2023
Thrombotic Microangiopathy and Acute Tubular Injury After Diethylene Glycol Ingestion: A Kidney Biopsy Teaching Case
Malvar G, Gunasekaran D, Mehr N, Ishibe S, Moeckel G. Thrombotic Microangiopathy and Acute Tubular Injury After Diethylene Glycol Ingestion: A Kidney Biopsy Teaching Case. Kidney Medicine 2023, 6: 100758. PMID: 38304581, PMCID: PMC10831151, DOI: 10.1016/j.xkme.2023.100758.Peer-Reviewed Original ResearchAcute tubular injuryThrombotic microangiopathyTubular injuryEndothelial injuryPossible life-threatening complicationsDirect toxic injuryIncidence of AKIInitial gastrointestinal symptomsLife-threatening complicationsTypical clinical courseDiethylene glycol poisoningPeripheral sensorimotor neuropathyHigh mortality rateDiethylene glycol ingestionGastrointestinal symptomsClinical courseKidney biopsyGlycol ingestionSensorimotor neuropathyGlycol poisoningPathological lesionsToxic injuryGenetic predispositionUnusual caseMortality rateIdentification and validation of urinary CXCL9 as a biomarker for diagnosis of acute interstitial nephritis
Moledina D, Obeid W, Smith R, Rosales I, Sise M, Moeckel G, Kashgarian M, Kuperman M, Campbell K, Lefferts S, Meliambro K, Bitzer M, Perazella M, Luciano R, Pober J, Cantley L, Colvin R, Wilson F, Parikh C. Identification and validation of urinary CXCL9 as a biomarker for diagnosis of acute interstitial nephritis. Journal Of Clinical Investigation 2023, 133: e168950. PMID: 37395276, PMCID: PMC10313360, DOI: 10.1172/jci168950.Peer-Reviewed Original ResearchConceptsUrinary CXCL9External validation cohortValidation cohortControl groupAIN diagnosisDiscovery cohortKidney tissueDiagnostic biomarkersAcute interstitial nephritisCXCL9 mRNA expressionAcute kidney injuryBiopsy-confirmed diagnosisAvailable clinical testsNational InstituteKidney injuryTubulointerstitial nephritisInterstitial nephritisKidney biopsyHistological confirmationHistological diagnosisTreatment optionsLymphocyte chemotaxisCXCL9MRNA expression differencesPatients
2019
Urine TNF-α and IL-9 for clinical diagnosis of acute interstitial nephritis
Moledina DG, Wilson FP, Pober JS, Perazella MA, Singh N, Luciano RL, Obeid W, Lin H, Kuperman M, Moeckel GW, Kashgarian M, Cantley LG, Parikh CR. Urine TNF-α and IL-9 for clinical diagnosis of acute interstitial nephritis. JCI Insight 2019, 4: e127456. PMID: 31092735, PMCID: PMC6542610, DOI: 10.1172/jci.insight.127456.Peer-Reviewed Original ResearchConceptsAcute interstitial nephritisAcute kidney diseasePrebiopsy diagnosisKidney biopsyKidney diseaseIL-9AIN diagnosisUrine TNFInterstitial nephritisSpecific T cell subsetsAcute tubular injuryDiabetic kidney diseaseIL-9 levelsTNF-α levelsT cell subsetsAddition of biomarkersPlasma cytokinesCytokine levelsTubular injuryHighest quartileMultivariable analysisCell subsetsUrinary TNFBlood eosinophilsGlomerular diseaseTelavancin-associated acute kidney injury.
Cavanaugh C, Moeckel GW, Perazella MA. Telavancin-associated acute kidney injury. Clinical Nephrology 2019, 91: 187-191. PMID: 30614441, DOI: 10.5414/cn109651.Peer-Reviewed Original ResearchConceptsAcute kidney injuryKidney injuryTubular injuryCases of AKIAcute interstitial nephritisProximal tubular injuryAcute tubular injuryHuman clinical trialsSelect infectionsInterstitial nephritisIntravenous therapyKidney biopsyKidney histopathologyHistologic changesClinical trialsHistopathologic descriptionAnimal modelsLysosomal proliferationTelavancinInjurySemi-synthetic derivativesNumerous phagolysosomesStaphylococciGram-positive bacteriaNephritisUpdate on the Native Kidney Biopsy: Core Curriculum 2019
Luciano RL, Moeckel GW. Update on the Native Kidney Biopsy: Core Curriculum 2019. American Journal Of Kidney Diseases 2019, 73: 404-415. PMID: 30661724, DOI: 10.1053/j.ajkd.2018.10.011.BooksConceptsKidney biopsyKidney diseaseCore Curriculum 2019Arteriovenous fistula formationNative kidney biopsiesPercutaneous kidney biopsyKidney biopsy procedureReal-time ultrasoundGross hematuriaPerinephric hematomaFistula formationPotential complicationsLower riskBiopsyBiopsy procedureGenetic testingSpecific procedural aspectsGold standardDiseaseComplicationsSimple light microscopyPreferred methodLight microscopyTomographic imagingHematuria
2018
Pathologic Perspectives on Acute Tubular Injury Assessment in the Kidney Biopsy
Moeckel GW. Pathologic Perspectives on Acute Tubular Injury Assessment in the Kidney Biopsy. Seminars In Nephrology 2018, 38: 21-30. PMID: 29291758, DOI: 10.1016/j.semnephrol.2017.09.003.Peer-Reviewed Original ResearchConceptsAcute tubular injuryKidney biopsy analysisRenal pathology laboratoryTissue injury markersClinical time courseCell injury pathwaysTime courseNephrologists' managementInjury markersTubular injuryTubular lesionsKidney biopsyPathophysiological mechanismsTreatment modalitiesPatient managementDrug choiceEtiologic mechanismsInjury pathwaysToxic injuryPathologic perspectiveToxic etiologyBiopsy samplesClinical practiceBiopsy analysisPathology practice
2017
Severe Orthostatic Hypotension Complicating Multiple Myeloma
Sury K, Mutter M, Moeckel G, Perazella M. Severe Orthostatic Hypotension Complicating Multiple Myeloma. Journal Of Onco-Nephrology 2017, 1: e8-e12. DOI: 10.5301/jo-n.5000029.Peer-Reviewed Original ResearchRenal replacement therapySevere hemodynamic instabilityVascular amyloidosisMultiple myelomaOrthostatic hypotensionHemodynamic instabilityReplacement therapyContinuous veno-venous hemodialysisSevere orthostatic hypotensionAcute kidney injuryMaximal medical therapyFatal cardiac arrestGlomerular amyloidosisKidney injuryUrinary findingsPersistent symptomsKidney biopsyMedical therapyKidney functionCardiac arrestMultiple fallsRenal amyloidosisTreatment challengesClinical aspectsAmyloidosis
2015
Comparison of amyloid deposition in human kidney biopsies as predictor of poor patient outcome
Castano E, Palmer MB, Vigneault C, Luciano R, Wong S, Moeckel G. Comparison of amyloid deposition in human kidney biopsies as predictor of poor patient outcome. BMC Nephrology 2015, 16: 64. PMID: 25924613, PMCID: PMC4424547, DOI: 10.1186/s12882-015-0046-0.Peer-Reviewed Original ResearchConceptsEnd-stage renal diseaseAmyloid depositionPatient outcomesAmyloid depositsBiopsy-proven renal amyloidosisHistological localizationHigher serum creatinineInterstitial inflammatory infiltrateStage renal diseaseUrine protein levelsGlomerular amyloid depositionGlomerular amyloid depositsPoor patient outcomesGlomerular capillary loopsHuman kidney biopsiesDifferent study groupsStudent's t-testGlomerular amyloidosisOverall survivalSerum creatinineVascular amyloidosisKidney biopsyRenal diseaseInflammatory infiltrateClinical parameters
2013
Cytomegalovirus Glomerulopathy and Cytomegalovirus Interstitial Nephritis on Sequential Transplant Kidney Biopsies
Vichot AA, Formica RN, Moeckel GW. Cytomegalovirus Glomerulopathy and Cytomegalovirus Interstitial Nephritis on Sequential Transplant Kidney Biopsies. American Journal Of Kidney Diseases 2013, 63: 536-539. PMID: 24568687, PMCID: PMC7210789, DOI: 10.1053/j.ajkd.2013.08.021.Peer-Reviewed Original ResearchConceptsSecond biopsy specimenBiopsy specimenCMV infectionInterstitial nephritisKidney biopsyKidney transplant biopsy specimensEndothelial cellsCMV-negative patientsCMV-positive cellsCMV-positive donorsFirst biopsy specimenKidney transplant graftsSequential kidney biopsiesTransplant biopsy specimensTransplant kidney biopsiesGlomerular capillary endothelial cellsTubular epithelial cellsGlomerular capillary loopsGlomerular capillary luminaCapillary endothelial cellsCytoplasmic viral particlesKidney transplantTubular injuryLymphoplasmacytic infiltrateTransplant graftsAcute kidney injury in a patient with sarcoidosis: hypercalciuria and hypercalcemia leading to calcium phosphate deposition.
Manjunath V, Moeckel G, Dahl NK. Acute kidney injury in a patient with sarcoidosis: hypercalciuria and hypercalcemia leading to calcium phosphate deposition. Clinical Nephrology 2013, 80: 151-5. PMID: 23845267, DOI: 10.5414/cn107258.Peer-Reviewed Original ResearchConceptsAcute kidney injuryAcute tubular necrosisKidney injuryOH vitamin D levelsVitamin D levelsCalcium oxalate nephrolithiasisRenal functionTubular necrosisKidney biopsyKidney functionCalcium phosphate depositionD levelsGiant cell formationOxalate nephrolithiasisSarcoidosisRandall's plaqueHypercalcemiaHypercalciuriaPatientsInjuryPhosphate depositionPlaquesCell formationCalcium phosphate crystalsDifferent mechanismsBabesiosis-Induced Acute Kidney Injury With Prominent Urinary Macrophages
Luciano RL, Moeckel G, Palmer M, Perazella MA. Babesiosis-Induced Acute Kidney Injury With Prominent Urinary Macrophages. American Journal Of Kidney Diseases 2013, 62: 801-805. PMID: 23643302, DOI: 10.1053/j.ajkd.2013.02.376.Peer-Reviewed Case Reports and Technical NotesConceptsAcute kidney injuryAcute tubular injuryKidney injuryTubular injuryDialysis-requiring acute kidney injuryAcute interstitial nephritisMultiorgan system failureSubsequent kidney biopsySevere symptomatic diseaseUrinary macrophagesUrinary findingsInterstitial nephritisKidney biopsySymptomatic diseaseMassive hemolysisSevere babesiosisVolume depletionCommon causeProfound hemolysisErythrocyte fragmentsUrine sedimentInjuryLarge macrophagesPigment toxicityUnique findingA 7-year-old boy with renal insufficiency and proteinuria after stem cell transplant for T-cell acute lymphoblastic leukemia
Goodwin JE, Palmer M, Pashankar F, Tufro A, Moeckel G. A 7-year-old boy with renal insufficiency and proteinuria after stem cell transplant for T-cell acute lymphoblastic leukemia. Clinical Nephrology 2013, 82: 205-210. PMID: 23391318, PMCID: PMC6990651, DOI: 10.5414/cn107767.Peer-Reviewed Original ResearchConceptsStem cell transplantHematopoietic stem cell transplantCell transplantRenal insufficiencyKidney biopsyPediatric patientsNephrotic syndromeExtensive foot process effacementAbnormal lymphocyte responsesT-cell acute lymphoblastic leukemiaChronic kidney diseaseChronic interstitial nephritisAcute lymphoblastic leukemiaPre-conditioning regimensFoot process effacementHost diseaseImmunosuppressive therapyRenal failureInterstitial nephritisLymphocyte responsesCommon sequelaeInterstitial infiltratesProphylactic medicationKidney diseaseLikely multifactorial