NihonJinzoGakkaiShi.2013;55(4):567-73.[Acaseofcrescenticpoststreptococcalacuteglomerulonephritis(PSAGN)accompaniedbymembranousnephropathy].[ArticleinJapanese]MatsudaJ,NagayamaI,YamaguchiY,ItanoS,MoriD,ImakitaN,TakejiM,YamauchiA.SourceDepartmentofGeriatricMedicineandNephrology,OsakaUniversityGraduateSchoolofMedicine,Osaka,Tokyo.AbstractIn2010,a71-year-oldmanwasreferredtoourhospitalbecauseofmildproteinuriaandhematuria.Atthattime,hehadbeenasymptomatic.Threemonthslaterhenoticedmacroscopichematuria,followedbygeneralmalaise,andthenanorexia.Hewasadmittedforacutekidneyinjury(serumcreatinine2.7mg/dL),markedproteinuria(4.35g/gCr),andelevatedC-reactiveprotein(7.21mg/dL).Somevesicleswerenotedonthesoftpalate,andathroatcultureyieldedagrowthofgroupAbeta-hemolyticstreptococci.AntistreptolysinOandantistreptokinasetiterswereelevated,butserumcomplementlevelswerewithinnormallimits.Antineutrophilcytoplasmicantibodies(ANCA)directedagainstelastaseandbactericidalpermeabilityincreasingprotein(BPI)werepositive.Therenalfunctionandinflammationdidnotimprovedespiteoralantibiotictherapy.Pathologicalexaminationofarenalbiopsyspecimenrevealeddiffusecrescentformation,numeroussubepithelialdome-shapeddeposits(humps),andprominentendocapillaryproliferation.Furthermore,afocalandsegmentalspikeappearancewasseen,withdepositssmallerthanhumps.Therewasastrikingclinicalimprovementaftersteroidpulsetherapyfollowedbyoralprednisolone.ThefeaturesofthiscasestronglysuggestcrescenticPSAGNaccompaniedbypre-existingmembranousnephropathy.KidneyInt.2013Aug;84(2):366-72.doi:10.1038/ki.2013.55.Epub2013Feb27.Plasmasolubleurokinasereceptorlevelsareincreasedbutdonotdistinguishprimaryfromsecondaryfocalsegmentalglomerulosclerosis.HuangJ,LiuG,ZhangYM,CuiZ,WangF,LiuXJ,ChuR,ChenY,ZhaoMH.Source1]RenalDivision,PekingUniversityFirstHospital,Beijing,People'sRepublicofChina[2]InstituteofNephrology,PekingUniversity,Beijing,People'sRepublicofChina[3]KeyLaboratoryofRenalDisease,MinistryofHealthofChina,Beijing,People'sRepublicofChina[4]KeyLaboratoryofCKDPreventionandTreatment,MinistryofEducationofChina,Beijing,People'sRepublicofChina.AbstractInthisstudy,wemeasuredsolubleurokinasereceptorlevels,apossiblepermeabilityfactor,intheplasmaofpatientswithprimaryfocalsegmentalglomerulosclerosis(FSGS)anddeterminedtheirassociationwithclinicalandpathologicaldatain74patientswithprimaryFSGS.Healthydonorsandpatientswithminimalchangedisease,membranousnephropathy,andsecondaryFSGSwereusedascontrols.Theplasma-solubleurokinasereceptorlevels,measuredbycommercialELISAkits,ofpatientswithprimaryFSGS(median:2923,interquartilerange2205-4360pg/ml)weresignificantlyhigherthanthoseofpatientswithminimalchangedisease(median2050pg/ml),membranousnephropathy(median2029pg/ml),andnormalindividuals(median1739pg/ml).Therewasnosignificantdifferenceinplasma-solubleurokinasereceptorlevelsbetweenthe74patientswithprimaryand14patientswithsecondaryFSGS.Thesolubleurokinasereceptorlevelsincreasedintheorderoftipvariant,toanototherwisespecifiedvariantandacellularvariant.ThesolubleurokinasereceptorlevelsweresignificantlybutnegativelycorrelatedwithcreatinineclearanceatpresentationbutpositivelycorrelatedwithcrescentformationinpatientswithprimaryFSGS.Duringfollow-up,receptorlevelsdecreasedsignificantlyinpatientswithcompleteremission.Thus,plasma-solubleurokinasereceptorlevelsdidnotdifferentiateprimarya...