Nephrotoxic serum nephritis

Various experimental procedures were described as models for glomerulonephritis in human beings. Most of them were developed in rats and rabbits. They involve the reactions of antibodies against renal components, such as Masugi nephritis (Masugi and Sato 1934), Heymann nephritis (Heymann 1959), nephrotoxic serum nephritis (Unanue and Dixon 1967), crescentic type anti-glomerular membrane nephritis (Nagoe et al. 1994, 1998), anti-Thyl nephritis (Chen etal. 1999). 

Nephrotoxic serum nephritis is produced in animals by administration of heterologous antibody against... 

Suzuki S, Gejyo F, Kuroda T et al. (1998) Effect of a new elas-tase inhibitor, ONO-5046, on nephrotoxic serum nephritis in rats. Kidney Intern 53 1291-1208... 

Scharschmidt, L., Miller, M., Holthofer, H., Sinha, A., Schlondorff, D., Gibbons, N., and Santiago, A. (1990) A Fish Oil Diet Preserves Renal Function in Nephrotoxic Serum Nephritis, J. Lab. Clin. Med. 115,405M-14. 

Al-Refaie FN, Wickens DG, Wonke B, Kontoghiorghes GJ, Hoffbrand AV (1992) Serum non-transferrin-bound iron in beta-thalassaemia major patients treated with desferrioxamine and LI. Br J Haematol 82 431-436 Alfrey AC, Froment DH, Hammond WS (1989) Role of iron in the tubulo-interstitial injury in nephrotoxic serum nephritis. Kidney Int 36 753-759... 

Fig. 1. Scheme for induction of murine crescentic nephritis. (NSS, normal sheep serum NTS, nephrotoxic serum sc, subcutaneous iv, intravenous.)... 

Lamivudine, a weak inhibitor of organic cation transport by renal tubule epithelial cells [70], has also not been associated with significant nephrotoxicity. Acute renal failure with eosinophilic interstitial nephritis was attributed to abaca vir in one patient with HIV infection who also had what appeared to be "classic" FSGS on renal biopsy [71]. The serum creatinine returned to baseline levels after treatment with prednisone and discontinuation of abacavir. 

Observational studies In a study of seven patients with lupus nephritis who failed on mycophenolate mofetil monotherapy, toxicity hmited the use of combination therapy with tacrolimus - - mycophenolate mofetil [84 ]. One patient achieved complete renal remission, and three achieved partial remission with reduced proteinuria. Four of seven patients stopped taking combination therapy because of diabetic ketoacidosis (n = 1), pneumonia ( = 1) and muscle pain (n = 2). Four patients had infectious complications, pneumonia (n = 2), herpes zoster (n = l), and septic arthritis ( = 1). There were no severe nephrotoxic adverse reactions, although there was a small increase in serum creatinine in two patients. 

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