Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  Treatment for glomerulonephritis depends on what’s causing it and your symptoms. […] If you have severe glomerulonephritis, you’ll usually be referred to a kidney specialist (nephrologist) for treatment. […] If glomerulonephritis is caused by problems with your immune system, medicines called immunosuppressants may be recommended. These medicines suppress your immune system. […] You may be put on a course of medicines containing steroids such as prednisolone. […] If you take immunosuppressants or steroids to suppress your immune system, you may also be given medicines to help prevent side effects such as infections and osteoporosis. […] Your blood pressure will be carefully monitored by the healthcare professionals treating you. […] You may need to take medicines that lower blood pressure and help reduce the amount of protein that leaks into your urine, such as either: an angiotensin-converting enzyme (ACE) inhibitors or an angiotensin receptor blockers (ARB).

• #2 Glomerulonephritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16167-glomerulonephritis-gn

  Treatment depends on whats causing the condition and if you have kidney damage. The goal of treatment is to reduce any further damage. […] Sometimes, treating the underlying cause, like taking medication to manage high blood pressure, is all thats necessary. If the cause is due to infection, antibiotics can treat the infection. […] At other times, your healthcare provider may recommend: Changes to your diet so that you eat less protein and salt, which put extra strain on your kidneys. […] Immunosuppressants, if a problem with your immune system causes glomerulonephritis. […] Medicine to lower your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin blockers (ARB). […] Corticosteroids to decrease inflammation. […] Dialysis, which helps clean your blood, remove extra fluid and control blood pressure. […] Diuretics (water pills) to reduce swelling and remove excess fluid from your body. […] Plasmapheresis, a special process that filters protein from your blood.

• #3 Glomerulonephritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/diagnosis-treatment/drc-20355710

  Treatment of glomerulonephritis and your outcome depend on: […] Some cases of acute glomerulonephritis, especially those that follow an infection with streptococcal bacteria, might improve on their own and require no treatment. If there’s an underlying cause such as high blood pressure, an infection or an autoimmune disease treatment will be directed to the underlying cause. […] In general, the goal of treatment is to protect your kidneys from further damage and to preserve kidney function. […] Acute kidney failure due to infection-related glomerulonephritis is treated with dialysis. Dialysis uses a device that works like an artificial, external kidney that filters your blood. […] End-stage kidney disease is chronic kidney disease that can only be managed by regular kidney dialysis or a kidney transplant.

• #4 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Glomerulonephritis is associated with a systemic disease; it is mostly resolved by managing the underlying cause. Primary glomerulonephritis is managed supportively and by specific disease-modifying therapy. The outcome mainly depends on the timely intervention, which, if not done, may lead to a progressive sequence of events causing glomerulonephritis to develop into chronic kidney disease (increasing the risk for simultaneous development of cardiovascular disease), the sequence finally culminates into end-stage renal disease (ESRD). […] The management of glomerulonephritis broadly follows two modalities. […] Specific management revolves around immunosuppression, which in turn is governed by factors like: […] – Histological diagnosis […] – Disease severity […] – Disease progression

• #5 Acute Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Diet and Activity

  https://emedicine.medscape.com/article/239278-treatment

  Treatment of acute poststreptococcal glomerulonephritis (PSGN) is mainly supportive, because there is no specific therapy for the kidney disease. […] When acute glomerulonephritis (AGN) is associated with chronic infections, the underlying infections must be treated. […] The expertise available in the intensive care unit may be needed for management of patients with hypertensive encephalopathy or pulmonary edema. Consultation with a nephrologist may be indicated. On an outpatient basis, kidney function, blood pressure, edema, serum albumin, and urine protein excretion rate should be monitored. […] Antibiotics (eg, penicillin) are used to control local symptoms and to prevent spread of infection to close contacts. […] Although the older literature advises that antimicrobial therapy does not prevent the development of glomerulonephritis, more recent reviews suggest that the evidence is inadequate, and possible benefit exists.

• #6 Acute Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Diet and Activity

  https://emedicine.medscape.com/article/239278-treatment

  In addition, antibiotic treatment of close contacts of the index case may help prevent development of PSGN. […] Loop diuretics may be required in patients who are edematous and hypertensive, in order to remove excess fluid and to correct hypertension. […] Vasodilator drugs (eg, nitroprusside, nifedipine, hydralazine, diazoxide) may be used if severe hypertension or encephalopathy is present. […] Glucocorticoids and cytotoxic agents are of no value, except in severe cases of PSGN. […] Sodium and fluid restriction should be advised for treatment of signs and symptoms of fluid retention (eg, edema, pulmonary edema). […] Protein restriction for patients with azotemia should be advised if the patient has no evidence of malnutrition. […] Bed rest is recommended until signs of glomerular inflammation and circulatory congestion subside. Prolonged inactivity is of no benefit in the patient recovery process. […] Long-term studies show higher mortality rates in elderly patients, particularly those on dialysis. Patients may be predisposed to crescent formation.

• #7

  https://www.nhs.uk/conditions/glomerulonephritis/

  Treatment for glomerulonephritis depends on the cause and severity of your condition. If an underlying condition can be identified, treating it can help. […] Treatment can be as simple as making changes to your diet, such as eating less salt to reduce the strain on your kidneys. […] Medicine to lower blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors, is commonly prescribed because it helps protect the kidneys. […] If the condition is caused by a problem with your immune system, medicine called immunosuppressants may be used.

• #8 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  – Comorbidities […] The available options include: […] – High-dose corticosteroids […] – Rituximab (a monoclonal antibody that causes the lysis of B-lymphocytes) […] – Cytotoxic agents (e.g., cyclophosphamide, along with glucocorticoids are of value in severe cases of post-streptococcal glomerulonephritis) […] – Plasma exchange (glomerular proliferative nephritis, pauci-immune glomerulonephritis used temporarily till chemotherapy takes effect) […] With progression into chronicity, general management is done on the lines of chronic kidney disease: […] 1. Keeping track of the renal function tests (RFTs), serum albumin, and urine protein excretion rate. […] 2. By controlling the BP and inhibiting the renin-angiotensin axis through Loop diuretics, which serve two purposes; the removal of excess fluid and the correction of hypertension. Angiotensin-converting enzyme inhibitors (ACEIs) are frequently the first choice for managing hypertension and chronic kidney disease (CKD). Angiotensin 2 receptor blockers (ARBs) have been found to halt CKD progression in diabetic or nondiabetic renal disease cases, much like ACEIs.

• #9 Glomerulonephritis | National Kidney Foundation

  https://www.kidney.org/kidney-topics/glomerulonephritis

  Treatment will depend on the cause or type of disease you have. Your healthcare team will work with you to create a treatment plan to help prevent kidney disease or keep it from getting worse. Certain nutrition and lifestyle recommendations and medicines may be involved. Be sure to keep up with medical visits. Glomerulonephritis can lead to kidney failure, which is treated with dialysis or a kidney transplant. […] The exact medicines that will be used depends on the disease causing the glomerulonephritis. Sometimes, the dose might need to be changed, or a different medicine might be used. Before taking any over-the-counter medicine or supplement, ask your healthcare team which ones are safe to use. […] You may need a blood pressure drug called an ACE inhibitor or an ARB. These two drugs control high blood pressure and reduce the amount of protein in the urine.

• #10 Acute Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Diet and Activity

  https://emedicine.medscape.com/article/239278-treatment

  In addition, antibiotic treatment of close contacts of the index case may help prevent development of PSGN. […] Loop diuretics may be required in patients who are edematous and hypertensive, in order to remove excess fluid and to correct hypertension. […] Vasodilator drugs (eg, nitroprusside, nifedipine, hydralazine, diazoxide) may be used if severe hypertension or encephalopathy is present. […] Glucocorticoids and cytotoxic agents are of no value, except in severe cases of PSGN. […] Sodium and fluid restriction should be advised for treatment of signs and symptoms of fluid retention (eg, edema, pulmonary edema). […] Protein restriction for patients with azotemia should be advised if the patient has no evidence of malnutrition. […] Bed rest is recommended until signs of glomerular inflammation and circulatory congestion subside. Prolonged inactivity is of no benefit in the patient recovery process. […] Long-term studies show higher mortality rates in elderly patients, particularly those on dialysis. Patients may be predisposed to crescent formation.

• #11 Poststreptococcal Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538255/

  PSGN is a self-limiting condition in most cases, and thus only symptomatic treatment is needed. Supportive treatment aims at controlling the complications of volume overload such as hypertension and edema, which are prominent during the acute phase of the disease. […] Patients with evidence of a streptococcal infection should receive a course of antibiotic therapy, and they may not prevent the development of PSGN. […] Loop diuretics (furosemide) are preferred over thiazides (hydrochlorothiazide or chlorthalidone). The efficacy of thiazide diuretics is very minimal when GFR 30 ml/min. […] Blood pressure can be managed by restricting salt and fluid intake along with diuretics are needed. In cases with uncontrolled blood pressure, the use of calcium channel blockers is recommended. The use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs) is recommended in patients with stable GFR and with near-normal potassium levels.

• #12 Get Glomerulonephritis Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/glomerulonephritis-treatment

  We may recommend avoiding certain foods since glomerulonephritis reduces your kidneys ability to remove waste from your blood. Physical activity, quitting smoking and drinking less alcohol can help protect your kidneys, too. […] Following treatment, youll have several follow-up appointments. Your provider may recommend maintenance therapy to prevent a flare-up of glomerulonephritis. We continue to watch your kidney function through urine and blood samples every few months. These regular visits help us detect any changes early on and adjust your treatment when needed.

• #13 Glomerulonephritis | National Kidney Foundation

  https://www.kidney.org/kidney-topics/glomerulonephritis

  Diuretics (water pills) are used to remove extra fluid from the body (edema). […] If needed, drugs such as prednisone (or other steroids) may be used. Prednisone is a type of immunosuppressant, which is a drug that suppress or „calms” the immune system (bodys defense system). This can keep the immune system from hurting the kidneys. Other immunosuppressants may also be used. […] People with glomerulonephritis may need to follow a healthy diet that is low in salt and cholesterol. Reducing sodium (salt) in your diet can help lower blood pressure and control swelling (edema). Lowering cholesterol in your diet can help reduce the risk for heart disease. You might also need to lower your fluid and water intake. It is important to work with a registered dietitian to discuss any changes needed in your diet.

• #14

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  A doctor may recommend medicine to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medicine. […] Plasma exchange may be used in certain circumstances if your condition is severe. […] If you have severe glomerulonephritis that cannot be improved with other treatments, you may require kidney dialysis or a kidney transplant. […] As glomerulonephritis can make you more vulnerable to infections, it’s a good idea to protect yourself by having a seasonal flu vaccine and a pneumonia vaccine (also called the pneumococcal vaccine).

• #15

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  Treatment for glomerulonephritis depends on what’s causing it and your symptoms. […] If you have severe glomerulonephritis, you’ll usually be referred to a kidney specialist (nephrologist) for treatment. […] If glomerulonephritis is caused by problems with your immune system, medicines called immunosuppressants may be recommended. These medicines suppress your immune system. […] You may be put on a course of medicines containing steroids such as prednisolone. […] If you take immunosuppressants or steroids to suppress your immune system, you may also be given medicines to help prevent side effects such as infections and osteoporosis. […] Your blood pressure will be carefully monitored by the healthcare professionals treating you. […] You may need to take medicines that lower blood pressure and help reduce the amount of protein that leaks into your urine, such as either: an angiotensin-converting enzyme (ACE) inhibitors or an angiotensin receptor blockers (ARB).

• #16 Glomerulonephritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16167-glomerulonephritis-gn

  Treatment depends on whats causing the condition and if you have kidney damage. The goal of treatment is to reduce any further damage. […] Sometimes, treating the underlying cause, like taking medication to manage high blood pressure, is all thats necessary. If the cause is due to infection, antibiotics can treat the infection. […] At other times, your healthcare provider may recommend: Changes to your diet so that you eat less protein and salt, which put extra strain on your kidneys. […] Immunosuppressants, if a problem with your immune system causes glomerulonephritis. […] Medicine to lower your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin blockers (ARB). […] Corticosteroids to decrease inflammation. […] Dialysis, which helps clean your blood, remove extra fluid and control blood pressure. […] Diuretics (water pills) to reduce swelling and remove excess fluid from your body. […] Plasmapheresis, a special process that filters protein from your blood.

• #17 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  – Comorbidities […] The available options include: […] – High-dose corticosteroids […] – Rituximab (a monoclonal antibody that causes the lysis of B-lymphocytes) […] – Cytotoxic agents (e.g., cyclophosphamide, along with glucocorticoids are of value in severe cases of post-streptococcal glomerulonephritis) […] – Plasma exchange (glomerular proliferative nephritis, pauci-immune glomerulonephritis used temporarily till chemotherapy takes effect) […] With progression into chronicity, general management is done on the lines of chronic kidney disease: […] 1. Keeping track of the renal function tests (RFTs), serum albumin, and urine protein excretion rate. […] 2. By controlling the BP and inhibiting the renin-angiotensin axis through Loop diuretics, which serve two purposes; the removal of excess fluid and the correction of hypertension. Angiotensin-converting enzyme inhibitors (ACEIs) are frequently the first choice for managing hypertension and chronic kidney disease (CKD). Angiotensin 2 receptor blockers (ARBs) have been found to halt CKD progression in diabetic or nondiabetic renal disease cases, much like ACEIs.

• #18 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Therapy for antineutrophil cytoplasmic antibody (ANCA)associated disease consists of a combination of corticosteroids and cyclophosphamide. Treatment with steroids alone results in a 3-fold increase in the risk of relapse compared with combination therapy. The only predictor of kidney survival is the serum creatinine value at the time of diagnosis. Therefore, a high index of suspicion is imperative to establish the diagnosis quickly and to institute treatment as soon as possible. Kidney failure requiring dialysis is not a contraindication to treatment. Many patients can be removed from dialysis for an extended period (18 mo to 2 y). […] Administer methylprednisolone at 7 mg/kg/d intravenously (not to exceed 1 g) for 3 days, followed by oral prednisone at 1 mg/kg/d (not to exceed 80 mg) for 3 weeks, and then oral prednisone at 2 mg/kg every other day (not to exceed 120 mg) for 3 months. This dose is decreased by 25% every 4 weeks until the patient stops taking prednisone.

• #19 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #20 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Therapy for antineutrophil cytoplasmic antibody (ANCA)associated disease consists of a combination of corticosteroids and cyclophosphamide. Treatment with steroids alone results in a 3-fold increase in the risk of relapse compared with combination therapy. The only predictor of kidney survival is the serum creatinine value at the time of diagnosis. Therefore, a high index of suspicion is imperative to establish the diagnosis quickly and to institute treatment as soon as possible. Kidney failure requiring dialysis is not a contraindication to treatment. Many patients can be removed from dialysis for an extended period (18 mo to 2 y). […] Administer methylprednisolone at 7 mg/kg/d intravenously (not to exceed 1 g) for 3 days, followed by oral prednisone at 1 mg/kg/d (not to exceed 80 mg) for 3 weeks, and then oral prednisone at 2 mg/kg every other day (not to exceed 120 mg) for 3 months. This dose is decreased by 25% every 4 weeks until the patient stops taking prednisone.

• #21 Glomerulonephritis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/glomerulonephritis-pro

  Glomerulonephritis includes a range of immune-mediated disorders that cause inflammation within the glomerulus and other compartments of the kidney. […] Many cases of glomerulonephritis result in a mild, asymptomatic illness that remains undiagnosed. […] Minimal change disease usually responds to a course of high-dose prednisolone but relapse is frequent. […] Relapsing disease may go into remission following treatment with prednisolone and cyclophosphamide or ciclosporin. […] Up to 80% of children with primary disease are resistant to treatment with steroids. If this is unsuccessful, some patients may respond to the addition of cyclophosphamide, ciclosporin, tacrolimus, mycophenolate mofetil (MMF), mizoribine, or leflunomide. […] One third of patients respond to conservative treatment with diuretics, statins, ACE inhibitors or angiotensin receptor blockers, systemic anticoagulant therapy, antihypertensives, and dietary salt restriction.

• #22 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  – Comorbidities […] The available options include: […] – High-dose corticosteroids […] – Rituximab (a monoclonal antibody that causes the lysis of B-lymphocytes) […] – Cytotoxic agents (e.g., cyclophosphamide, along with glucocorticoids are of value in severe cases of post-streptococcal glomerulonephritis) […] – Plasma exchange (glomerular proliferative nephritis, pauci-immune glomerulonephritis used temporarily till chemotherapy takes effect) […] With progression into chronicity, general management is done on the lines of chronic kidney disease: […] 1. Keeping track of the renal function tests (RFTs), serum albumin, and urine protein excretion rate. […] 2. By controlling the BP and inhibiting the renin-angiotensin axis through Loop diuretics, which serve two purposes; the removal of excess fluid and the correction of hypertension. Angiotensin-converting enzyme inhibitors (ACEIs) are frequently the first choice for managing hypertension and chronic kidney disease (CKD). Angiotensin 2 receptor blockers (ARBs) have been found to halt CKD progression in diabetic or nondiabetic renal disease cases, much like ACEIs.

• #23 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Administer cyclophosphamide either intravenously or orally. Intravenous therapy is initially administered at a dose of 0.5 g/m2, and the oral dose is 2 mg/kg. Both are adjusted according to a 2-week leukocyte nadir count (goal 3000-4000/L). The maximum intravenous dose is 1 g/m2. Oral and intravenous cyclophosphamide appears to be equally efficacious. However, this remains an area of controversy, particularly in the case of granulomatosis with polyangiitis, for which some advocate oral therapy. The advantage to using the intravenous preparation is that the risk of cumulative toxicity is lower because a lower total dose is used. […] Another protocol, which has been used widely and with success in Europe, is the substitution of azathioprine for cyclophosphamide after a 3-month induction period. Azathioprine is administered at 2 mg/kg orally in a single daily dose. This is continued for 6-12 months.

• #24 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Administer cyclophosphamide either intravenously or orally. Intravenous therapy is initially administered at a dose of 0.5 g/m2, and the oral dose is 2 mg/kg. Both are adjusted according to a 2-week leukocyte nadir count (goal 3000-4000/L). The maximum intravenous dose is 1 g/m2. Oral and intravenous cyclophosphamide appears to be equally efficacious. However, this remains an area of controversy, particularly in the case of granulomatosis with polyangiitis, for which some advocate oral therapy. The advantage to using the intravenous preparation is that the risk of cumulative toxicity is lower because a lower total dose is used. […] Another protocol, which has been used widely and with success in Europe, is the substitution of azathioprine for cyclophosphamide after a 3-month induction period. Azathioprine is administered at 2 mg/kg orally in a single daily dose. This is continued for 6-12 months.

• #25 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #26 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #27 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Focal segmental glomerulosclerosis: Treatment is done initially with ACE inhibitors/ARBs and by controlling BP. Calcineurin inhibitors, plasma exchange, corticosteroids, and rituximab are helpful treatment options. […] Membranoproliferative GN: Treatment is done initially with ACE inhibitors/ARBs and by controlling BP. Immunosuppression is useful if no underlying cause is found. Work is currently ongoing to block or modify C3 activation.

• #28 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  – Comorbidities […] The available options include: […] – High-dose corticosteroids […] – Rituximab (a monoclonal antibody that causes the lysis of B-lymphocytes) […] – Cytotoxic agents (e.g., cyclophosphamide, along with glucocorticoids are of value in severe cases of post-streptococcal glomerulonephritis) […] – Plasma exchange (glomerular proliferative nephritis, pauci-immune glomerulonephritis used temporarily till chemotherapy takes effect) […] With progression into chronicity, general management is done on the lines of chronic kidney disease: […] 1. Keeping track of the renal function tests (RFTs), serum albumin, and urine protein excretion rate. […] 2. By controlling the BP and inhibiting the renin-angiotensin axis through Loop diuretics, which serve two purposes; the removal of excess fluid and the correction of hypertension. Angiotensin-converting enzyme inhibitors (ACEIs) are frequently the first choice for managing hypertension and chronic kidney disease (CKD). Angiotensin 2 receptor blockers (ARBs) have been found to halt CKD progression in diabetic or nondiabetic renal disease cases, much like ACEIs.

• #29 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Plasmapheresis may be a beneficial addition to therapy for patients who present with severe kidney failure (serum creatinine 6 mg/dL) or those whose disease progresses despite treatment. […] Rituximab may improve kidney outcomes in ANCA-associated vasculitis; in addition to antiB-cell therapy, therapy directed at T cells may improve kidney outcome, according to a study conducted by Berden et al. […] Other medications have been used in an attempt to attain a remission, such as intravenous immunoglobulin, antithymocyte antibody, and humanized monoclonal antibody to CD4 and CD25. Avacopan, a complement 5a receptor antagonistas approved as adjunctive treatment of severe ANCA-associated granulomatosis with polyangiitis and microscopic polyangiitis in combination with glucocorticoids, might be considered for cases refractory to standard treatment.

• #30

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  A doctor may recommend medicine to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medicine. […] Plasma exchange may be used in certain circumstances if your condition is severe. […] If you have severe glomerulonephritis that cannot be improved with other treatments, you may require kidney dialysis or a kidney transplant. […] As glomerulonephritis can make you more vulnerable to infections, it’s a good idea to protect yourself by having a seasonal flu vaccine and a pneumonia vaccine (also called the pneumococcal vaccine).

• #31 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Plasmapheresis may be a beneficial addition to therapy for patients who present with severe kidney failure (serum creatinine 6 mg/dL) or those whose disease progresses despite treatment. […] Rituximab may improve kidney outcomes in ANCA-associated vasculitis; in addition to antiB-cell therapy, therapy directed at T cells may improve kidney outcome, according to a study conducted by Berden et al. […] Other medications have been used in an attempt to attain a remission, such as intravenous immunoglobulin, antithymocyte antibody, and humanized monoclonal antibody to CD4 and CD25. Avacopan, a complement 5a receptor antagonistas approved as adjunctive treatment of severe ANCA-associated granulomatosis with polyangiitis and microscopic polyangiitis in combination with glucocorticoids, might be considered for cases refractory to standard treatment.

• #32 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  – Comorbidities […] The available options include: […] – High-dose corticosteroids […] – Rituximab (a monoclonal antibody that causes the lysis of B-lymphocytes) […] – Cytotoxic agents (e.g., cyclophosphamide, along with glucocorticoids are of value in severe cases of post-streptococcal glomerulonephritis) […] – Plasma exchange (glomerular proliferative nephritis, pauci-immune glomerulonephritis used temporarily till chemotherapy takes effect) […] With progression into chronicity, general management is done on the lines of chronic kidney disease: […] 1. Keeping track of the renal function tests (RFTs), serum albumin, and urine protein excretion rate. […] 2. By controlling the BP and inhibiting the renin-angiotensin axis through Loop diuretics, which serve two purposes; the removal of excess fluid and the correction of hypertension. Angiotensin-converting enzyme inhibitors (ACEIs) are frequently the first choice for managing hypertension and chronic kidney disease (CKD). Angiotensin 2 receptor blockers (ARBs) have been found to halt CKD progression in diabetic or nondiabetic renal disease cases, much like ACEIs.

• #33 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #34 Acute Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Diet and Activity

  https://emedicine.medscape.com/article/239278-treatment

  Treatment of acute poststreptococcal glomerulonephritis (PSGN) is mainly supportive, because there is no specific therapy for the kidney disease. […] When acute glomerulonephritis (AGN) is associated with chronic infections, the underlying infections must be treated. […] The expertise available in the intensive care unit may be needed for management of patients with hypertensive encephalopathy or pulmonary edema. Consultation with a nephrologist may be indicated. On an outpatient basis, kidney function, blood pressure, edema, serum albumin, and urine protein excretion rate should be monitored. […] Antibiotics (eg, penicillin) are used to control local symptoms and to prevent spread of infection to close contacts. […] Although the older literature advises that antimicrobial therapy does not prevent the development of glomerulonephritis, more recent reviews suggest that the evidence is inadequate, and possible benefit exists.

• #35 About Post-Streptococcal Glomerulonephritis | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/about/post-streptococcal-glomerulonephritis.html

  Treatment usually focuses on managing swelling and blood pressure but can include antibiotics. […] Treatment of PSGN focuses on managing symptoms as needed. Healthcare providers limit salt and water intake or prescribe a diuretic to decrease swelling. A diuretic is a medicine that increases the flow of urine. […] Healthcare providers prescribe blood pressure medicine to manage the patient’s blood pressure. […] People with PSGN who still have a group A strep infection are often given antibiotics.

• #36 Post-Infectious Glomerulonephritis (GN) | UNC Kidney Center

  https://unckidneycenter.org/kidneyhealthlibrary/glomerular-disease/post-infectious-glomerulonephritis-gn/

  There is no specific treatment for Post-Infectious GN. Treatment is focused on relieving symptoms. Antibiotics, such as penicillin, should be used to treat any bacterial infection. Blood pressure medications and diuretic medications may be needed to control swelling and high blood pressure. Dietary salt restriction may be necessary to control swelling and high blood pressure. […] GN after a Strep infection usually goes away by itself after several weeks to months. In a small number of adults, it may progress to chronic kidney failure.

• #37 Poststreptococcal Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538255/

  PSGN is a self-limiting condition in most cases, and thus only symptomatic treatment is needed. Supportive treatment aims at controlling the complications of volume overload such as hypertension and edema, which are prominent during the acute phase of the disease. […] Patients with evidence of a streptococcal infection should receive a course of antibiotic therapy, and they may not prevent the development of PSGN. […] Loop diuretics (furosemide) are preferred over thiazides (hydrochlorothiazide or chlorthalidone). The efficacy of thiazide diuretics is very minimal when GFR 30 ml/min. […] Blood pressure can be managed by restricting salt and fluid intake along with diuretics are needed. In cases with uncontrolled blood pressure, the use of calcium channel blockers is recommended. The use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs) is recommended in patients with stable GFR and with near-normal potassium levels.

• #38 Acute Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Diet and Activity

  https://emedicine.medscape.com/article/239278-treatment

  In addition, antibiotic treatment of close contacts of the index case may help prevent development of PSGN. […] Loop diuretics may be required in patients who are edematous and hypertensive, in order to remove excess fluid and to correct hypertension. […] Vasodilator drugs (eg, nitroprusside, nifedipine, hydralazine, diazoxide) may be used if severe hypertension or encephalopathy is present. […] Glucocorticoids and cytotoxic agents are of no value, except in severe cases of PSGN. […] Sodium and fluid restriction should be advised for treatment of signs and symptoms of fluid retention (eg, edema, pulmonary edema). […] Protein restriction for patients with azotemia should be advised if the patient has no evidence of malnutrition. […] Bed rest is recommended until signs of glomerular inflammation and circulatory congestion subside. Prolonged inactivity is of no benefit in the patient recovery process. […] Long-term studies show higher mortality rates in elderly patients, particularly those on dialysis. Patients may be predisposed to crescent formation.

• #39 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  3. For individuals with severe/refractory hypertension with/without encephalopathy, vasodilators (e.g., nitroprusside and nifedipine) can be used. […] 4. Clinicians can manage the complications associated with progressive chronic disease, including anemia, bone mineral disorders, acidosis, cardiovascular disease, and restless legs/cramps. […] 5. Appropriate counseling regarding diet. […] 6. Preparation for renal replacement therapy (RRT), if needed. […] Nephritic Glomerulonephritis […] IgA nephropathy: ACE inhibitors/ARBs (3 to 6 months) are used as they reduce proteinuria. Corticosteroids and fish oil can be prescribed if proteinuria exceeds 1 gm (provided GFR50) even after the initial therapy. Henoch Schonlein purpura (HSP) is managed on the same lines. Steroids are also helpful for gastrointestinal tract (GIT) related symptoms here.

• #40 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  3. For individuals with severe/refractory hypertension with/without encephalopathy, vasodilators (e.g., nitroprusside and nifedipine) can be used. […] 4. Clinicians can manage the complications associated with progressive chronic disease, including anemia, bone mineral disorders, acidosis, cardiovascular disease, and restless legs/cramps. […] 5. Appropriate counseling regarding diet. […] 6. Preparation for renal replacement therapy (RRT), if needed. […] Nephritic Glomerulonephritis […] IgA nephropathy: ACE inhibitors/ARBs (3 to 6 months) are used as they reduce proteinuria. Corticosteroids and fish oil can be prescribed if proteinuria exceeds 1 gm (provided GFR50) even after the initial therapy. Henoch Schonlein purpura (HSP) is managed on the same lines. Steroids are also helpful for gastrointestinal tract (GIT) related symptoms here.

• #41 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #42 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Therapy for antineutrophil cytoplasmic antibody (ANCA)associated disease consists of a combination of corticosteroids and cyclophosphamide. Treatment with steroids alone results in a 3-fold increase in the risk of relapse compared with combination therapy. The only predictor of kidney survival is the serum creatinine value at the time of diagnosis. Therefore, a high index of suspicion is imperative to establish the diagnosis quickly and to institute treatment as soon as possible. Kidney failure requiring dialysis is not a contraindication to treatment. Many patients can be removed from dialysis for an extended period (18 mo to 2 y). […] Administer methylprednisolone at 7 mg/kg/d intravenously (not to exceed 1 g) for 3 days, followed by oral prednisone at 1 mg/kg/d (not to exceed 80 mg) for 3 weeks, and then oral prednisone at 2 mg/kg every other day (not to exceed 120 mg) for 3 months. This dose is decreased by 25% every 4 weeks until the patient stops taking prednisone.

• #43 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Administer cyclophosphamide either intravenously or orally. Intravenous therapy is initially administered at a dose of 0.5 g/m2, and the oral dose is 2 mg/kg. Both are adjusted according to a 2-week leukocyte nadir count (goal 3000-4000/L). The maximum intravenous dose is 1 g/m2. Oral and intravenous cyclophosphamide appears to be equally efficacious. However, this remains an area of controversy, particularly in the case of granulomatosis with polyangiitis, for which some advocate oral therapy. The advantage to using the intravenous preparation is that the risk of cumulative toxicity is lower because a lower total dose is used. […] Another protocol, which has been used widely and with success in Europe, is the substitution of azathioprine for cyclophosphamide after a 3-month induction period. Azathioprine is administered at 2 mg/kg orally in a single daily dose. This is continued for 6-12 months.

• #44 Rapidly Progressive Glomerulonephritis Treatment & Management: Medical Care, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/240457-treatment

  Plasmapheresis may be a beneficial addition to therapy for patients who present with severe kidney failure (serum creatinine 6 mg/dL) or those whose disease progresses despite treatment. […] Rituximab may improve kidney outcomes in ANCA-associated vasculitis; in addition to antiB-cell therapy, therapy directed at T cells may improve kidney outcome, according to a study conducted by Berden et al. […] Other medications have been used in an attempt to attain a remission, such as intravenous immunoglobulin, antithymocyte antibody, and humanized monoclonal antibody to CD4 and CD25. Avacopan, a complement 5a receptor antagonistas approved as adjunctive treatment of severe ANCA-associated granulomatosis with polyangiitis and microscopic polyangiitis in combination with glucocorticoids, might be considered for cases refractory to standard treatment.

• #45 Glomerulonephritis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/glomerulonephritis-pro

  Another third respond to alternating courses of steroids and cyclophosphamide, rituximab, calcineurin inhibitors, chlorambucil, mycophenolate mofetil, or adrenocorticotropic hormone (ACTH) analogs. […] Treatment is done initially with ACE inhibitors/ARBs and by controlling BP. Immunosuppression is useful if no underlying cause is found. […] Some studies suggest that a course of high-dose prednisolone can reduce proteinuria and delay renal impairment. In patients with deteriorating renal function, immunosuppressive drugs are also often used. […] Without treatment, the disease progresses to end-stage kidney disease within a few months. Prednisolone and cyclophosphamide are generally effective in patients before severe renal damage occurs. Rituximab may be useful in some patients. […] Treatment with prednisolone, cyclophosphamide and plasma exchange is generally effective as long as it is started before renal disease is advanced.

• #46 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Post Streptococcal GN: Supportive treatment and antibiotics to get rid of nephritogenic bacteria. […] Anti-GBM Disease: The available options include plasma exchange, corticosteroids, rituximab, and cyclophosphamide. […] Rapidly progressive glomerulonephritis (RPGN): RPGN is treated with corticosteroids and cyclophosphamide. […] Plasma exchange is used for anti-GBM/ANCA vasculitis. […] For lupus nephritis, monoclonal antibodies, cyclophosphamide, mycophenolate mofetil, corticosteroids, and other immunomodulatory drugs can be used in various combinations. […] Nephrotic Glomerulonephritis […] Minimal change disease: Prednisolone 1 mg/kg (4 to 16 weeks). If relapsing, immunosuppression with greater intensity or for longer durations are options. Cyclophosphamide and calcineurin inhibitors are effective options.

• #47 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  Focal segmental glomerulosclerosis: Treatment is done initially with ACE inhibitors/ARBs and by controlling BP. Calcineurin inhibitors, plasma exchange, corticosteroids, and rituximab are helpful treatment options. […] Membranoproliferative GN: Treatment is done initially with ACE inhibitors/ARBs and by controlling BP. Immunosuppression is useful if no underlying cause is found. Work is currently ongoing to block or modify C3 activation.

• #48

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  A doctor may recommend medicine to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medicine. […] Plasma exchange may be used in certain circumstances if your condition is severe. […] If you have severe glomerulonephritis that cannot be improved with other treatments, you may require kidney dialysis or a kidney transplant. […] As glomerulonephritis can make you more vulnerable to infections, it’s a good idea to protect yourself by having a seasonal flu vaccine and a pneumonia vaccine (also called the pneumococcal vaccine).

• #49 Glomerulonephritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/diagnosis-treatment/drc-20355710

  Treatment of glomerulonephritis and your outcome depend on: […] Some cases of acute glomerulonephritis, especially those that follow an infection with streptococcal bacteria, might improve on their own and require no treatment. If there’s an underlying cause such as high blood pressure, an infection or an autoimmune disease treatment will be directed to the underlying cause. […] In general, the goal of treatment is to protect your kidneys from further damage and to preserve kidney function. […] Acute kidney failure due to infection-related glomerulonephritis is treated with dialysis. Dialysis uses a device that works like an artificial, external kidney that filters your blood. […] End-stage kidney disease is chronic kidney disease that can only be managed by regular kidney dialysis or a kidney transplant.

• #50 Glomerulonephritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16167-glomerulonephritis-gn

  Treatment depends on whats causing the condition and if you have kidney damage. The goal of treatment is to reduce any further damage. […] Sometimes, treating the underlying cause, like taking medication to manage high blood pressure, is all thats necessary. If the cause is due to infection, antibiotics can treat the infection. […] At other times, your healthcare provider may recommend: Changes to your diet so that you eat less protein and salt, which put extra strain on your kidneys. […] Immunosuppressants, if a problem with your immune system causes glomerulonephritis. […] Medicine to lower your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin blockers (ARB). […] Corticosteroids to decrease inflammation. […] Dialysis, which helps clean your blood, remove extra fluid and control blood pressure. […] Diuretics (water pills) to reduce swelling and remove excess fluid from your body. […] Plasmapheresis, a special process that filters protein from your blood.

• #51 Glomerulonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560644/

  3. For individuals with severe/refractory hypertension with/without encephalopathy, vasodilators (e.g., nitroprusside and nifedipine) can be used. […] 4. Clinicians can manage the complications associated with progressive chronic disease, including anemia, bone mineral disorders, acidosis, cardiovascular disease, and restless legs/cramps. […] 5. Appropriate counseling regarding diet. […] 6. Preparation for renal replacement therapy (RRT), if needed. […] Nephritic Glomerulonephritis […] IgA nephropathy: ACE inhibitors/ARBs (3 to 6 months) are used as they reduce proteinuria. Corticosteroids and fish oil can be prescribed if proteinuria exceeds 1 gm (provided GFR50) even after the initial therapy. Henoch Schonlein purpura (HSP) is managed on the same lines. Steroids are also helpful for gastrointestinal tract (GIT) related symptoms here.

• #52 Glomerulonephritis: symptoms, causes, types and treatments

  https://www.kidneyresearchuk.org/conditions-symptoms/glomerulonephritis/

  Some types of glomerulonephritis can be cured, others can be stopped, and most can at least be slowed down. However, sometimes glomerulonephritis can recur (come back) after a person has had a kidney transplant. […] Treatments (depending on the type of glomerulonephritis) include: […] Medicine to control blood pressure […] Drugs that dampen down the immune system and reduce inflammation in the kidney (immunosuppressants). These are strong drugs which can have serious side-effects. Because of this they are often only used for those patients with severe disease or rapidly worsening kidney function.

• #53 Glomerulonephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/symptoms-causes/syc-20355705

  Glomerulonephritis can come on suddenly (acute) or gradually (chronic). […] Treatment depends on the type of glomerulonephritis you have. […] Acute kidney failure is the sudden, rapid decline in kidney function, often associated with an infectious cause of glomerulonephritis. The accumulation of waste and fluids can be life-threatening if not treated promptly with an artificial filtering machine (dialysis). The kidneys often resume typical function after recovery. […] Chronic kidney disease is generally defined as kidney damage or decreased function for three or more months. Chronic kidney disease may advance to end-stage kidney disease, which requires either dialysis or a kidney transplant. […] There may be no way to prevent some forms of glomerulonephritis. However, here are some steps that might be beneficial: Seek prompt treatment of a strep infection with a sore throat or impetigo. […] Control high blood pressure, which lessens the likelihood of damage to your kidneys from hypertension. […] Control your blood sugar to help prevent diabetic nephropathy.

• #54 Transforming glomerulonephritis care through emerging diagnostics and therapeutics

  https://www.probiologists.com/article/transforming-glomerulonephritis-care-through-emerging-diagnostics-and-therapeutics

  Glomerulonephritis refers to a range of conditions involving inflammation and injury to the kidneys’ glomeruli, often leading to significant morbidity if left untreated. This review aims to examine emerging advancements in the prevention and treatment of glomerulonephritis and highlight progress in transforming the prognosis of this spectrum of diseases, while also identifying gaps requiring ongoing effort. Novel targeted immunotherapies utilizing engineered delivery platforms and biologicals like monoclonal antibodies are progressing in research pipelines, potentially offering safer, more efficacious alternatives to current standard immunosuppression. High-throughput biomarker assays and AI/machine learning algorithms have demonstrated the ability to improve early detection of kidney damage and guide personalized treatment plans. Further prevention opportunities emerge from modulating microbiome-immune interactions, lifestyle factors, and vaccinations shielding against infections triggering renal disorders. Although challenges remain, recent advancements in unraveling the pathogenesis of glomerulonephritis coupled with the emergence of cutting-edge diagnostics and targeted interventions set the stage for a new era combating the risk and progression of this spectrum of diseases.

• #55 Transforming glomerulonephritis care through emerging diagnostics and therapeutics

  https://www.probiologists.com/article/transforming-glomerulonephritis-care-through-emerging-diagnostics-and-therapeutics

  However, more research, innovation, and patient education are still needed to maximize these opportunities and develop improved prevention, diagnosis, and treatment approaches. Beyond recent advances, prevention strategies like healthy lifestyles, vaccines, and herbal medicine are also being investigated to reduce disease risk. Conventional treatments like immunosuppressants, plasmapheresis, and transplant remain important options. Emerging evidence suggests the gut microbiome may influence development and progression, so modulating it is being explored as a prevention and treatment approach. Other promising research directions are stem cell therapy, telemedicine, remote monitoring, patient support programs, and collaborative data networks. […] Implementing these advances faces challenges including costs, integration into healthcare systems, ensuring access and efficacy, and sustainability. A collaborative, comprehensive effort among stakeholders is required to overcome these hurdles and realize the goal of improving prevention, diagnosis, and treatment of this disease.

• #56 Advancements in Glomerulonephritis Treatment: The Impact of Recent Clinical Trials – European Medical Journal

  https://www.emjreviews.com/nephrology/congress-review/advancements-in-glomerulonephritis-treatment-the-impact-of-recent-clinical-trials-j120123/

  IgAN is a progressive, immune complex-mediated disease, and the most common primary glomerulonephritis, representing the leading cause of chronic kidney and end-stage renal disease. […] Barratt discussed traditional strategies for treating immune-related kidney diseases, including B-cell depletion and modulation. Rituximab has historically been shown to be effective but new therapies targeting CD38, a cell surface protein expressed on plasma cells, therapies such as felzartamab and mezagitamab, are in advanced trial phases. […] Trials targeting components of the complement system, such as factor B, D, and C5, have shown potential in reducing proteinuria and inflammation, with drugs like ravulizumab demonstrating significant efficacy. […] New therapies, including sodium-glucose cotransporter 2 inhibitors and endothelin receptor antagonists, have shown effectiveness in preserving kidney function.

• #57 Treatment for C3G | National Kidney Foundation

  https://www.kidney.org/kidney-topics/treatment-c3g

  Eculizumab is another drug known as a monoclonal antibody. This drug can specifically target the complement system and has been used to treat C3G. […] It is important to realize that over time, until an effective treatment is found, some patients with C3G, but not all, will slowly get worse until they reach kidney failure. If this happens, patients need a kidney transplant or dialysis to stay alive. […] However, the ability for clinicians and researchers to predict what may happen is improving, but it’s not a guarantee.

• #58 Advancements in Glomerulonephritis Treatment: The Impact of Recent Clinical Trials – European Medical Journal

  https://www.emjreviews.com/nephrology/congress-review/advancements-in-glomerulonephritis-treatment-the-impact-of-recent-clinical-trials-j120123/

  IgAN is a progressive, immune complex-mediated disease, and the most common primary glomerulonephritis, representing the leading cause of chronic kidney and end-stage renal disease. […] Barratt discussed traditional strategies for treating immune-related kidney diseases, including B-cell depletion and modulation. Rituximab has historically been shown to be effective but new therapies targeting CD38, a cell surface protein expressed on plasma cells, therapies such as felzartamab and mezagitamab, are in advanced trial phases. […] Trials targeting components of the complement system, such as factor B, D, and C5, have shown potential in reducing proteinuria and inflammation, with drugs like ravulizumab demonstrating significant efficacy. […] New therapies, including sodium-glucose cotransporter 2 inhibitors and endothelin receptor antagonists, have shown effectiveness in preserving kidney function.

• #59 Advancements in Glomerulonephritis Treatment: The Impact of Recent Clinical Trials – European Medical Journal

  https://www.emjreviews.com/nephrology/congress-review/advancements-in-glomerulonephritis-treatment-the-impact-of-recent-clinical-trials-j120123/

  Sparsentan received accelerated approval from the FDA in 2023 for proteinuria reduction in high-risk patients with IgAN, with continued approval hinging on sparsentan delaying long-term kidney function decline. […] The logical progression is the therapeutic target of the complement system as the final effector mechanism contributing to podocyte damage and target of plasma cells, to reduce autoantibody production. […] Currently the only plasma cell targeting therapy to have preliminary clinical trial data is an anti-CD38 monoclonal antibody, called felzartamab. […] Tomas stressed that the data are promising and demonstrate the potential of plasma cell-targeted therapies. […] Advancements in IgAN and MN clinical trials, particularly in targeted therapies and regulatory frameworks, herald a new era of effective disease management, offering improved outcomes for patients previously left with few treatment options.

• #60 Advancements in Glomerulonephritis Treatment: The Impact of Recent Clinical Trials – European Medical Journal

  https://www.emjreviews.com/nephrology/congress-review/advancements-in-glomerulonephritis-treatment-the-impact-of-recent-clinical-trials-j120123/

  IgAN is a progressive, immune complex-mediated disease, and the most common primary glomerulonephritis, representing the leading cause of chronic kidney and end-stage renal disease. […] Barratt discussed traditional strategies for treating immune-related kidney diseases, including B-cell depletion and modulation. Rituximab has historically been shown to be effective but new therapies targeting CD38, a cell surface protein expressed on plasma cells, therapies such as felzartamab and mezagitamab, are in advanced trial phases. […] Trials targeting components of the complement system, such as factor B, D, and C5, have shown potential in reducing proteinuria and inflammation, with drugs like ravulizumab demonstrating significant efficacy. […] New therapies, including sodium-glucose cotransporter 2 inhibitors and endothelin receptor antagonists, have shown effectiveness in preserving kidney function.

• #61 Advancements in Glomerulonephritis Treatment: The Impact of Recent Clinical Trials – European Medical Journal

  https://www.emjreviews.com/nephrology/congress-review/advancements-in-glomerulonephritis-treatment-the-impact-of-recent-clinical-trials-j120123/

  Sparsentan received accelerated approval from the FDA in 2023 for proteinuria reduction in high-risk patients with IgAN, with continued approval hinging on sparsentan delaying long-term kidney function decline. […] The logical progression is the therapeutic target of the complement system as the final effector mechanism contributing to podocyte damage and target of plasma cells, to reduce autoantibody production. […] Currently the only plasma cell targeting therapy to have preliminary clinical trial data is an anti-CD38 monoclonal antibody, called felzartamab. […] Tomas stressed that the data are promising and demonstrate the potential of plasma cell-targeted therapies. […] Advancements in IgAN and MN clinical trials, particularly in targeted therapies and regulatory frameworks, herald a new era of effective disease management, offering improved outcomes for patients previously left with few treatment options.

• #62 Application of nanotechnology in the treatment of glomerulonephritis: current status and future perspectives | Journal of Nanobiotechnology | Full Text

  https://jnanobiotechnology.biomedcentral.com/articles/10.1186/s12951-023-02257-8

  Glomerulonephritis (GN) is the most common cause of end-stage renal failure worldwide; in most cases, it cannot be cured and can only delay the progression of the disease. At present, the main treatment methods include symptomatic therapy, immunosuppressive therapy, and renal replacement therapy. However, effective treatment of GN is hindered by issues such as steroid resistance, serious side effects, low bioavailability, and lack of precise targeting. […] The current application of nanoparticles in GN is summarized to provide a reference for better treatment of GN in the future. […] At present, the primary clinical therapy for GN is symptomatic therapy and immunosuppressive therapy (e.g. glucocorticoid, ciclosporin, etc.). Most patients with GN can only delay the progression of the disease and cannot be completely cured. Some types of patients with GN are prone to relapse and steroid resistance after treatment, or progress to ESRD, which are very difficult to treat.

• #63 Application of nanotechnology in the treatment of glomerulonephritis: current status and future perspectives | Journal of Nanobiotechnology | Full Text

  https://jnanobiotechnology.biomedcentral.com/articles/10.1186/s12951-023-02257-8

  Therefore, new GN treatment methods are urgently needed. […] Nanotechnology has flourished in multiple fields, including medicine, such as targeted transportation, in vivo imaging, assisted diagnosis, and disease treatment. Encapsulating drugs with nanoparticles (NPs) can target drug delivery, improve bioavailability, avoid systemic effects, and reduce drug toxicity and adverse reactions. […] There have been many attempts to deliver drugs to the kidney by nanodrug loading systems, which mainly deliver drugs to mesangial cells, podocytes and endothelial cells. […] This review briefly introduces the concept, pathologic changes and current treatment situation of GN, summarizes the application of nanotechnology in the treatment of primary GN and secondary GN (DN and LN), and proposes some treatment methods that have the potential to be applied in the treatment of GN.

• #64 Application of nanotechnology in the treatment of glomerulonephritis: current status and future perspectives | Journal of Nanobiotechnology | Full Text

  https://jnanobiotechnology.biomedcentral.com/articles/10.1186/s12951-023-02257-8

  In the treatment of primary GN, NPs typically function as a delivery system capable of transporting various drugs and nucleic acids. Additionally, they can modulate ion channel gating to regulate inflammation. […] In membranous GN, alkylating agents (such as cyclophosphamide) plus corticosteroids or calcineurin inhibitors are commonly used for treatment. […] Renal replacement therapy includes hemodialysis, peritoneal dialysis and kidney transplantation. […] Nanomaterials are widely used in kidney diseases and can be used for disease diagnosis, detection of renal structure and function, delivery of drugs, and prevention of diseases (such as transplant-induced reactions). […] Researchers are committed to developing NPs with both diagnostic and therapeutic functions. […] The use of nanomaterial-loaded drugs can accurately target kidney cells, reduce adverse drug reactions, and produce better therapeutic effects. […] The application of nanodrug delivery systems can increase the therapeutic efficiency of LN, which has promising application prospects.

• #65 Transforming glomerulonephritis care through emerging diagnostics and therapeutics

  https://www.probiologists.com/article/transforming-glomerulonephritis-care-through-emerging-diagnostics-and-therapeutics

  The prevention of glomerulonephritis involves controlling risk factors and reducing inflammation to prevent damage to the kidneys. Recent advances in innovative approaches for the prevention of glomerulonephritis include lifestyle modifications, vaccinations, probiotics, anti-inflammatory agents, and genetic screening and counseling. […] Emerging therapies and technologies have the potential to revolutionize the management of glomerulonephritis. […] Gene therapy has emerged as a prospective new technique for glomerulonephritis management. […] Stem cell therapy shows potential as a method for glomerulonephritis management. […] Biological therapy has emerged as a prospective approach for glomerulonephritis management. […] Vaccination is a crucial preventive strategy against glomerulonephritis, which can result from infections like Streptococcal infections that trigger immune responses causing kidney damage.

• #66 A safer, effective treatment for autoimmune glomerulonephritis – Research Outreach

  https://researchoutreach.org/articles/safer-effective-treatment-autoimmune-glomerulonephritis/

  In the disease autoimmune glomerulonephritis, the bodys own immune system attacks the blood vessels of the glomeruli, the part of the kidney that filters the blood. This condition is life-threatening, but current treatments are limited and carry a high risk of serious side-effects. Recently, Dr Dragana Odobasic of Monash University, Melbourne, Australia, and her colleagues investigated the potential of tolerogenic dendritic cells in treating glomerulonephritis. They found that this treatment could effectively and specifically protect the blood vessels of the glomeruli, and so could offer a safer, effective therapy for this devasting disease. […] Current treatment options for anti-MPO GN are limited. The medications that are available are only partially effective, and are associated with many adverse effects; in particular, as the treatments cause broad suppression of the immune system, the patient has a high risk of contracting a serious infection. Safer, more specific treatments for anti-MPO GN are needed. Ideally, these treatments should supress only the anti-MPO immune response, and thus protect the kidneys from damage.

• #67 A safer, effective treatment for autoimmune glomerulonephritis – Research Outreach

  https://researchoutreach.org/articles/safer-effective-treatment-autoimmune-glomerulonephritis/

  Tolerogenic dendritic cells promote immunosuppression, and could therefore fulfil the need for a specific, targeted treatment for anti-MPO GN. […] Together, these results strongly suggest that tolerogenic dendritic cells could be a new, effective and safe treatment for anti-MPO GN. Such a treatment would be a huge benefit for anti-MPO GN patients, improving their quality of life and allowing them to avoid the dangerous side effects that accompany many of the current, non-specific, treatments. In fact, these cells could potentially offer an effective cure for anti-MPO GN, by preventing damage to the tiny blood vessels of the glomeruli. […] Dr Odobasic’s work has demonstrated, for the first time, that injecting tolerogenic dendritic cells can specifically switch off anti-MPO autoimmunity and protect the glomeruli from vasculitis.

• #68 Glomerulonephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/symptoms-causes/syc-20355705

  Glomerulonephritis can come on suddenly (acute) or gradually (chronic). […] Treatment depends on the type of glomerulonephritis you have. […] Acute kidney failure is the sudden, rapid decline in kidney function, often associated with an infectious cause of glomerulonephritis. The accumulation of waste and fluids can be life-threatening if not treated promptly with an artificial filtering machine (dialysis). The kidneys often resume typical function after recovery. […] Chronic kidney disease is generally defined as kidney damage or decreased function for three or more months. Chronic kidney disease may advance to end-stage kidney disease, which requires either dialysis or a kidney transplant. […] There may be no way to prevent some forms of glomerulonephritis. However, here are some steps that might be beneficial: Seek prompt treatment of a strep infection with a sore throat or impetigo. […] Control high blood pressure, which lessens the likelihood of damage to your kidneys from hypertension. […] Control your blood sugar to help prevent diabetic nephropathy.

• #69

  https://www.nhs.uk/conditions/glomerulonephritis/treatment/

  A doctor may recommend medicine to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medicine. […] Plasma exchange may be used in certain circumstances if your condition is severe. […] If you have severe glomerulonephritis that cannot be improved with other treatments, you may require kidney dialysis or a kidney transplant. […] As glomerulonephritis can make you more vulnerable to infections, it’s a good idea to protect yourself by having a seasonal flu vaccine and a pneumonia vaccine (also called the pneumococcal vaccine).

• #70 Transforming glomerulonephritis care through emerging diagnostics and therapeutics

  https://www.probiologists.com/article/transforming-glomerulonephritis-care-through-emerging-diagnostics-and-therapeutics

  Probiotics have exhibited promise for glomerulonephritis management, but limitations and challenges remain, such as restricted understanding of the intestinal microbiota’s role in glomerulonephritis pathogenesis and probiotics’ mechanisms of action. […] Telemedicine is an innovative healthcare delivery approach that utilizes technology for remote medical care and consultation. […] Implementing advances in glomerulonephritis poses challenges including cost limiting patient access, infrastructure changes needing electronic medical records upgrades, personnel training, protocol adoption, clinical resistance to unfamiliar technologies/therapies, prolonged regulatory approval delaying availability, data privacy/security risk necessitating protection, and variable patient acceptance depending on uncertainties surrounding technologies, treatments, side effects or risks.

• #71 Glomerulonephritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/diagnosis-treatment/drc-20355710

  Treatment of glomerulonephritis and your outcome depend on: […] Some cases of acute glomerulonephritis, especially those that follow an infection with streptococcal bacteria, might improve on their own and require no treatment. If there’s an underlying cause such as high blood pressure, an infection or an autoimmune disease treatment will be directed to the underlying cause. […] In general, the goal of treatment is to protect your kidneys from further damage and to preserve kidney function. […] Acute kidney failure due to infection-related glomerulonephritis is treated with dialysis. Dialysis uses a device that works like an artificial, external kidney that filters your blood. […] End-stage kidney disease is chronic kidney disease that can only be managed by regular kidney dialysis or a kidney transplant.

• #72 Glomerulonephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/symptoms-causes/syc-20355705

  Glomerulonephritis can come on suddenly (acute) or gradually (chronic). […] Treatment depends on the type of glomerulonephritis you have. […] Acute kidney failure is the sudden, rapid decline in kidney function, often associated with an infectious cause of glomerulonephritis. The accumulation of waste and fluids can be life-threatening if not treated promptly with an artificial filtering machine (dialysis). The kidneys often resume typical function after recovery. […] Chronic kidney disease is generally defined as kidney damage or decreased function for three or more months. Chronic kidney disease may advance to end-stage kidney disease, which requires either dialysis or a kidney transplant. […] There may be no way to prevent some forms of glomerulonephritis. However, here are some steps that might be beneficial: Seek prompt treatment of a strep infection with a sore throat or impetigo. […] Control high blood pressure, which lessens the likelihood of damage to your kidneys from hypertension. […] Control your blood sugar to help prevent diabetic nephropathy.

• #73 Get Glomerulonephritis Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/glomerulonephritis-treatment

  We may recommend avoiding certain foods since glomerulonephritis reduces your kidneys ability to remove waste from your blood. Physical activity, quitting smoking and drinking less alcohol can help protect your kidneys, too. […] Following treatment, youll have several follow-up appointments. Your provider may recommend maintenance therapy to prevent a flare-up of glomerulonephritis. We continue to watch your kidney function through urine and blood samples every few months. These regular visits help us detect any changes early on and adjust your treatment when needed.

• #74 Recovery & Support for Glomerulonephritis in Children | NYU Langone Health

  https://nyulangone.org/conditions/glomerulonephritis-in-children/support

  Children who develop acute glomerulonephritis after a bacterial infection often recover completely. But others especially those with chronic glomerulonephritis caused by an autoimmune condition may need ongoing treatment and support. […] Specialists at Hassenfeld Childrens Hospital at NYU Langone develop an individualized follow-up plan for your child, depending on the treatments he or she is receiving and the severity of the condition. […] Our doctors also help children and their families cope with ongoing treatment for kidney problems. […] Immunosuppressive medications, which are often used to treat children with glomerulonephritis caused by autoimmune conditions, can increase your child’s risk of viral and bacterial infections. […] Medication and other treatments for glomerulonephritis can be expensive. Our social workers can help families determine which treatments are covered by insurance. They can also offer advice about other options to help ensure that your child receives the treatment he or she needs to restore kidney function and prevent complications.

• #75 Transforming glomerulonephritis care through emerging diagnostics and therapeutics

  https://www.probiologists.com/article/transforming-glomerulonephritis-care-through-emerging-diagnostics-and-therapeutics

  However, more research, innovation, and patient education are still needed to maximize these opportunities and develop improved prevention, diagnosis, and treatment approaches. Beyond recent advances, prevention strategies like healthy lifestyles, vaccines, and herbal medicine are also being investigated to reduce disease risk. Conventional treatments like immunosuppressants, plasmapheresis, and transplant remain important options. Emerging evidence suggests the gut microbiome may influence development and progression, so modulating it is being explored as a prevention and treatment approach. Other promising research directions are stem cell therapy, telemedicine, remote monitoring, patient support programs, and collaborative data networks. […] Implementing these advances faces challenges including costs, integration into healthcare systems, ensuring access and efficacy, and sustainability. A collaborative, comprehensive effort among stakeholders is required to overcome these hurdles and realize the goal of improving prevention, diagnosis, and treatment of this disease.

Zobacz więcej