Glomerulonephritiden – nicht nur für den Nephrologen wichtig

Abstract

Chronic kidney disease (CKD) is an increasing health problem in all societies. The role of diabetes mellitus and hypertension in CKD is well established in the medical community. This is not necessarily the case for the various forms of glomerulonephitis (GN). The single entities of GN are rare diseases. In total, glomerulonephritis, however, is accountable for about 20 % of all patients which reach end stage renal disease (ESRD). GN therefore plays an important clinical role. Since many forms of GN have only sparse clinical symptoms at the beginning of the disease and the treatment is only effective in early stages, it is important for patients’ outcome to make an early diagnosis. In case of any – even small – changes in the urine of patients the diagnoses of GN should be considered. It is the purpose of this article to describe the clinical significance and the road to the diagnosis of the most frequent forms of GN to allow an early start of therapy in order to prevent the development of ESRD.

Da die Behandlung von Glomerulonephritiden – entzündlichen Veränderungen der Nierenkörperchen – meist nur in den Anfangsstadien erfolgreich einen Nierenfunktionsverlust verhindern kann, ist eine frühe Diagnose das Wichtigste für die Prognose dieser Patienten. Bei Auffälligkeiten des Urins ist es deshalb entscheidend, an Glomerulonephritiden als Ursache zu denken.

Schlüsselwörter

Glomerulonephritiden - Nierenerkrankung - chronische Niereninsuffizienz

Key words

glomerulonephritis - kidney disease - chronic renal insufficiency

• Literatur

• 1 Couser WG. Primary membranous nephropathy. Clin J Am Soc Nephrol 2017; 12: 983-997
• 2 Stahl RAK, Hoxha E. Membranöse Glomerulonephritis. Internist 2019; 60: 440-449
• 3 Beck LH, Bonegio RG, Lambeau G. et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 2009; 361: 11-21
• 4 Mahmud M, Pinnschmidt HO, Reinhard L. et al. Role of the phospholipase A2 receptor 1 antibody level at diagnosis for long-term renal outcome in membranous nephropathy. Plos One 2019; DOI: doi.org/10.1371/journal.pone.
• 5 Tomas NM, Beck Jr LH, Meyer-Schwesinger C. et al. Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. N Engl J Med 2014; 371: 2277-2287
• 6 Hoxha E, Wiech T, Stahl PR. et al. A mechanism for cancer-associated membranous nephropathy. N Engl J Med 2016; 374: 1995-1996
• 7 Fervenza FC, Appel GB, Barbour SJ. et al. Rituximab or cyclosporine in the treatment of membranous nephropathy. N Engl J Med 2019; 381: 36-46
• 8 Roberts ISD. The Oxford Classification: novel aspects and future trends. Kidney Dis 2018; 4: 184-185
• 9 Trimarchi H, Barrat J, Monteiro RC. et al. IgA nephropathy: „state of the art“. Kidney Int 2019; 95: 150-156
• 10 Rauen T, Eitner F, Fitzner C. et al. Intensive supportive care plus immunosuppression in IgA nephropathy. N Engl J Med 2015; 373: 2225-2236
• 11 Müller-Deile J, Schenk H, Schiffer M. Minimal Change Glomerulonephritis und fokal segmentale Glomerulonephritis. Internist 2019; 60: 450-457
• 12 Korbet SM, Schwartz MM, Lewis EJ. Primary focal segmental glomerulosclerosis: Clinical course and response to therapy. Am J Kidney Dis 1994; 23: 773-783
• 13 Waldmann M, Crew RJ, Valeri A. et al. Adult minimal change disease: Clinical characteristics, treatment and outcome. Clin J Am Soc Nephrol 2007; 2: 445-453
• 14 Brix SR, Noriega M, Tennstedt P. et al. Development and validation of a renal risk score in ANCA-associated glomerulonephritis. Kidney Int 2018; 94: 1177-1188
• 15 Jennette J, Nachman PH. ANCA glomerulonephritis and vasculitis. J Am Soc Nephrol 2017; 12: 1680-1691
• 16 Cui Z, Zhao J, Jia XY. et al. Clinical features and outcomes of anti-glomerular basement membrane disease in older patients. Am J Kidney Dis 2011; 57: 575-581
• 17 Stock J, Kuenanz J, Glonke N. et al. Prospective study on the potential of RAAS blockade to halt renal disease in Alport syndrome patients with heterozygous mutations. Pediatr Nephrol 2017; 32: 131-137
• 18 Motwani SS, Herlitz L, Monga D. et al. Paraprotein-Related Kidney Disease: Glomerular Diseases Associated with Paraproteinemias. Clin J Am Soc Nephrol 2016; 11: 2260-2272