Glomerulonephritis: Current Diagnosis, Treatment and Future Options

Dear Colleagues,

Glomerulonephritis is a complex and challenging condition affecting the kidneys, being the cause of ESRD in up to 30% of patients reaching RRT and causing an enormous impact on patients and a burden for the health system.

This Special Issue aims to explore the significant advancements in the diagnosis and management of distinct glomerulonephritis made in recent years.

The topics of interest for publication include, but are not limited to, the latest diagnostic techniques used to identify glomerulonephritis. Additionally, we are interested in hearing about the various treatment options available for patients with glomerulonephritis. Furthermore, we are excited to learn about any promising future treatments or research developments in the field of glomerulonephritis. This could include novel drug therapies, emerging technologies, or potential genetic factors influencing the disease.

For this Special Issue, original research articles and reviews are welcome.

Your contribution to this Special Issue will not only educate our readers but also help advance our understanding of glomerulonephritis and improve patient outcomes. We look forward to receiving your contributions on this important subject.

Dr. Ana I. Ávila
Dr. Montserrat M. Díaz-Encarnación
Guest Editors

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• glomerulonephritis
• diagnosis
• management
• drug therapies
• treatment

Title: Barriers to Treatment of IgA Nephropathy with Novel Therapies
Authors: Samantha Collins PA-C, Lindsay Penninger PA-C
Affiliation: Carolina Kidney Associates
Abstract: IgA Nephropathy (IgAN) is widely considered the most common primary cause of glomerulonephritis worldwide associated with potential serious renal deterioration.1 The disease is autoimmune in nature and leads to chronic renal inflammation. It is defined by the presence of IgA immune deposits in the glomerular mesangium on biopsy. 3 Pathophysiology of this disease is poorly understood but ongoing research is providing insight to the potential mechanism and targets for therapy. Various studies have concluded that epidemiological and genetic factors play a role in the prevalence of this disease. The varying presentations that have been reported range from asymptomatic to ESRD. These factors play a role in barriers to IgAN diagnosis as well as patient access to nephrologist and concerns regarding patient risk for biopsy. Once diagnosis is confirmed additional barriers for treatment can affect patient outcomes. New therapies have been identified in the last several years which are not included in current 2021 KDIGO guidelines. Due to this, some providers may not be aware of novel therapies which could help prevent progression of disease. These novel therapies can also be expensive, have undesired adverse effects and require enrollment that can lead to additional paperwork for both patient and provider. Many of the solutions to overcoming these barriers start with education of both patient and providers. Our goal is to help recognize barriers and propose solutions to improve management of IgAN leading to better patient outcomes.

Title: Diagnosis and treatment of renal ANCA Vasculitis: a summary of the Consensus Document of the Catalan Group for the Study of Glomerular Diseases (GLOMCAT)
Authors: Juliana Bordignon; Helena Marco; Meritxell Ibernon; Irene Agraz; Carola Arcal; Xoana Barros; Victoria Cabrera; Iara Karla Da Silva; Montserrat Días; Xavier Fulladosa; Elena Guillen; Patricia Lescano; Laura M; Eva Marquez; Nadia Martin; Ana Merino; Maru Navarro; Eva Rodríguez; Maria José Soler; Joan Torras; Luís Quintana
Affiliation: Nephrology Department Hospital Moisès Broggi
Abstract: The document provides a comprehensive overview of the diagnosis, monitoring, and treatment of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) with renal involvement, focusing on granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). It outlines the definitions, clinical presentation, histopathological classification, monitoring strategies, induction and maintenance treatments, as well as special considerations for relapsing, refractory, and frail patients with renal AAV.

Title: Role of Avacopan on ANCA-Associated Vasculitis
Authors: Justo Sandino; Enrique Morales
Affiliation: Departamento de Nefrología Hospital 12 de Octubre, Instituto de Investigación Sanitaria del Hospital 12 de Octubre (imas12)
Abstract: Antineutrophil cytoplasmic antibody-associated (ANCA) vasculitis is a group of autoimmune diseases characterized by inflammation of the microvasculature, leading to life-threatening complications, including kidney disease. These diseases are associated with a high morbidity and mortality rate. Conventional treatment modalities have evolved towards personalized therapies intending to mitigate inflammation and minimize the adverse effects of traditional immunosuppressive agents. Avacopan, a novel C5a receptor inhibitor, represents a promising therapeutic option for vasculitis with renal involvement. This article provides a comprehensive review of the role of complement in the pathogenesis of vasculitis with renal involvement and the role of avacopan for its treatment, taking into account recent updates to both the EULAR and KDIGO guidelines and published experience of avacopan use in real clinical settings.