Advances in primary glomerulonephritis.
Recent advances in understanding the pathogenesis of the primary glomerulonephritides have produced novel targeted therapies and trials that, alongside updated KDIGO guidance, may substantially reduce progression to end-stage kidney disease.
Background
Primary glomerulonephritis comprises several renal-limited diseases that can cause hematoproteinuria, chronic kidney disease, nephrotic syndrome, and end-stage kidney disease, with the most common being IgA nephropathy, primary membranous nephropathy, focal segmental glomerulosclerosis, and minimal change disease. Although individually uncommon, these diseases impose a significant burden on health systems given the high cost of treating end-stage kidney disease with dialysis or transplantation.
Key recommendations
The review summarizes the international KDIGO guidelines for the treatment of IgA nephropathy, primary membranous nephropathy, focal segmental glomerulosclerosis, and minimal change disease, alongside recent research on disease pathogenesis. Until recently the pathogenesis of these conditions was largely obscure, but improved mechanistic understanding has driven the introduction of novel therapeutic agents.
Clinical implications
Trials that are underway or recently completed have substantial implications for the standard of care across the primary glomerulonephritides. These therapeutic advances are anticipated to dramatically reduce the number of patients who progress to end-stage kidney disease.
Category
KDIGO
Source
Br J Hosp Med (Lond)
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.