Glomerular disease treatment guidelines updated

Given the rapidly growing evidence base in glomerular disease, the Kidney Disease Improving Global Outcomes group, known as KDIGO, recently published an updated clinical practice guideline for the management of immunoglobulin A nephropathy (IgAN) and immunoglobulin A vasculitis (IgAV). University of Cincinnati nephrologists recently shared what's new and what's next with MedCentral.

IgAN, or Berger's disease, is an autoimmune disease characterized by the buildup of the immune protein immunoglobulin A (IgA) in the glomeruli, leading to inflammation and, eventually, kidney damage or failure.

On the other hand, IgAV, also known as Henoch-Schönlein purpura, is a rare condition that causes the swelling of small blood vessels characterized by IgA-mediated inflammation and bleeding involving the skin, joints, gastrointestinal tract and kidneys. It occurs predominantly in children and is frequently preceded by an infectious trigger.

Expanding on the 2021 KDIGO clinical practice guideline for the management of glomerular diseases, this new summary highlights practical risk stratification, diagnostic workup, supportive therapy, use of targeted pharmacologic agents, and management in pregnancy, pediatrics, and rapidly progressive presentations.

“The guidelines will likely be updated again soon, given a few new targeted therapies that have completed multiple phase 3 studies with excellent results,” said Ahmad Anjak, MD, associate professor of clinical medicine at the University of Cincinnati College of Medicine in the Division of Nephrology in the Department of Internal Medicine.

“IgAN usually affects 20- and 30-year-olds during their most productive years,” said Manish Anand, MD, associate professor of clinical medicine and director of transplant nephrology clinical trials at the University of Cincinnati College of Medicine in the Division of Nephrology in the Department of Internal Medicine. “In addition to the risk of end-stage renal disease (ESRD), most of these patients suffer from poor psychosocial functioning, such as anxiety, depression and fatigue, in addition to financial burden, so this is a promising time for IgAN patients and physicians taking care of them."

"These are exciting times for IgA nephropathy patients, since we have robust research studies and multiple therapeutic agents that are currently approved and going to be approved soon that will change the trajectory and outcome of the disease, and lead to better clinical outcomes and better quality of life for IgA nephropathy patients, thereby reducing the progression to ESRD," Dr. Anjak concluded.

Read the full MedCentral article.

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