized manifestation of neonatal lupus erythematosus (NLE), caused by transplacental transfer of maternal anti-Ro/Sjögren's Syndrome Type A (SSA) and anti-La/Sjögren's Syndrome Type B (SSB) antibodies. Although non-cardiac manifestations of NLE typically resolve within the first year of life, the long-term autoimmune risk in affected offspring remains unclear. We report a 24-year-old woman with CCAVB secondary to maternal Sjögren's disease who presented with acute heart failure, nephrotic-range proteinuria, bicytopenia, pericardial effusion, and findings concerning for Libman-Sacks endocarditis. Despite negative conventional lupus serologies, renal biopsy demonstrated Class IV/V lupus-like immune-complex glomerulonephritis with full-house immune complex …

Clinicopathologic Spectrum Of Renal Disease In Sars-Cov-2 Infection And Post-Covid-19 Vaccination, Naya Williams, Mohammed S. Razzaque

School of Medicine Publications

Both SARS-CoV-2 infection and COVID-19 vaccination have been associated with renal complications. In the context of SARS-CoV-2 infection, kidney injury is primarily attributed to a complex interplay of systemic immune dysregulation and vascular damage. Severe infection triggers a cytokine-mediated inflammatory response characterized by elevated levels of pro-inflammatory mediators, resulting in systemic hemodynamic instability, increased capillary permeability, and renal hypoperfusion, ultimately leading to acute tubular injury. In addition, virus-induced endothelial activation promotes a prothrombotic state, microvascular injury, and further impairment of renal perfusion. Collectively, these processes converge to produce acute kidney injury (AKI) and, in severe or prolonged cases, may contribute …

Diabetic Nephropathy Masquerading As Systemic Disease: The Critical Role Of Renal Biopsy In A Young Uninsured Woman With Nephrotic Syndrome, Yolanda V. Gutierrez, Alexis Vargas Del Toro, Cristina Kochi Yamamoto, Jose Loayza Pintado, Andres Suarez-Parraga

School of Medicine Publications

Nephrotic syndrome can have overlapping features across multiple diseases, making diagnosis difficult without tissue confirmation. We describe a 30-year-old uninsured Hispanic woman with type 1 diabetes, hypertension, and CKD3B who presented with nephrotic syndrome, sepsis, and progressive muscle weakness. Her pleural effusions, periorbital changes, elevated free light chains, and dysphagia raised concern for systemic conditions such as amyloidosis or polymyositis, especially given inconsistent outpatient follow-up. Because her management would differ significantly depending on the underlying cause and due to the high risk of loss to follow-up, a renal biopsy was pursued. Serologic studies were unremarkable, and biopsy ultimately confirmed diabetic …

Dna Damage Is Overcome By Trip13 Overexpression During Cisplatin Nephrotoxicity, Taketsugu Hama, Prashanth K.B. Nagesh, Pallabita Chowdhury, Bob M. Moore Ii, Murali M. Yallapu, Kevin R. Regner, Frank Park

School of Medicine Publications

Cisplatin is a commonly used chemotherapeutic agent to treat a wide array of cancers that is frequently associated with toxic injury to the kidney due to oxidative DNA damage and perturbations in cell cycle progression leading to cell death. In this study, we investigated whether thyroid receptor interacting protein 13 (TRIP13) plays a central role in the protection of the tubular epithelia following cisplatin treatment by circumventing DNA damage. Following cisplatin treatment, double-stranded DNA repair pathways were inhibited using selective blockers to proteins involved in either homologous recombination or non-homologous end joining. This led to increased blood markers of acute …

Multi National Survey Of The Advice Given To Muslim Kidney Graft Recipients By Muslim Nephrologists About Lifestyle And Religious Rituals With Potential Medical Risk, Ziad M. S. Arabi, Elwaleed A. Elhassan, Mubarak I. Abdalla, Mahfooz A. Farooqui, Atif A. Mateen, Saleh Kaysi, Syed A. Alam, Saif A. Khan, Mohamed F. Elmuzaini, Mourad M. Alsabbagh, Abdulrahman R. Altheaby

School of Medicine Publications

Muslim renal transplant recipients often ask their physicians if performing certain lifestyles or religious obligations may be harmful to their health. Permissibility as advised by an expert Muslim physician is considered as being religiously accepted. A cross-sectional, survey-based study was conducted enquiring what nephrologists would advise their transplant recipients to do, about some lifestyles and religious duties. Fifty-eight nephrologists responded to the survey. Of these, 77% routinely follow-up post-transplant patients; 34% were from Saudi Arabia, 18% from the USA, and 20% from Pakistan. Fifty-four percent of the respondents would let patients with stable graft function fast during Ramadan, while 20% …