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PODCAST

Arkana Advances

Arkana Laboratories

Arkana Advances is a research podcast, hosted by Dr. Rebecca May, discussing the work of Arkana physicians and scientists as they ask questions that lead to advancing the understanding of disease.

science & medicine medicine

All Episodes

00:31:58

Use of a Smartphone Camera at the Bedside to Access...

Arkana Advances ·

2023/07/19

Over the past decade, there has been a dramatic increase in kidney biopsy inadequacy rate. Evaluation of biopsy adequacy by pathology is often not available. This study utilizes a smartphone camera to take a photograph of the biopsy at the bedside, which is then enlarged to allow for distinction between cortex and medulla. The physician performing the procedure, most often a radiologist, can then decide if additional samples are needed. In this study, there was a high agreement rate in the

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00:36:09

How Times Have Changed! A Cornucopia of Antigens for...

Arkana Advances ·

2022/06/29

Membranous Nephropathy, or Membranous Glomerulopathy, is an autoimmune disease-causing nephrotic syndrome in which there is subepithelial deposition of IgG and complements along the glomerular basement membrane. Membranous Nephropathy is the second leading cause of nephrotic syndrome in adults. Following the description of the first membranous antigen PLA2R in 2009, there has been numerous antigens described and associations with different diseases. In addition to a discussion of the

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00:12:10

Lipoic acid in neural epidermal growth factor-like...

Arkana Advances ·

2022/05/25

NELL1 is a recently described antigen seen in membranous glomerulopathy, which has been associated with malignancy. A recent study linked Lipoic Acid supplementation with membranous glomerulopathy. In this letter to the editor, medication use was examined in 115 patients with NELL1 positive membranous glomerulopathy and 200 patients with membranous glomerulopathy of other types. In the NELL1 positive group, 15 patients had active Lipoic Acid use, while no Lipoic Acid supplementation was seen in the

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00:18:21

Increasing Incidence of Inadequate Kidney Biopsy...

Arkana Advances ·

2022/02/16

A renal biopsy is an invasive procedure requiring sedation that is often necessary for appropriate patient treatment. A biopsy is "inadequate" when a complete diagnosis cannot be rendered, usually due to the lack of sufficient renal cortex within the biopsy. Over a 16 year period, a total of 123,372 native renal biopsies were received at Arkana Laboratories. The rate of inadequate kidney biopsies increased from approximately 2% in 2005 to 14% in 2020. In 2005, only 5% of biopsies were performed by

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00:15:36

Transforming Growth Factor Beta Receptor 3...

Arkana Advances ·

2022/02/02

Approximately half of lupus patients have kidney disease, including membranous glomerulopathy. On renal biopsy, immunofluorescence shows granular capillary loop deposits, and holes are seen in the capillary loops on silver stain. Electron microscopy shows subepithelial immune complex deposits. It is important to determine an antigen in these cases, as it can be linked to patient prognosis. The most common antigen seen in membranous lupus nephritis is EXT1/2, followed by NCAM1. This study identified

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00:15:58

Glomerular Disease in Temporal Association to...

Arkana Advances ·

2022/01/19

The association of rare autoimmune responses to vaccination is well known. This study investigates the effect of COVID-19 vaccination on the kidney. In a six-month period, 29 cases (including relapse of disease) were identified with temporal association to COVID-19 vaccination out of approximately 10,000 biopsies. The most common diagnoses were IgA Nephropathy (10 cases), minimal change disease (7 cases), and crescentic glomerulopathy with positive ANCA (6 cases). The overall frequency of these

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00:16:05

(NCAM1) Neural Cell Adhesion Molecule 1 Is A Novel...

Arkana Advances ·

2022/01/05

Membranous nephropathy is a leading cause of nephrotic syndrome. On renal biopsy, immunofluorescence shows granular capillary loop deposits, and holes are seen in the capillary loops on silver stain. Electron microscopy shows subepithelial immune complex deposits. Membranous glomerulopathy can be seen in association with autoimmune diseases including lupus. The most common antigen seen in membranous lupus nephritis is EXT1/2. This study identified a new target antigen, NCAM1, which was present in

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00:19:43

NELL1 Is A Target Antigen In Malignancy-Associated...

Arkana Advances ·

2021/12/22

Membranous nephropathy is a leading cause of nephrotic syndrome. On renal biopsy, immunofluorescence shows granular capillary loop deposits, and holes are seen in the capillary loops on silver stain. Electron microscopy shows subepithelial immune complex deposits. A majority of cases have autoantibodies against PLA2R and THSD7A. This study identified a new target antigen, NELL1, which was present in 1.7% of membranous cases. NELL1 can also be detected in the serum of these patients. Approximately

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00:10:10

Infantile Nephrocalcinosis Resulting From a...

Arkana Advances ·

2021/12/18

Nephrocalcinosis is the finding of abundant calcium phosphate deposits within the tubulointerstitium of the kidney. This is a case report of a renal biopsy from an 11 month old male with hypercalcemia and developmental delay, who was found to have nephrocalcinosis. It is a rare diagnosis in infants, and should prompt a genetic workup. Genetic workup revealed a CYP24A1 mutation, which results in a truncated protein. This is a novel mutation in this gene. CYP24A1 is involved in Vitamin D metabolism

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00:11:21

Resistant Starch Slows the Progression of CKD in the...

Arkana Advances ·

2021/11/24

In patients with chronic kidney disease, toxins normally excreted by the kidney continue to circulate, leading to increased kidney damage. The gut microbiome likely plays a role in this damage and contributes to systemic inflammation. Supplementation with dietary fiber (resistant starch) may prevent this kidney damage. This study uses a mouse model of chronic kidney disease and showed that mice fed resistant starch had significantly less kidney fibrosis. A diet including resistant starch altered the

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00:19:18

A Diagnostician’s Field Guide To Crystalline...

Arkana Advances ·

2021/11/10

This discussion focuses on a review article of crystals seen in renal biopsies. Crystalline nephropathies are often associated with systemic conditions. We discuss calcium-based crystals, dysproteinemia-related (such as light chain), crystal storing histiocytosis, crystalglobulin/cryocrystalglobulin, metabolic disorders, and drug-associated crystals. We review the appearance of the crystals, their etiology, and the associated prognosis for the patient. This is an excellent synopsis of the most

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00:21:30

A Practical Approach To The Pathology Of Renal...

Arkana Advances ·

2021/10/27

Dr. May discusses a review article with Dr. Dvanajsack that focuses on renal intratubular casts in Episode 5 of Arkana Advances.Both benign casts as well as six types of pathologic casts are addressed (light chain casts, myoglobin/hemoglobin casts, red blood cell casts, neutrophil casts, and bile casts). The pair review the appearance of these casts, their etiology, and the associated prognosis for the patient. This is an excellent synopsis of the most common renal casts for both trainees and

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00:14:18

Viral-like Inclusions in COVID-19 Negative Renal...

Arkana Advances ·

2021/10/13

In Episode 4 of Arkana Advances, Dr. May interviews Dr. Cassol over her recent publication discussing viral-like inclusions in COVID-19 negative renal biopsies detected by electron microscopy. Early in the COVID-19 pandemic in the United States, few publications from different organ systems claimed to have found COVID-19 viral particles, including in the kidney. Viral particles are known to be of varying sizes, making proper identification even more difficult. To see whether these viral particles

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00:15:09

Collapsing Glomerulopathy and APOL1 High-Risk...

Arkana Advances ·

2021/09/29

Dr. May and Dr. Larsen discuss Covid-19 and its effect on collapsing glomerulopathy and APOL1 in Episode 3 of Arkana Advances. Collapsing glomerulopathy is a variant of focal segmental glomerulosclerosis (FSGS) in which there is capillary loop collapse and epithelial cell hyperplasia and hypertrophy. There is rapid progression to end-stage renal disease. Early in the COVID-19 pandemic in the United States, these publications demonstrated for the first time that collapsing glomerulopathy is seen in

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00:12:00

Anti-Brush Border Antibody Disease (Anti-LRP2...

Arkana Advances ·

2021/09/15

Anti-brush border antibody disease is a rare autoimmune disease. Auto-antibodies are targeted against LRP2/Megalin, which is present on the apical brush border of the proximal tubule epithelial cells and is an endocytic receptor for many substances. This disease is typically seen in elderly patients who present with acute kidney injury. On renal biopsy, light microscopy shows acute tubular injury. Granular tubular basement membrane, as well as apical brush border staining for IgG, is seen on

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00:20:25

SAP Staining In the Diagnosis of MGMID

Arkana Advances ·

2021/09/01

Membranous-like glomerulopathy with masked IgG kappa deposits (MGMID) is a rare condition in which subepithelial deposits are present on electron microscopy (compatible with membranous glomerulopathy), but routine immunofluorescence is exclusively positive for C3. When a different processing technique is used and immunofluorescence is performed on the paraffin-embedded tissue, staining is "unmasked" revealing deposits that stain with IgG1, C3, and kappa. These patients are more often younger women

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16 results

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