By Sharma S Prabhakar
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Additional resources for An update on glomerulopathies : clinical and treatment aspects
Etiologic Classification of Focal Segmental Glomerulosclerosis Focal Segmental Glomerulosclerosis 31 Differences in clinical manifestations correlate with differences in pathologic phenotypes. Collapsing variant of FSGS often has more severe proteinuria and renal insufficiency but less hypertension than typical variant. g. episodes of upper respiratory infections, diarrhea that are usually ascribed to the viral or other infectious processes. However, the symptoms of fever, anorexia, aches and pains are present only in 20% of patients at the time of onset of nephrosis.
Recently, a small RCT study 18 An Update on Glomerulopathies – Clinical and Treatment Aspects conducted in Spain demonstrated that rituximab was of benefit in 13 Spanish patients with idiopathic MN and CNI dependence, allowing successful weaning of the nephrotoxic CN. A review of the published literature about rituximab describing the use of rituximab in MN highlights that, while promising, the existing literature consists of too few patients, heterogeneous populations, and insufficient follow-up to recommend the use of rituximab outside the research setting.
Patients with massive edema with impaired oral absorption may require intravenous administration of loop diuretics. In patients with refractory conditions, addition of other diuretics (eg, metolazone) and potassium-sparing agents (eg, spironolactone, triamterene) facilitates diuresis and prevents hypokalemia. Rarely, some patients (especially children) with intractable edema may need intravenous albumin and diuretics in a hospital setting to initiate diuresis. Protracted use of intravenous albumin should be discouraged; the regimen is expensive and ineffective, because most of the infused albumin is lost in the urine.
An update on glomerulopathies : clinical and treatment aspects by Sharma S Prabhakar