Approach to Diagnosis and Management of Primary Glomerular Diseases Due to Podocytopathies in Adults: Core Curriculum 2020
- PMID: 32331832
- DOI: 10.1053/j.ajkd.2019.12.019
Approach to Diagnosis and Management of Primary Glomerular Diseases Due to Podocytopathies in Adults: Core Curriculum 2020
Abstract
Podocyte injury is the initiating step in the pathway toward clinically evident forms of nephrotic syndrome known as podocytopathies, represented as either minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS). There are hallmark differences in the histologic appearances of MCD and FSGS, which in turn represent distinct pathogenic models after initial podocyte injury (eg, no change in podocyte number in MCD vs podocyte detachment and death in FSGS). However, MCD and FSGS also share a number of common causes, supporting the theory that these diseases lie along a shared podocytopathy spectrum. In this installment of AJKD's Core Curriculum in Nephrology, we demonstrate how the podocytopathies can be classified according to pathogenesis and treatment response as an alternative to histologic description. Using case examples, we show how these alternative classification schemes can assist not only diagnosis, but also long-term management of podocytopathies.
Keywords: Podocytopathy; disease classification; focal segmental glomerulosclerosis (FSGS); minimal change disease (MCD); nephrotic syndrome; review.
Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Comment in
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Infections and Collapsing Glomerulopathy.Am J Kidney Dis. 2020 Oct;76(4):600-601. doi: 10.1053/j.ajkd.2020.05.016. Epub 2020 Jun 26. Am J Kidney Dis. 2020. PMID: 32598981 Free PMC article. No abstract available.
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