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Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention
Francesco Pesce1, Emma D Stea1, Michele Rossini1
1Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Frontiers in Medicine
|March 19, 2021
Summary
Glomerulonephritis causes 10% of acute kidney injury (AKI) in adults. Early diagnosis using biomarkers and prompt treatment with immunosuppressants and plasma exchange are vital for better outcomes in these kidney diseases.
Area of Science:
- Nephrology
- Immunology
- Internal Medicine
Background:
- Acute kidney injury (AKI) is a global health concern, with sepsis, surgery, and drugs as common causes.
- Glomerulonephritis accounts for approximately 10% of adult AKI cases, often linked to rapidly progressive forms like granulomatous polyangiitis (GPA) and anti-GBM disease.
Purpose of the Study:
- To review the spectrum of glomerulopathies causing AKI.
- To describe the immunological mechanisms of these glomerular diseases.
- To provide an overview of diagnostic and therapeutic strategies for AKI due to glomerulonephritis.
Main Methods:
- Review of the literature on glomerulonephritis-associated AKI.
- Discussion of diagnostic assays supporting clinical hypotheses when kidney biopsy is not feasible.
- Outline of current therapeutic options for glomerulonephritis in AKI patients.
Main Results:
- Various glomerulonephritides, including GPA, MPA, anti-GBM disease, lupus nephritis, and IgA nephropathy, can lead to AKI.
- Diagnostic support comes from assays like ANCAs, anti-dsDNA, anti-GBM antibodies, and complement levels.
- Effective management involves early diagnosis and treatment.
Conclusions:
- Glomerulonephritis represents a significant cause of AKI requiring specific diagnostic and therapeutic approaches.
- Non-invasive diagnostic tools are crucial for critically ill patients.
- Treatment strategies encompass corticosteroids, cyclophosphamide, and plasma exchange to improve patient outcomes.
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