The Kidney Disease: Improving Global Outcomes (KDIGO) initiative organized a Controversies Conference on glomerular diseases in November 2017. The conference focused on the 2012 KDIGO guideline with the aim of identifying new insights into nomenclature, pathogenesis, diagnostic work-up, and, in particular, therapy of glomerular diseases since the guideline’s publication. It was the consensus of the group that most guideline recommendations, in particular those dealing with therapy, will need to be revisited by the guideline-updating Work Group. This report covers general management of glomerular disease, IgA nephropathy, and membranous nephropathy. По инициативе Kidney Disease: Improving Global Outcomes (KDIGO) в ноябре 2017 года была организована конференция по противоречивым вопросам в ведении гломерулярных болезней. Работа конференции была сфокусирована на рекомендациях KDIGO 2012 года и преследовала цель – определить новые моменты в понимании номенклатуры, патогенеза, диагностики и, в частности, лечения гломерулярной патологии. Участники пришли к консенсусу в том, что большинство основных рекомендаций, в особенности касающихся лечения, должны быть пересмотрены соответствующей рабочей группой. Данная часть отчета охватывает общие принципы ведения гломерулярных болезней, IgA-нефропатии и мембранозной нефропатии.

Принципы ведения гломерулярных болезней: итоги согласительной конференции Kidney disease: improving global outcomes (KDIGO). Часть 1 // Management and treatment of glomerular diseases (part 1): conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference

Purpose:The goal of these recommendations is to provide guidance on the optimal care of children with glomerular diseases during the COVID-19 pandemic. Patients with glomerular diseases are known t...

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Management of Canadian Pediatric Patients With Glomerular Diseases During the COVID-19 Pandemic: Recommendations From the Canadian Association of Pediatric Nephrologists COVID-19 Rapid Response Team.

Background: The novel coronavirus disease (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an evolving pandemic with significant mortality. Information about the impact of infection on glomerular disease patients in particular has been lacking. Understanding the virus’s effect in glomerular disease is constantly changing. This review article summarizes the data published thus far on COVID-19 and its manifestations in pre-existing and de novo glomerular disease. Summary: While patients with glomerular disease may be at higher risk of severe COVID-19 due to their immunosuppressed status, some data suggest that a low amount of immunosuppression may be helpful in mitigating the systemic inflammatory response which is associated with high mortality rates in COVID-19. There have been a few case reports on COVID-19 causing glomerular disease relapse in patients. Multiple mechanisms have been proposed for kidney injury, proteinuria, and hematuria in the setting of COVID-19. More commonly, these are caused by direct tubular injury due to hemodynamic instability and hypoxic injury. However, the cytokine storm induced by COVID-19 may trigger common post-viral glomerular disease such as IgA nephropathy, anti-GBM, and ANCA vasculitis that have also been described in COVID-19 patients. Collapsing glomerulopathy, a hallmark of HIV-associated nephropathy, is being reported SARS-CoV-2 cases, particularly in patients with high-risk APOL1 alleles. Direct viral invasion of glomerular structures is hypothesized to cause a podocytopathy due to virus’s affinity to ACE2, but evidence for this remains under study. Key Messages: Infection with SARS-CoV-2 may cause glomerular disease in certain patients. The mechanism of de novo glomerular disease in the setting of COVID-19 is under study. The management of patients with existing glomerular disease poses unique challenges, especially with regard to immunosuppression management. Further studies are needed to inform clinician decisions about the management of these patients during the COVID-19 pandemic.

/pdf/current-understanding-of-clinical-manifestations-of-covid-19-2l55pvb7an.pdf

Current Understanding of Clinical Manifestations of COVID-19 in Glomerular Disease

With the evolution of SARS‐CoV‐2 pandemic, it was believed to be a direct respiratory virus. But, its deleterious effects were observed on different body systems, including kidneys.

Kidneys in SARS‐CoV‐2 era: A challenge of multiple faces

Purpose of program:This article will provide guidance on how to best manage patients with glomerulonephritis (GN) during the COVID-19 pandemic.Sources of information:We reviewed relevant published ...

https://journals.sagepub.com/doi/pdf/10.1177/2054358120968955

Management of Patients With Glomerulonephritis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team.

Heather N. Reich

Papers

Management of Patients With Glomerulonephritis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team.