1.To treat or not to treat: CUBN-associated persistent proteinuria
Yun Young CHOI ; Yo Han AHN ; Eujin PARK ; Ji Hyun KIM ; Hee Gyung KANG ; Hyun Kyung LEE
Kidney Research and Clinical Practice 2024;43(5):663-670
Persistent proteinuria is an important indicator of kidney damage and requires active evaluation and intervention. However, tubular proteinuria of genetic origin typically does not improve with immunosuppression or antiproteinuric treatment. Recently, defects in CUBN were found to cause isolated proteinuria (mainly albuminuria) due to defective tubular albumin reuptake. Unlike most other genetically caused persistent albuminuria, CUBN C-terminal variants have a benign course without progression to chronic kidney disease according to the literature. Here, we present Korean cases with persistent proteinuria associated with C-terminal variants of CUBN. Methods: We identified Korean patients with CUBN variants among those with an identified genetic cause of proteinuria and evaluated their clinical features and clinical course. We also reviewed the literature on CUBN-associated isolated proteinuria published to date and compared it with Korean patients. Results: All patients presented with incidentally found, asymptomatic isolated proteinuria at a median age of 5 years. The proteinuria was in the subnephrotic range and did not significantly change over time, regardless of renin- angiotensin system inhibition. Initial physical examination, laboratory findings, and kidney biopsy results, when available, were unremarkable other than significant proteinuria. All patients maintained kidney function throughout the follow-up duration. All patients had at least one splicing mutation, and most of the variants were located C-terminal side of the gene. Conclusion: We report Korean experience of CUBN-related benign proteinuria, that aligns with previous reports, indicating that this condition should be considered in cases with incidentally found asymptomatic isolated proteinuria, especially in young children.
2.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
3.Asymptomatic hematuria in children: Korean Society of Pediatric Nephrology recommendations for diagnosis and management
Eujin PARK ; Sang Woon KIM ; Su Jin KIM ; Minki BAEK ; Yo Han AHN ; Eun Mi YANG ; Myung Hyun CHO ; Hyun Kyung LEE ; Kyoung Hee HAN ; Yae Lim KIM ; Miyoung CHOI ; Hee Gyung KANG ; Jin-Soon SUH ;
Kidney Research and Clinical Practice 2024;43(5):565-574
Hematuria is a relatively common condition among school-aged children. Because international guidelines for asymptomatic hematuria in children are unavailable, developing practical guidelines for the diagnosis and management of asymptomatic hematuria based on scientific evidence while considering real-world practice settings, values, and patient and physician preferences is essential. The Korean Society of Pediatric Nephrology developed clinical guidelines to address key questions regarding the diagnosis and management of asymptomatic hematuria in children.
4.To treat or not to treat: CUBN-associated persistent proteinuria
Yun Young CHOI ; Yo Han AHN ; Eujin PARK ; Ji Hyun KIM ; Hee Gyung KANG ; Hyun Kyung LEE
Kidney Research and Clinical Practice 2024;43(5):663-670
Persistent proteinuria is an important indicator of kidney damage and requires active evaluation and intervention. However, tubular proteinuria of genetic origin typically does not improve with immunosuppression or antiproteinuric treatment. Recently, defects in CUBN were found to cause isolated proteinuria (mainly albuminuria) due to defective tubular albumin reuptake. Unlike most other genetically caused persistent albuminuria, CUBN C-terminal variants have a benign course without progression to chronic kidney disease according to the literature. Here, we present Korean cases with persistent proteinuria associated with C-terminal variants of CUBN. Methods: We identified Korean patients with CUBN variants among those with an identified genetic cause of proteinuria and evaluated their clinical features and clinical course. We also reviewed the literature on CUBN-associated isolated proteinuria published to date and compared it with Korean patients. Results: All patients presented with incidentally found, asymptomatic isolated proteinuria at a median age of 5 years. The proteinuria was in the subnephrotic range and did not significantly change over time, regardless of renin- angiotensin system inhibition. Initial physical examination, laboratory findings, and kidney biopsy results, when available, were unremarkable other than significant proteinuria. All patients maintained kidney function throughout the follow-up duration. All patients had at least one splicing mutation, and most of the variants were located C-terminal side of the gene. Conclusion: We report Korean experience of CUBN-related benign proteinuria, that aligns with previous reports, indicating that this condition should be considered in cases with incidentally found asymptomatic isolated proteinuria, especially in young children.
5.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
6.Asymptomatic hematuria in children: Korean Society of Pediatric Nephrology recommendations for diagnosis and management
Eujin PARK ; Sang Woon KIM ; Su Jin KIM ; Minki BAEK ; Yo Han AHN ; Eun Mi YANG ; Myung Hyun CHO ; Hyun Kyung LEE ; Kyoung Hee HAN ; Yae Lim KIM ; Miyoung CHOI ; Hee Gyung KANG ; Jin-Soon SUH ;
Kidney Research and Clinical Practice 2024;43(5):565-574
Hematuria is a relatively common condition among school-aged children. Because international guidelines for asymptomatic hematuria in children are unavailable, developing practical guidelines for the diagnosis and management of asymptomatic hematuria based on scientific evidence while considering real-world practice settings, values, and patient and physician preferences is essential. The Korean Society of Pediatric Nephrology developed clinical guidelines to address key questions regarding the diagnosis and management of asymptomatic hematuria in children.
7.Three-dimensional analysis of buccally unilateral maxillary impacted canines
Eujin JANG ; Dong-Hwa CHUNG ; Jin-Woo LEE ; Sang-Min LEE ; Mo-Hyeon LEE
Journal of Dental Rehabilitation and Applied Science 2024;40(4):225-233
Purpose:
The aim was to conduct a three-dimensional comparison of impacted canines with their contralateral normal counterparts in patients exhibiting unilateral buccal impaction of the maxillary canine, utilizing the palatal plane as the benchmark reference.
Materials and Methods:
Computed tomography scans from a cohort of 31 patients diagnosed with unilateral buccal impaction of the maxillary canine were analyzed. The impacted canine was examined against the contralateral normal canine, focusing on the variables of rotation, torque, angulation, root length, and root volume. The disparities in these parameters between the left and right canines and their association with patient age were evaluated.
Results:
Notable differences were observed in rotation, angulation, torque, root length, and root volume when comparing the impacted canine to its contralateral normal counterpart.Furthermore, a significant positive correlation was identified between the age of the patients and the root length discrepancy of the impacted and contralateral normal canines.
Conclusion
The palatal plane proves to be a viable skeletal reference for predicting the impaction of maxillary canines, with rotation, angulation, and torque serving as reliable indicators. The study further elucidates that the unilateral buccally impacted maxillary canine is characterized by a discernibly shorter root length and diminished root volume in comparison to the contralateral normal canine.
8.Three-dimensional analysis of buccally unilateral maxillary impacted canines
Eujin JANG ; Dong-Hwa CHUNG ; Jin-Woo LEE ; Sang-Min LEE ; Mo-Hyeon LEE
Journal of Dental Rehabilitation and Applied Science 2024;40(4):225-233
Purpose:
The aim was to conduct a three-dimensional comparison of impacted canines with their contralateral normal counterparts in patients exhibiting unilateral buccal impaction of the maxillary canine, utilizing the palatal plane as the benchmark reference.
Materials and Methods:
Computed tomography scans from a cohort of 31 patients diagnosed with unilateral buccal impaction of the maxillary canine were analyzed. The impacted canine was examined against the contralateral normal canine, focusing on the variables of rotation, torque, angulation, root length, and root volume. The disparities in these parameters between the left and right canines and their association with patient age were evaluated.
Results:
Notable differences were observed in rotation, angulation, torque, root length, and root volume when comparing the impacted canine to its contralateral normal counterpart.Furthermore, a significant positive correlation was identified between the age of the patients and the root length discrepancy of the impacted and contralateral normal canines.
Conclusion
The palatal plane proves to be a viable skeletal reference for predicting the impaction of maxillary canines, with rotation, angulation, and torque serving as reliable indicators. The study further elucidates that the unilateral buccally impacted maxillary canine is characterized by a discernibly shorter root length and diminished root volume in comparison to the contralateral normal canine.
9.To treat or not to treat: CUBN-associated persistent proteinuria
Yun Young CHOI ; Yo Han AHN ; Eujin PARK ; Ji Hyun KIM ; Hee Gyung KANG ; Hyun Kyung LEE
Kidney Research and Clinical Practice 2024;43(5):663-670
Persistent proteinuria is an important indicator of kidney damage and requires active evaluation and intervention. However, tubular proteinuria of genetic origin typically does not improve with immunosuppression or antiproteinuric treatment. Recently, defects in CUBN were found to cause isolated proteinuria (mainly albuminuria) due to defective tubular albumin reuptake. Unlike most other genetically caused persistent albuminuria, CUBN C-terminal variants have a benign course without progression to chronic kidney disease according to the literature. Here, we present Korean cases with persistent proteinuria associated with C-terminal variants of CUBN. Methods: We identified Korean patients with CUBN variants among those with an identified genetic cause of proteinuria and evaluated their clinical features and clinical course. We also reviewed the literature on CUBN-associated isolated proteinuria published to date and compared it with Korean patients. Results: All patients presented with incidentally found, asymptomatic isolated proteinuria at a median age of 5 years. The proteinuria was in the subnephrotic range and did not significantly change over time, regardless of renin- angiotensin system inhibition. Initial physical examination, laboratory findings, and kidney biopsy results, when available, were unremarkable other than significant proteinuria. All patients maintained kidney function throughout the follow-up duration. All patients had at least one splicing mutation, and most of the variants were located C-terminal side of the gene. Conclusion: We report Korean experience of CUBN-related benign proteinuria, that aligns with previous reports, indicating that this condition should be considered in cases with incidentally found asymptomatic isolated proteinuria, especially in young children.
10.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.

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