TY - JOUR
T1 - Advances in Understanding of Pathogenesis and Treatment of Immune-Mediated Kidney Disease
T2 - A Review
AU - Kant, Sam
AU - Kronbichler, Andreas
AU - Sharma, Purva
AU - Geetha, Duvuru
N1 - Funding Information:
Sam Kant, MD, Andreas Kronbichler, MD, PhD, Purva Sharma, MD, and Duvuru Geetha, MD, MRCP (UK). None. Dr Geetha is a consultant to ChemoCentryx and Aurinia. Dr Kronbichler has received personal fees from Novartis, Terumo BCT, Miltenyi Biotech, Vifor Pharma, and Alexion. The other authors declare that they have no relevant financial interests. Received March 11, 2021. Evaluated by 2 external peer reviewers, with direct editorial input from an Associate Editor and a Deputy Editor. Accepted in revised form July 25, 2021.
Publisher Copyright:
© 2021 National Kidney Foundation, Inc.
PY - 2022/4
Y1 - 2022/4
N2 - There continues to be rapid advancement in our understanding of the pathogenesis of immune-mediated kidney disease. This progress has culminated in the development of multiple therapeutic agents that have consistently improved renal and patient outcomes. The focus of this review is to discuss these recent advancements in immune-mediated kidney disease via the lens of direct and indirect immune-mediated mechanisms. In the direct immune-mediated disease, recently described antigens in anti–glomerular basement membrane (GBM) disease and membranous nephropathy are discussed, along with new therapeutic regimens in membranous nephropathy and focal segmental glomerulosclerosis. From an indirect immune-mediated disease standpoint, recent pivotal trials in antineutrophil cytoplasmic antibody vasculitis, lupus nephritis, and IgA nephropathy are examined from a real-world practice perspective. New molecular pathways in various disorders of alternate complement pathway are described, which in turn have led to development of various experimental therapies. In addition, pivotal and ongoing therapeutic trials in the aforementioned diseases are presented.
AB - There continues to be rapid advancement in our understanding of the pathogenesis of immune-mediated kidney disease. This progress has culminated in the development of multiple therapeutic agents that have consistently improved renal and patient outcomes. The focus of this review is to discuss these recent advancements in immune-mediated kidney disease via the lens of direct and indirect immune-mediated mechanisms. In the direct immune-mediated disease, recently described antigens in anti–glomerular basement membrane (GBM) disease and membranous nephropathy are discussed, along with new therapeutic regimens in membranous nephropathy and focal segmental glomerulosclerosis. From an indirect immune-mediated disease standpoint, recent pivotal trials in antineutrophil cytoplasmic antibody vasculitis, lupus nephritis, and IgA nephropathy are examined from a real-world practice perspective. New molecular pathways in various disorders of alternate complement pathway are described, which in turn have led to development of various experimental therapies. In addition, pivotal and ongoing therapeutic trials in the aforementioned diseases are presented.
KW - Alternative complement pathway
KW - C3 glomerulopathy (C3G)
KW - IgA nephropathy (IgAN)
KW - anti-GBM disease
KW - antibodies
KW - atypical hemolytic uremic syndrome (aHUS)
KW - autoantibodies
KW - glomerular basement membrane (GBM)
KW - glomerulonephritis
KW - immune complex deposition
KW - immune-mediated kidney disease
KW - immunosuppression
KW - lupus nephritis (LN)
KW - pathogenesis
KW - review
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U2 - 10.1053/j.ajkd.2021.07.019
DO - 10.1053/j.ajkd.2021.07.019
M3 - Review article
C2 - 34508831
AN - SCOPUS:85120482078
SN - 0272-6386
VL - 79
SP - 582
EP - 600
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -