Российское диализное общество

Просмотр статьи

<< Вернуться к списку статей журнала

Том 23 №2 2021 год - Нефрология и диализ

Современные представления о первичном фокальном сегментарном гломерулосклерозе у взрослых: патогенез и подходы к лечению. Обзор литературы


Чеботарева Н.В. Лысенко Л.В.

DOI: 10.28996/2618-9801-2021-2-160-173

Аннотация: Введение: первичный фокальный сегментарный гломерулосклероз является морфологическим вариантом нефропатии, в основе которой лежит повреждение подоцитов. Патогенез первичного ФСГС изучается с 90-х годов, однако полностью не расшифрован до настоящего времени. Вместе с тем, накоплено большое количество данных, позволяющих сформулировать определенную концепцию развития заболевания. Цель настоящего обзора представить современный взгляд на патогенез и подходы к терапии первичного ФСГС у взрослых. Основные сведения: в обзоре представлен современный взгляд на патогенез первичного фокального сегментарного гломерулосклероза. Обсуждается роль подоцитов и париетальных эпителиальных клеток в формировании очагов склероза и прогрессировании заболевания. Особое внимание уделено предполагаемым молекулам-кандидатам на роль циркулирующих факторов проницаемости: растворимого рецептора активатора плазминогена (suPAR), кардиотрофин-подобного фактора-1 (CLCF-1), CD80 (B7-1) и механизмам их действия. Повышенный уровень этих факторов выявляют в сыворотке крови и на поверхности подоцитов у больных ФСГС. Согласно современной концепции, патогенез первичного ФСГС связан с нарушением адаптивного иммунного ответа. Представлены данные о том, что дисбаланс определенных Т-клеточных подклассов участвует в патогенезе заболевания. Повышение Th17 лимфоцитов и снижение количества Т-регуляторных клеток может оказаться решающим для развития первичного ФСГС. Имеет также значение активация В-клеток, о чем свидетельствуют непосредственное влияние В-лимфоцитов на развитие протеинурии, выявление циркулирующих антител и эффективность применения ритуксимаба у больных с ФСГС. Обсуждается возможная роль анти-CD40-антител и антител к убиквитин карбоксильной гидролазе L1 в развитии первичного ФСГС. Прямо или через продукцию факторов проницаемости эти механизмы ведут к повреждению подоцитов. В отдельном разделе представлен алгоритм иммуносупрессивной терапии: глюкокортикостероидов и цитостатиков. Рассмотрены перспективы терапии ФСГС с учетом предполагаемых патогенетических механизмов заболевания.

Весь текст

Ключевые слова: фокальный сегментарный гломерулосклероз, факторы проницаемости, нефротический синдром, лечение, focal segmental glomerulosclerosis, permeability factors, nephrotic syndrome, treatment

Список литературы:
  1. Sethi S., Glassock R.J., Fervenza F.C. Focal segmental glomerulosclerosis: towards a better understanding for the practicing nephrologist. Nephrol Dial Transplant. 2015; 30(3):375-84
  2. D'Agati V. Pathologic classification of focal segmental glomerulosclerosis. Semin Nephrol 2003; 23:117.
  3. Abdi R, Dong VM, Rubel JR, et al. Correlation between glomerular size and long-term renal function in patients with substantial loss of renal mass. J Urol 2003; 170:42.
  4. D'Agati VD, Chagnac A, de Vries AP, et al. Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016; 12:453.
  5. Cunningham EE, Zielezny MA, Venuto RC. Heroin-associated nephropathy. A nationwide problem. JAMA 1983; 250:2935.
  6. Barri YM, Munshi NC, Sukumalchantra S, et al. Podocyte injury associated glomerulopathies induced by pamidronate. Kidney Int 2004; 65:634.
  7. Dressler D, Wright JR, Houghton JB, Kalra PA. Another case of focal segmental glomerulosclerosis in an acutely uraemic patient following interferon therapy. Nephrol Dial Transplant 1999; 14:2049.
  8. Herlitz LC, Markowitz GS, Farris AB, et al. Development of focal segmental glomerulosclerosis after anabolic steroid abuse. J Am Soc Nephrol 2010; 21:163.
  9. Santella RN, Rimmer JM, MacPherson BR. Focal segmental glomerulosclerosis in patients receiving lithium carbonate. Am J Med 1988; 84:951.
  10. Mohamed N, Goldstein J, Schiff J, John R. Collapsing glomerulopathy following anthracycline therapy. Am J Kidney Dis 2013; 61:778.
  11. Meehan SM, Pascual M, Williams WW, et al. De novo collapsing glomerulopathy in renal allografts. Transplantation 1998; 65:1192.
  12. Izzedine H, Brocheriou I, Frances C. Post-transplantation proteinuria and sirolimus. N Engl J Med 2005; 353:2088.
  13. Malone AF, Phelan PJ, Hall G, et al. Rare hereditary COL4A3/COL4A4 variants may be mistaken for familial focal segmental glomerulosclerosis. Kidney Int 2014; 86:1253.
  14. Hinkes BG, Mucha B, Vlangos CN, et al. Nephrotic syndrome in the first year of life: two thirds of cases are caused by mutations in 4 genes (NPHS1, NPHS2, WT1, and LAMB2). Pediatrics 2007; 119:e907.
  15. Boyer O, Benoit G, Gribouval O, et al. Mutations in INF2 are a major cause of autosomal dominant focal segmental glomerulosclerosis. J Am Soc Nephrol 2011; 22:239.
  16. Haas M, Meehan SM, Karrison TG, Spargo BH. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976-1979 and 1995-1997. Am J Kidney Dis 1997; 30:621.
  17. Rivera F, López-Gómez JM, Pérez-García R, Spanish Registry of Glomerulonephritis. Clinicopathologic correlations of renal pathology in Spain. Kidney Int 2004; 66:898
  18. Hommos M.S., De Vriese A.S., Alexander M.P., Sethi S., Vaughan L., Zand L., et al. The incidence of primary vs secondary focal segmental glomerulosclerosis: a clinicopathologic study. Mayo Clin Proc. 2017;92(12):1772-81.
  19. Kitiyakara C, Eggers P, Kopp JB. Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United States. Am J Kidney Dis 2004; 44:815
  20. Yao T, Udwan K, John R, et al. Integration of Genetic Testing and Pathology for the Diagnosis of Adults with FSGS. Clin J Am Soc Nephrol 2019; 14:213.
  21. Yamaguchi Y, Iwano M, Suzuki D. et al. Epithelial-mesenchymal transition as a potential explanation for podocyte depletion in diabetic nephropathy. Am J Kidney Dis. 2009;54:653-664.
  22. Reidy K., Susztak K. Epithelial-mesenchymal transition and podocyte loss in diabetic kidney disease. Am J Kidney Dis. 2009;54:590-593.
  23. Kriz W. Progressive renal failure-Inability of podocytes to replicate and the consequences for development of glomerulosclerosis. Nephrol Dial Transplant. 1996;11:1738-1742.
  24. Lemley K.V., Lafayette A., Safai G., et al. Podocytopenia and disease severity in IgA nephropathy. Kidney Int. 2002; 61: 1475-1485
  25. Smeets B., Kuppe C., Sicking E-M., et al. Parietal Epithelial Cells Participate in the Formation of Sclerotic Lesions in Focal Segmental Glomerulosclerosis. J Am Soc Nephrol. 201; 22(7): 1262-1274.
  26. Kuppe C, Leuchtle K, Wagner A, et al. Novel parietal epithelial cell subpopulations contribute to focal segmental glomerulosclerosis and glomerular tip lesions. Kidney International. 2019; 96; 80-93. https://doi.org/10.1016/j.kint.2019.01.037
  27. Fatima H., Moeller M.J., Smeets B., et al. Parietal Epithelial Cell Activation Marker in Early Recurrence of FSGS in the Transplant. Clin J Am Soc Nephrol. 2012; 7(11): 1852-1858.
  28. Roeder S.S., Barnes T.J., Lee J.S. et al. Activated ERK1/2 increases CD44 in glomerular parietal epithelial cells leading to matrix expansion. Kidney Int. 2017;91(4):896-913. doi: 10.1016/j.kint.2016.10.015.
  29. Shalhoub J.R. Pathogenesis of lipoid nephrosis: a disorder of T-cell function. Lancet. 1974 Sep 7;2(7880):556-60. doi: 10.1016/s0140-6736(74)91880-7.
  30. Savin V.S., Sharma R., Sharma M., et al. Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis. N Engl J Med. 1996;334:878-883 doi: 10.1056/NEJM199604043341402
  31. Feld S.M., Figueroa P., Savin V. Plasmapheresis in the treatment of steroid-resistant focal segmental glomerulosclerosis in native kidneys. Am J Kidney Dis. 1998;32: 230-7
  32. Gallon L., Leventhal J., Skaro A., et al. Resolution of recurrent focal segmental glomerulosclerosis after retransplantation. N Engl J Med.2012; 366:1648-1649
  33. Kashgary A., Sontrop J.M., Li L., et al. The role of plasma exchange in treating post-transplant focal segmental glomerulosclerosis: A systematic review and meta-analysis of 77 case-reports and case-series. BMC Nephrology. 2016; 17 (104)
  34. Wei C., Möller C.C., Altintas M.M., et al. Modification of kidney barrier function by the urokinase receptor. Nat Med. 2008;14(1):55-63. doi: 10.1038/nm1696
  35. Wei C., Hindi S.E., Li J., et al. Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med. 2011;17(8):952-60. doi: 10.1038/nm.2411
  36. Bock M.E., Price H.E., Gallon L., Langman C.B. Serum soluble urokinase-type plasminogen activator receptor levels and idiopathic FSGS in children: a single-center report. Clin J Am Soc Nephrol.2013; 8:1304-11
  37. Cara-Fuentes G., Wei C., Segarra A., et al. CD80 and suPAR in patients with minimal change disease and focal segmental glomerulosclerosis: diagnostic and pathogenic significance. Pediatr Nephrol. 2014; 29:1363-71.
  38. Peng Z., Mao J., Chen X., et al. Serum suPAR levels help differentiate steroid resistance from steroid-sensitive nephrotic syndrome in children. Pediatric Nephrology. 2015; 30:301-7.
  39. Spinale J.M., Mariani L.H., Kapoor S., et al. A reassessment of soluble urokinase-type plasminogen activator receptor in glomerular disease. Kidney Int. 2015;87(3):564-74. doi: 10.1038/ki.2014.346
  40. Huang J, Liu G, Zhang Y-M, Cui Z, Wang F, Liu X-J, Chu R, Chen Y, Zhao M-H. Plasma soluble urokinase receptor levels are increased but do not distinguish primary from secondary focal segmental glomerulosclerosis. Kidney International. 2013; 84(2):366-372
  41. Delville M., Sigdel T.K., Wei C., et al. A circulating antibody panel for pretransplant prediction of FSGS recurrence after kidney transplantation. Sci Transl Med. 2014; 6(256):256ra136.doi: 10.1126/scitranslmed.3008538
  42. Savin V.J., Sharma M., Zhou J., et al. Renal and Hematological Effects of CLCF-1, a B-Cell-Stimulating Cytokine of the IL-6 Family. J Immunol Res.2015; 2015: 714964
  43. Sharma M., Zhou J., Gauchat J-F., et al. JAK2/STAT3 Inhibitors Attenuate the Effect of Cardiotrophin-Like Cytokine Factor-1 and Human Focal Segmental Glomerulosclerosis Serum on Glomerular Filtration Barrier. Transl Res.2015; 166(4): 384-398.
  44. Ha T-S. Circulating Permeability Factors in Idiopathic Nephrotic Syndrome. Child Kidney Dis. 2019; 23(1): 7-21.
  45. Reiser J, Nast C.C., Alachkar N. Permeability Factors in Focal and Segmental Glomerulosclerosis. Adv Chronic Kidney Dis. 2014; 21(5): 417-421.
  46. Jaiswal A, Prasad N, Agarwal V, Yadav B, Tripathy D, Rai M, Nath M, Sharma RK, Modi DR. Regulatory and effector T cells changes in remission and resistant state of childhood nephrotic syndrome. Indian J Nephrol. 2014; 24(6): 349-355.
  47. Cunard R, Kelly CJ. T Cells and Minimal Change Disease. ASN. 2002; 13 (5): 1409-1411
  48. Chen P, Chen Y, Jiang M, Mo Y, Ying H, Tang X, Zhang J. 2020. Usefulness of the cytokines expression ofTh1/Th2/Th17 and urinary CD80 excretion in adult-onset minimal change disease.PeerJ8:e985.
  49. Stangou M, Spartalis M, Daikidou D-V., et al. Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental glomerulosclerosis and minimal change disease. J Nephropathol. 2017; 6(3): 187-195.
  50. Hulton S.-A., Shah V., Byrne M. R., et al. Lymphocyte subpopulations, interleukin-2 and interleukin-2 receptor expression in childhood nephrotic syndrome. Pediatric Nephrology. 1994;8(2):135-139. doi: 10.1007/bf00865458.
  51. Wang L., Li Q., Wang L. et al. The Role of Th17/IL-17 in the Pathogenesis of Primary Nephrotic Syndrome in Children. Kidney Blood Press Res. 2013;37:332-345
  52. Чеботарева НВ, Виноградов АА, Гиндис АА, Бобкова ИН, Цао В, Лысенко ЛВ. Нарушение баланса провоспалительных цитокинов и Т-регуляторных клеток у больных хроническим гломерулонефритом. Терапевтический архив 2020;92(6):46-52. doi: 10.26442/00403660.2020.06.000671
  53. Boumediene A., Vachin P., Sendeyo K., et al. NEPHRUTIX: A randomized, double-blind, placebo vs Rituximab-controlled trial assessing T-cell subset changes in Minimal Change Nephrotic Syndrome. J Autoimmun. 2018;88:91-102.
  54. Gizinski A.M., Fox D.A., Sarkar S. Costimulation and T cells as therapeutic targets. Best Pract Res Clin Rheumatol. 2010; 24(4): 463-477. doi: 10.1016/j.berh.2009.12.015
  55. Shimada M., Araya C., Rivard C., et al. Minimal change disease: a "two-hit" podocyte immune disorder? Pediatr Nephrol. 2011;26(4):645-649.
  56. Yu C-C., Fornoni A., Astrid Weins A., et al. Abatacept in B7-1-Positive Proteinuric Kidney Disease. N Engl J Med. 2013; 369:2416-2423. DOI: 10.1056/NEJMoa1304572
  57. Hansrivijit P, Cheungpasitporn W, Thongprayoon C, Ghahramani N. Rituximab therapy for focal segmental glomerulosclerosis and minimal change disease in adults: a systematic review and meta-analysis. BMC Nephrol. 2020;21(1):134. doi: 10.1186/s12882-020-01797-7. PMID: 32293308; PMCID: PMC7160971
  58. Kim A.H.J, Chung J-J., Akilesh S., et al. B cell-derived IL-4 acts on podocytes to induce proteinuria and foot process effacement. JCI Insight. 2017; 2(21): e81836.
  59. Jamin A., Berthelot L., Couderc A., et al. Autoantibodies against podocytic UCHL1 are associated with idiopathic nephrotic syndrome relapses and induce proteinuria in mice. J Autoimmun. 2018;89:149-161. doi: 10.1016/j.jaut.2017.12.014.
  60. Wang Y., Zheng C., Wang X., et al. Proteomic profile based screening of potential protein biomarkers in the urine of patients with nephrotic syndrome. Molecular Medicine reports. 2017; 22: 6276-6284. https://doi.org/10.3892/mmr.2017.7329
  61. Gauckler P, Shin JI, Albericie F, Audard V, Bruchfeld A, Busch M et al. Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown? Autoimmunity Reviews. 2020; 19 (11): 102671
  62. Troyanov S., Wall C.A., Miller J.A., et al. Focal and Segmental Glomerulosclerosis: Definition and Relevance of a Partial RemissionJ Am Soc Nephrol. 2005; 16:1061.
  63. Rydel JJ, Korbet SM, Borok RZ, Schwartz MM. Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment. Am J Kidney Dis 1995; 25:534.
  64. Stirling CM, Mathieson P, Boulton-Jones JM, et al. Treatment and outcome of adult patients with primary focal segmental glomerulosclerosis in five UK renal units. QJM 2005; 98:443.
  65. KDIGO Clinical Practice Guideline for Glomerulonephritis. Kidney International Supplements. 2012; 2 (2)
  66. Ponticelli C., Villa M., Banfi G., et al. Can prolonged treatment improve the prognosis in adults with focal segmental glomerulosclerosis? American Journal of Kidney Diseases.1999; 34: 618-625
  67. Laurin L.P., Gasim A.M., Poulton C.J.et al.Treatment with Glucocorticoids or Calcineurin Inhibitors in Primary FSGS. Clin J Am Soc Nephrol. 2016;11(3):386-94. doi: 10.2215/CJN.07110615
  68. Duncan N., Dhaygude A., Owen J., et al. Treatment of focal and segmental glomerulosclerosis in adults with tacrolimus monotherapy. Nephrol Dial Transplant. 2004;19(12):3062-3067.
  69. Cattran D.C., Appel G.B., Hebert L.A., et al. A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis. Kidney International. 1999; 56: 2220-2226
  70. Ramachandran R., Kumar V., Rathi M., et al. Tacrolimus therapy in adult-onset steroid-resistant nephrotic syndrome due to a focal segmental glomerulosclerosis single-center experience. Nephrol Dial Transplant.2014;29: 1918-1924 doi: 10.1093/ndt/gfu097
  71. Beer A., Mayer G., Kronbichler A. Treatment Strategies of Adult Primary Focal Segmental Glomerulosclerosis: A Systematic Review Focusing on the Last Two Decades. Biomed Res Int. 2016;2016:4192578.
  72. Ren H., Shen P., Li X., et al. Tacrolimus versus cyclophosphamide in steroid-dependent or steroid-resistant focal segmental glomerulosclerosis: a randomized controlled trial. Am J Nephrol. 2013;37(1):84-90.
  73. Iijima K, Sako M, Nozu K, Mori R, Tuchida N, Kamei K et al. Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2014 Oct 4;384(9950):1273-81
  74. Hansrivijit P, Cheungpasitporn W, Thongprayoon C, Ghahramani N. Rituximab therapy for focal segmental glomerulosclerosis and minimal change disease in adults: a systematic review and meta-analysis. BMC Nephrol. 2020;21(1):134. doi: 10.1186/s12882-020-01797-7.
  75. Radhakrishnan J, Cattran DC. The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines-application to the individual patient. Kidney Int. 2012;82(8):840-856.
  76. Sandoval D, Poveda R, Draibe J, Pérez-Oller L, Díaz M, Ballarín J et al. Efficacy of mycophenolate treatment in adults with steroid-dependent/frequently relapsing idiopathic nephrotic syndrome. Clin Kidney J. 2017 Oct; 10(5): 632-638
  77. Beaudreuil S., Lorenzo H.K., Elias M., et al. Optimal management of primary focal segmental glomerulosclerosis in adults. Int J Nephrol Renovasc Dis. 2017;10:97-107
  78. Gipson D. Clinical Trials in FSGS: Past Challenges and New Trial Designs. Semin Nephrol. 2016;36(6):453-459
  79. Zagury A., de Oliveira A.L.; Montalvão J.A.A., et al. Steroid-resistant idiopathic nephrotic syndrome in children: long-term follow-up and risk factors for end-stage renal disease J. Bras. Nefrol. 2013; 35(3) https://doi.org/10.5935/0101-2800.20130031
  80. Ponticelli C., Rizzoni G., Edefonti A., et al. A randomized trial of cyclosporine in steroid-resistant idiopathic nephrotic syndrome. Kidney Int,1993; 43: 1377-1384
  81. Meyrier A., Noël L.H., Auriche P., et al. Long-term renal tolerance of cyclosporine A treatment in adult idiopathic nephrotic syndrome. Collaborative Group of the Société de Néphrologie. Kidney Int. 1994; 45: 1446-1456
  82. Gipson D.S., Trachtman H., Kaskel F.J., et al. Clinical trial of focal segmental glomerulosclerosis in children and young adults. Kidney Int. 2011; 80: 868-878
  83. Segarra A., Vila J., Pou L., et al. Combined therapy of Tacrolimus and corticosteroids in cyclosporin-resistant or -dependent idiopathic focal glomerulosclerosis: a preliminary uncontrolled study with prospective follow-up. Nephrol Dial Transpl. 2002; 17: 655-662
  84. Li X., Li H., Ye H., et al. Tacrolimus therapy in adults with steroid- and cyclophosphamide-resistant nephrotic syndrome and normal or mildly reduced GFR. Am J Kidney Dis. 2009; 54: 51-58
  85. Nayagam L.S., Ganguli A., Rathi M., et al. Mycophenolate mofetil or standard therapy for membranous nephropathy and focal segmental glomerulosclerosis: a pilot study. Nephrology Dialysis Transplantation. 2008;23 (6):1926-1930, https://doi.org/10.1093/ndt/gfm538
  86. Ren H., Shen P., Li X., et al. Tacrolimus versus cyclophosphamide in steroid-dependent or steroid-resistant focal segmental glomerulosclerosis: a randomized controlled trial. Am J Nephrol. 2013;37(1):84-90.
  87. Fornoni A., Sageshima J., Wei C., et al. Rituximab targets podocytes in recurrent focal segmental glomerulosclerosis. Sci Transl Med. 2011;3(85):85ra46. doi: 10.1126/scitranslmed.3002231.
  88. Fernandez-Fresnedo G., Segarra A., González E., et al. Rituximab treatment of adult patients with steroid-resistant focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2009;4(8):1317-23. doi: 10.2215/CJN.00570109
  89. Colliou E, Karras A, Boffa JJ, et al. Outcomes of Older Patients (>/=60 years) with New-Onset Idiopathic Nephrotic Syndrome Receiving Immunosuppressive Regimen: A Multicentre Study of 116 Patients. J Clin Med. 2019 Mar; 8(3): 298.
  90. Ramachandran R, Bharati J, Rao I, et al. Persistent CD-19 depletion by rituximab is cost-effective in maintaining remission in calcineurin-inhibitor dependent podocytopathy. Nephrology (Carlton). 2019;24(12):1241-1247
  91. Чеботарева Н.В., Кучиева А.М., Ли О.А. и соавт. Опыт применения ритуксимаба при резистентном к терапии фокально-сегментарном гломерулосклерозе у взрослых: серия наблюдений и краткий обзор литературы. Нефрология. 2020;24(2):52-59. https://doi.org/10.36485/1561-6274-2020-24-2-52-59
  92. Bazu B. Ofatumumab for rituximab-resistant nephrotic syndromeN Engl J Med. 2014;370(13):1268-70. doi: 10.1056/NEJMc1308488.
  93. Alachkar N., Carter-Monroe N., Reiser J. Abatacept in B7-1-positive proteinuric kidney disease. N Engl J Med. 2014;370:1263-1264.
  94. Garin E.H., Reiser J., Cara-Fuentes G., et al. Case series: CTLA4-IgG1 therapy in minimal change disease and focal segmental glomerulosclerosis. Pediatr Nephrol. 2015;30: 469-477.
  95. Alkandari O., Nampoory N., Nair P., et al. Recurrent focal segmental glomerulosclerosis and abatacept: case report. Exp Clin Transplant. 2016;14: 456-459.
  96. Grellier J., Del Bello A., Milongo D., et al. Belatacept in recurrent focal segmental glomerulosclerosis after kidney transplantation. Transplant International. 2015;28: 1109-1110. doi:10.1111/tri.12574
  97. Trachtman H, Vento S, Herreshoff E, Radeva M, Gassman J, T. Stein DT et al. Efficacy of galactose and adalimumab in patients with resistant focal segmental glomerulosclerosis: report of the font clinical trial group. BMC Nephrol. 2015;16, 111.
  98. Dose-Exploration Evaluating the Efficacy and Safety of Voclosporin in Subjects With Focal Segmental Glomerulosclerosis (AURONA™) https://www.clinicaltrials.gov/ct2/show/NCT03598036
  99. Rovin BH, Solomons N, Pendergraft WF, Dooley MA, Tumlin J, Romero-Diaz J et al. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis. Kidney Int. 2019 Jan;95(1):219-231.doi: 10.1016/j.kint.2018.08.025
  100. Trachtman H, Nelson P, Adler S, Campbell KN, Chaudhuri A, Derebail VK et al. DUET: A Phase 2 Study Evaluating the Efficacy and Safety of Sparsentan in Patients with FSGS. J Am Soc Nephrol. 2018 Nov;29(11):2745-2754
  101. Mitwalli A.H. Adding plasmapheresis to corticosteroids and alkylating agents: Does it benefit patients with focal segmental glomerulosclerosis? Nephrol Dial Transplant.1998;13:1524-1528
  102. Merscher S, Pedigo CE, Mendez AJ. Metabolism, energetics, and lipid biology in the podocyte - cellular cholesterol-mediated glomerular injury. Front. Endocrinol. 2014 https://doi.org/10.3389/fendo.2014.00169
  103. Pei K, Gui T, Li C, Zhang Q, Feng H, Li Y, Wu J, Gai Z. Recent Progress on Lipid Intake and Chronic Kidney Disease. BioMed Research International. 2020 https://doi.org/10.1155/2020/3680397
  104. Knisel W, Di Nicuolo A, Pfohl M, Müller H, Risler T, Eggstein M, Seifried E. Different effects of two methods of low-density lipoprotein apheresis on the coagulation and fibrinolytic systems. J Intern Med. 1993;234:479-487
  105. Tasaki H, Tsuda Y, Yamashita K, Toyokawa T, Yashiro A, Osajima A, Nakashima Y, Kuroiwa A. Removal of plasma fibrinogen by LDL apheresis. Jpn J Apheresis. 1997;16:263
  106. Muso E.,Mune M., Tsutomu Hirano T., et al. A Prospective Observational Survey on the Long-Term Effect of LDL Apheresis on Drug-Resistant Nephrotic Syndrome. Nephron Extra. 2015; 5(2): 58-66.
  107. Raina R., Krishnappa V., Sanchez-Kazi C., et al. Dextran-Sulfate Plasma Adsorption Lipoprotein Apheresis in Drug Resistant Primary Focal Segmental Glomerulosclerosis Patients: Results From a Prospective, Multicenter, Single-Arm Intervention Study. Front Pediatr. 2019; 7: 454.
  108. Jefferson J.A., Shankland S J. The pathogenesis of focal segmental glomerulosclerosis. Adv Chronic Kidney Dis. 2014 Sep; 21(5): 408-416.

Другие статьи по теме


Навигация по статьям
Разделы журнала
Наиболее читаемые статьи
Журнал "Нефрология и диализ"