Suroj Supavekin

Renal outcome and risk factors for end‐stage renal disease in pediatric rapidly progressive glomerulonephritis

Rapidly progressive glomerulonephritis (RPGN), defined as acute nephritic syndrome with dramatic loss of renal function within a few months, is associated with crescentic glomerulonephritis (CresGN), which requires ≥50% crescents on pathology. The disease characteristics and renal outcome in children with RPGN, however, will differ according to the percentage of crescents.

Immune-mediated hemolytic anemia in pediatric renal transplantation.

Abstract:  The aim of the study was to demonstrate clinical course of the first reported cases of PLS in pediatric kidney transplantation and therapeutic outcome for such condition using a combination of high‐dose corticosteroid and tacrolimus. We report a single case (a nine‐year‐old Thai boy) with end‐stage kidney disease secondary to obstructive uropathy developed immune‐mediated hemolytic anemia from the PLS at second week after a pre‐emptive living‐related kidney transplantation. The alloimmune hemolysis was a result of anti‐B antibodies, derived from blood group O‐donor lymphocytes. Using a combination of high‐dose corticosteroid and a substitution of cyclosporin with tacrolimus, there was no further hemolysis although the anti‐B antibodies remained detectable until the eighth week post‐transplantation. An impairment of the graft function because of hemoglobinuria was resolved after the hemolysis was stopped. The alloimmune hemolysis caused by PLS in pediatric kidney transplantation could be controlled with a combination of high‐dose corticosteroid and tacrolimus.

Combined renin angiotensin blockade in childhood steroid-resistant nephrotic syndrome.

Background:  Reduced proteinuria results in delayed deterioration of renal function and remission of proteinuria predicts a good long‐term prognosis in steroid‐resistant nephrotic syndrome (SRNS). The aim of this study was to analyze the effects of the combined angiotensin‐converting enzyme inhibitor and angiotensin II receptor blocker in reducing proteinuria in SRNS.