MODERN DRUG TREATMENT OF PATIENTS WITH GLOMERULONEPHRITIS

Abstract:

IgA nephropathy (IgAN) is the most common type of glomerulonephritis in the world. Most patients are asymptomatic or have mild symptoms, and loss of CFT occurs slowly, if at all. Thus, the main focus of therapy is optimized supportive care, that is, measures that lower blood pressure, reduce proteinuria, minimize lifestyle risk factors, and otherwise help reduce nonspecific kidney damage. The value of immunosuppression remains controversial and, if it exists at all, high-dose systemic corticosteroid therapy over several months should be considered, taking into account patient characteristics that may justify or preclude such therapy. In addition, side effects associated with corticosteroid therapy increase significantly as GFR decreases. With the exception of corticosteroids, there is little evidence that any additional immunosuppression other than mycophenolate mofetil is beneficial in Asian patients. Many clinical trials are ongoing, ranging from enteric-coated budesonide to B-cell blockade and complement inhibitors, and in the future we hope that this will allow for more targeted treatment of patients at high risk of progression to IgAN.