Abstract
The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Glomerular Diseases is an update to the KDIGO 2012 guideline. The aim is to assist clinicians caring for individuals with glomerulonephritis (GN), both adults and children. The scope includes various glomerular diseases, including IgA nephropathy and IgA vasculitis, membranous nephropathy, nephrotic syndrome, minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), infection-related GN, antineutrophil cytoplasmic antibody (ANCA) vasculitis, lupus nephritis, and anti–glomerular basement membrane antibody GN. In addition, this guideline will be the first to address the subtype of complement-mediated diseases. Each chapter follows the same format providing guidance related to diagnosis, prognosis, treatment, and special situations. The goal of the guideline is to generate a useful resource for clinicians and patients by providing actionable recommendations based on evidence syntheses, with useful infographics incorporating views from experts in the field. Another aim is to propose research recommendations for areas where there are gaps in knowledge. The guideline targets a broad global audience of clinicians treating GN while being mindful of implications for policy and cost. Development of this guideline update followed an explicit process whereby treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, with areas of future research also presented.
Original language | English (US) |
---|---|
Pages (from-to) | 753-779 |
Number of pages | 27 |
Journal | Kidney international |
Volume | 100 |
Issue number | 4 |
DOIs | |
State | Published - Oct 2021 |
Keywords
- AAV
- ANCA
- C3
- FSGS
- IgA nephropathy
- IgA vasculitis
- KDIGO
- MPGN
- anti-GBM
- complement
- evidence-based
- glomerular diseases
- glomerulonephritis
- guideline
- infection-related glomerulonephritis
- lupus nephritis
- membranous nephropathy
- minimal change disease
- nephrotic syndrome
- systematic review
ASJC Scopus subject areas
- Nephrology
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Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. / Rovin, Brad H.; Adler, Sharon G.; Barratt, Jonathan et al.
In: Kidney international, Vol. 100, No. 4, 10.2021, p. 753-779.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases
AU - Rovin, Brad H.
AU - Adler, Sharon G.
AU - Barratt, Jonathan
AU - Bridoux, Frank
AU - Burdge, Kelly A.
AU - Chan, Tak Mao
AU - Cook, H. Terence
AU - Fervenza, Fernando C.
AU - Gibson, Keisha L.
AU - Glassock, Richard J.
AU - Jayne, David R.W.
AU - Jha, Vivekanand
AU - Liew, Adrian
AU - Liu, Zhi Hong
AU - Mejía-Vilet, Juan M.
AU - Nester, Carla M.
AU - Radhakrishnan, Jai
AU - Rave, Elizabeth M.
AU - Reich, Heather N.
AU - Ronco, Pierre
AU - Sanders, Jan Stephan F.
AU - Sethi, Sanjeev
AU - Suzuki, Yusuke
AU - Tang, Sydney C.W.
AU - Tesar, Vladimír
AU - Vivarelli, Marina
AU - Wetzels, Jack F.M.
AU - Lytvyn, Lyubov
AU - Craig, Jonathan C.
AU - Tunnicliffe, David J.
AU - Howell, Martin
AU - Tonelli, Marcello A.
AU - Cheung, Michael
AU - Earley, Amy
AU - Floege, Jürgen
N1 - Funding Information: BHR reports consultancy for AstraZeneca/MedImmune, Aurinia, Biogen Idec, Bristol Myers Squibb, Calliditas, ChemoCentryx, EMD Serono, Genentech/Hoffmann-La Roche, Omeros, Janssen, Lupus Foundation of America, MorphoSys, Novartis, Pfizer, RILITE Foundation∗, and Travere (formerly Retrophin); and grant/research support from Lupus Clinical Investigators Network∗ and National Institutes of Health∗. SGA reports consultancy for Bayer and MorphoSys; and grants/research support from Bayer∗, Bristol Myers Squibb∗, Omeros∗, National Institute of Diabetes and Digestive and Kidney Diseases (REBOOT), and Travere (formerly Retrophin). JB reports serving on study steering committees for Alnylam, Calliditas, Chinook, Novartis, Omeros, and Travere (formerly Retrophin); consultancy for Alnylam, Argenx, Astellas, BioCryst, Calliditas, Chinook, Dimerix, Galápagos, Novartis, Omeros∗, Syncona, Takeda, Travere (formerly Retrophin), UCB, Vera Therapeutics, and Visterra; grant/research support for basic science work for 6 companies under confidentiality agreements; and other (named in a patent to be submitted by Calliditas based on analysis of exploratory data generated from the NEFECON® trial, conducted at the University of Leicester). FB reports consultancy for AstraZeneca, Baxter, and Prothena; grants/research support from Amgen; and speaker bureaus for Amgen, AstraZeneca, Celgene, and Janssen. TMC reports consultancy for Novartis; and grant/research support from Astellas, AstraZeneca, and Baxter. HTC reports consultancy for Alexion, Apellis, Aurinia, and Novartis; grant/research support from Achillion∗ and Ra Pharmaceuticals∗; and speaker bureaus for Alexion. FCF reports serving as a board member for UpToDate (Associate Editor); consultancy for Alexion, Alnylam, BioCryst, and Takeda; and grant/research support from Achillion, Genentech, Janssen, MorphoSys, and Travere (formerly Retrophin). KLG reports serving as an advisory board member for Reata and Travere (formerly Retrophin); and consultancy for Aurinia. RJG reports consultancy for Apellis, Aurinia, BioCryst, Bristol Myers Squibb, Calliditas, ChemoCentryx, Equillium Bio, Horizon, Ionis, Natera (Renasight), Novartis, Omeros, Travere (formerly Retrophin), and Walden Biosciences; expert testimony for legal firms in the United States; speaker bureaus for Aurinia; manuscript preparation for NephSAP (Associate Editor), Karger, and Wolters Kluwer (UpToDate); stock/stock options from Reata; and travel expenses from various academic centers in the United States, Europe, China, and South America. DRWJ reports consultancy for AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, ChemoCentryx, Chugai, CSL Behring, GlaxoSmithKline, InflaRx, Janssen, Novartis, Roche/Genentech, Takeda, and Vifor; speaker bureaus for Vifor; and grant/research support from GlaxoSmithKline∗, Medical Research Council∗, National Institute for Health Research∗, and Roche/Genentech∗. VJ reports consultancy for NephroPlus∗; grants/research support from Baxter Healthcare∗, Biocon∗, and GlaxoSmithKline∗; and speaker bureaus for AstraZeneca∗ and Baxter Healthcare∗. AL reports consultancy for Alnylam, AstraZeneca, DaVita, and George Clinical; and speaker bureaus for AstraZeneca and Baxter Healthcare. CMN reports advisory boards for Achillion, Alexion, BioCryst, Novartis, and Pfizer; grant/research support from Achillion, Alexion, BioCryst, Novartis, and Travere (formerly Retrophin); and author royalties for UpToDate. JR reports serving as an advisory board member for Reata; consultancy for Aurinia, Equillium Bio, Novartis, Reata, and Travere; and grant/research support from Travere. EMR reports serving as a board member for Davita. HNR reports consultancy for Calliditas, Omeros, Pfizer, and Retrophin; the University Health Network (UHN) GN fellowship supported by the Louise Fast Foundation; clinical trials for Alnylam, Calliditas, ChemoCentryx, Omeros, and Pfizer; and a speaker fee from Gilead and Omeros. PR reports consultancy for Alexion, Amicus, Idorsia, and MorphoSys; grant/research support from Alexion∗ and Amgen∗; manuscript preparation for UpToDate; and travel expenses from the American Society of Nephrology, French Society of Nephrology, and Sanofi-Genzyme. J-SFS reports grant/research support from Chiesi, Dutch Kidney Society, The Netherlands Organisation for Health Research and Development, and Novartis. SS reports consultancy for Novartis. YS reports consultancy for Bayer, Chinook, Chugai, Daiichi Sankyo, Kyowa Kirin, Mitsubishi Tanabe Pharma, MorphoSys, Novartis, Travere (formerly Retrophin), and Visterra; grant/research support from Astellas∗, Bayer∗, Chinook, Chugai∗, Daiichi Sankyo∗, the Japan Agency for Medical Research and Development∗, the Japan Society for the Promotion of Science∗, Kyowa Kirin∗, the Ministry of Health, Labour and Welfare in Japan∗, Moderna, MSD K.K.∗, Ono∗, Sanwa Kagaku Kenkyusho∗, Sumitomo Dainippon Pharma∗, Sunstar∗, Suzuken Memorial Foundation∗, Takeda∗, Teijin Pharma∗, Torii Pharmaceutical∗, Travere (formerly Retrophin), and Visterra; speakers bureaus for Asahi Kasei Pharma, Astellas, Bayer, Chugai, Daiichi Sankyo, Kissei, Kowa, Kyowa Kirin, Mitsubishi Tanabe Pharma, MSD K.K., Novartis, Ono, and Sumitomo Dainippon Pharma; and manuscript preparation for Chugai-Igakusha, Fuji Medical Publishing, Japan Medical Journal, Kagaku Hyoronsha Co., Ltd., Medicus Shuppan, Publishers Co., Ltd., Nankodo Co., Ltd., Shindan to Chiryo Sha, Inc., and Tokyo-Igakusha. SCWT reports consultancy for Novartis and Travere (formerly Retrophin); grants/research support from Sanofi; and speaker bureaus for AstraZeneca. VT reports consultancy for Abbvie, Amgen, Baxter, Bayer, Boehringer Ingelheim, ChemoCentryx, and Fresenius Medical Care; speaker bureaus for Bayer and Boehringer Ingelheim; and travel expenses from AbbVie. MV reports consultancy for Apellis, Novartis, Roche, and Travere (formerly Retrophin). JFMW reports serving as an international scientific advisory board member for Alexion∗; consultancy for MorphoSys, Novartis, and Travere (formerly Retrophin); grant/research support from Alexion, MorphoSys∗, and Novartis; and speaker bureaus for Novartis∗. MAT reports honoraria from AstraZeneca and Travere (formerly Retrophin) with monies donated to charity. JF reports consultancy for Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Calliditas, MorphoSys, Novo Nordisk, Omeros, Travere (formerly Retrophin), and Visterra; and speaker bureaus for Amgen and Fresenius-Vifor. All the other authors declared no competing interests. Funding Information: A special debt of gratitude is owed to following people for their contribution to this important guideline effort: Melissa Thompson, Debbie Maizels, Suetonia C. Palmer, Giovanni F.M. Strippoli, Fiona Russell, Gail Y. Higgins, Brydee Cashmore, Michel Jadoul, Wolfgang C. Winkelmayer, Kathleen Conn, Danielle Green, Tanya Green, and John Davis. Publisher Copyright: © 2021 International Society of Nephrology
PY - 2021/10
Y1 - 2021/10
N2 - The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Glomerular Diseases is an update to the KDIGO 2012 guideline. The aim is to assist clinicians caring for individuals with glomerulonephritis (GN), both adults and children. The scope includes various glomerular diseases, including IgA nephropathy and IgA vasculitis, membranous nephropathy, nephrotic syndrome, minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), infection-related GN, antineutrophil cytoplasmic antibody (ANCA) vasculitis, lupus nephritis, and anti–glomerular basement membrane antibody GN. In addition, this guideline will be the first to address the subtype of complement-mediated diseases. Each chapter follows the same format providing guidance related to diagnosis, prognosis, treatment, and special situations. The goal of the guideline is to generate a useful resource for clinicians and patients by providing actionable recommendations based on evidence syntheses, with useful infographics incorporating views from experts in the field. Another aim is to propose research recommendations for areas where there are gaps in knowledge. The guideline targets a broad global audience of clinicians treating GN while being mindful of implications for policy and cost. Development of this guideline update followed an explicit process whereby treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, with areas of future research also presented.
AB - The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Glomerular Diseases is an update to the KDIGO 2012 guideline. The aim is to assist clinicians caring for individuals with glomerulonephritis (GN), both adults and children. The scope includes various glomerular diseases, including IgA nephropathy and IgA vasculitis, membranous nephropathy, nephrotic syndrome, minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), infection-related GN, antineutrophil cytoplasmic antibody (ANCA) vasculitis, lupus nephritis, and anti–glomerular basement membrane antibody GN. In addition, this guideline will be the first to address the subtype of complement-mediated diseases. Each chapter follows the same format providing guidance related to diagnosis, prognosis, treatment, and special situations. The goal of the guideline is to generate a useful resource for clinicians and patients by providing actionable recommendations based on evidence syntheses, with useful infographics incorporating views from experts in the field. Another aim is to propose research recommendations for areas where there are gaps in knowledge. The guideline targets a broad global audience of clinicians treating GN while being mindful of implications for policy and cost. Development of this guideline update followed an explicit process whereby treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, with areas of future research also presented.
KW - AAV
KW - ANCA
KW - C3
KW - FSGS
KW - IgA nephropathy
KW - IgA vasculitis
KW - KDIGO
KW - MPGN
KW - anti-GBM
KW - complement
KW - evidence-based
KW - glomerular diseases
KW - glomerulonephritis
KW - guideline
KW - infection-related glomerulonephritis
KW - lupus nephritis
KW - membranous nephropathy
KW - minimal change disease
KW - nephrotic syndrome
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85115038445&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115038445&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2021.05.015
DO - 10.1016/j.kint.2021.05.015
M3 - Article
C2 - 34556300
AN - SCOPUS:85115038445
VL - 100
SP - 753
EP - 779
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 4
ER -