Primary glomerulonephritis: A review of important recent discoveries

Abstract

The publication of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines on the treatment of glomerular diseases in 2012 marked a milestone in this field, as it is the first time that comprehensive guidelines are provided for such disease entities. The current review focuses on major findings, both pathogenesis related and clinical, in the primary glomerulonephritis that have been made after the guidelines came into effect.

Keywords: Focal segmental glomerulosclerosis; IgA nephropathy; Membranoproliferative glomerulonephritis; Membranous glomerulonephritis; Minimal change disease.

Figure 1

World-wide genetic risk for immunoglobulin A nephropathy (IgAN). Gene-wide association studies indicate different worldwide risks for IgAN. (Reprinted with permission from Kiryluk K, Li Y, Sanna-Cherchi S, Rohanizadegan M, Suzuki H, Eitner F, Snyder HJ, Choi M, Hou P, Scolari F, Izzi C, Gigante M, Gesualdo L, Savoldi S, Amoroso A, Cusi D, Zamboli P, Julian BA, Novak J, Wyatt RJ, Mucha K, Perola M, Kristiansson K, Viktorin A, Magnusson PK, Thorleifsson G, Thorsteinsdottir U, Stefansson K, Boland A, Metzger M, Thibaudin L, Wanner C, Jager KJ, Goto S, Maixnerova D, Karnib HH, Nagy J, Panzer U, Xie J, Chen N, Tesar V, Narita I, Berthoux F, Floege J, Stengel B, Zhang H, Lifton RP, Gharavi AG. Geographic differences in genetic susceptibility to IgA nephropathy: GWAS replication study and geospatial risk analysis. PLoS Genet 8:e1002765, 2012)

Figure 2

Therapy algorithm for immunoglobulin A nephropathy. Details of the suggested supportive therapy can be found in . AKI, acute kidney injury; RPGN, rapidly progressive glomerulonephritis. Modified from .

Figure 3

Therapy algorithm for membranous nephropathy. For details of the suggested immunosuppressive approach, please refer to the KDIGO 2012 guidelines . AKI, acute kidney injury; KDIGO, Kidney Disease: Improving Global Outcomes; NS, nephrotic syndrome.