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The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome.

Canetta PA, Radhakrishnan J - Front Pediatr (2015)

Bottom Line: Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy.The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012.Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Columbia University Medical Center, Columbia University College of Physicians and Surgeons , New York, NY , USA.

ABSTRACT
Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

No MeSH data available.


Related in: MedlinePlus

A suggested algorithm for the clinical approach to adult FSGS. *Note that KDIGO guidelines explicitly recommend against genetic testing. **Highlighted are some of the monogenic causes of FSGS more likely to be found in adults with genetic disease; see text and highlighted references for further discussion. NPHS2, Podocin; CD2AP, CD2-associated protein; ACTN4, α-actinin-4; INF2, inverted formin-2; TRPC6, transient receptor potential channel 6; WT1, Wilms tumor protein.
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Figure 1: A suggested algorithm for the clinical approach to adult FSGS. *Note that KDIGO guidelines explicitly recommend against genetic testing. **Highlighted are some of the monogenic causes of FSGS more likely to be found in adults with genetic disease; see text and highlighted references for further discussion. NPHS2, Podocin; CD2AP, CD2-associated protein; ACTN4, α-actinin-4; INF2, inverted formin-2; TRPC6, transient receptor potential channel 6; WT1, Wilms tumor protein.

Mentions: Figure 1 presents our suggested summary algorithm for the diagnostic and therapeutic approach to an adult with FSGS on kidney biopsy, which largely follows the KDIGO guidelines. Such an algorithm, like the practice guidelines themselves, should not supplant clinical judgment.


The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome.

Canetta PA, Radhakrishnan J - Front Pediatr (2015)

A suggested algorithm for the clinical approach to adult FSGS. *Note that KDIGO guidelines explicitly recommend against genetic testing. **Highlighted are some of the monogenic causes of FSGS more likely to be found in adults with genetic disease; see text and highlighted references for further discussion. NPHS2, Podocin; CD2AP, CD2-associated protein; ACTN4, α-actinin-4; INF2, inverted formin-2; TRPC6, transient receptor potential channel 6; WT1, Wilms tumor protein.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585181&req=5

Figure 1: A suggested algorithm for the clinical approach to adult FSGS. *Note that KDIGO guidelines explicitly recommend against genetic testing. **Highlighted are some of the monogenic causes of FSGS more likely to be found in adults with genetic disease; see text and highlighted references for further discussion. NPHS2, Podocin; CD2AP, CD2-associated protein; ACTN4, α-actinin-4; INF2, inverted formin-2; TRPC6, transient receptor potential channel 6; WT1, Wilms tumor protein.
Mentions: Figure 1 presents our suggested summary algorithm for the diagnostic and therapeutic approach to an adult with FSGS on kidney biopsy, which largely follows the KDIGO guidelines. Such an algorithm, like the practice guidelines themselves, should not supplant clinical judgment.

Bottom Line: Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy.The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012.Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Columbia University Medical Center, Columbia University College of Physicians and Surgeons , New York, NY , USA.

ABSTRACT
Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

No MeSH data available.


Related in: MedlinePlus