Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases

Brad H. Rovin; Sharon G. Adler; Jonathan Barratt; Frank Bridoux; Kelly A. Burdge; Tak Mao Chan; H. Terence Cook; Fernando C. Fervenza; Keisha L. Gibson; Richard J. Glassock; David R.W. Jayne; Vivekanand Jha; Adrian Liew; Zhi Hong Liu; Juan M. Mejía-Vilet; Carla M. Nester; Jai Radhakrishnan; Elizabeth M. Rave; Heather N. Reich; Pierre Ronco; Jan Stephan F. Sanders; Sanjeev Sethi; Yusuke Suzuki; Sydney C.W. Tang; Vladimír Tesar; Marina Vivarelli; Jack F.M. Wetzels; Lyubov Lytvyn; Jonathan C. Craig; David J. Tunnicliffe; Martin Howell; Marcello A. Tonelli; Michael Cheung; Amy Earley; Jürgen Floege

doi:10.1016/j.kint.2021.05.015

Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases

Brad H. Rovin, Sharon G. Adler, Jonathan Barratt, Frank Bridoux, Kelly A. Burdge, Tak Mao Chan, H. Terence Cook, Fernando C. Fervenza, Keisha L. Gibson, Richard J. Glassock, David R.W. Jayne, Vivekanand Jha, Adrian Liew, Zhi Hong Liu, Juan M. Mejía-Vilet, Carla M. Nester, Jai Radhakrishnan, Elizabeth M. Rave, Heather N. Reich, Pierre RoncoJan Stephan F. Sanders, Sanjeev Sethi, Yusuke Suzuki, Sydney C.W. Tang, Vladimír Tesar, Marina Vivarelli, Jack F.M. Wetzels, Lyubov Lytvyn, Jonathan C. Craig, David J. Tunnicliffe, Martin Howell, Marcello A. Tonelli, Michael Cheung, Amy Earley, Jürgen Floege

Research output: Contribution to journal › Article › peer-review

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	https://doi.org/10.1016/j.kint.2021.05.015
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

Access to Document

10.1016/j.kint.2021.05.015

Cite this

Rovin, B. H., Adler, S. G., Barratt, J., Bridoux, F., Burdge, K. A., Chan, T. M., Cook, H. T., Fervenza, F. C., Gibson, K. L., Glassock, R. J., Jayne, D. R. W., Jha, V., Liew, A., Liu, Z. H., Mejía-Vilet, J. M., Nester, C. M., Radhakrishnan, J., Rave, E. M., Reich, H. N., ... Floege, J. (2021). Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney international, 100(4), 753-779. https://doi.org/10.1016/j.kint.2021.05.015

Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. / Rovin, Brad H.; Adler, Sharon G.; Barratt, Jonathan; Bridoux, Frank; Burdge, Kelly A.; Chan, Tak Mao; Cook, H. Terence; Fervenza, Fernando C.; Gibson, Keisha L.; Glassock, Richard J.; Jayne, David R.W.; Jha, Vivekanand; Liew, Adrian; Liu, Zhi Hong; Mejía-Vilet, Juan M.; Nester, Carla M.; Radhakrishnan, Jai; Rave, Elizabeth M.; Reich, Heather N.; Ronco, Pierre; Sanders, Jan Stephan F.; Sethi, Sanjeev; Suzuki, Yusuke; Tang, Sydney C.W.; Tesar, Vladimír; Vivarelli, Marina; Wetzels, Jack F.M.; Lytvyn, Lyubov; Craig, Jonathan C.; Tunnicliffe, David J.; Howell, Martin; Tonelli, Marcello A.; Cheung, Michael; Earley, Amy; Floege, Jürgen.

In: Kidney international, Vol. 100, No. 4, 10.2021, p. 753-779.

Research output: Contribution to journal › Article › peer-review

Rovin, BH, Adler, SG, Barratt, J, Bridoux, F, Burdge, KA, Chan, TM, Cook, HT, Fervenza, FC, Gibson, KL, Glassock, RJ, Jayne, DRW, Jha, V, Liew, A, Liu, ZH, Mejía-Vilet, JM, Nester, CM, Radhakrishnan, J, Rave, EM, Reich, HN, Ronco, P, Sanders, JSF, Sethi, S, Suzuki, Y, Tang, SCW, Tesar, V, Vivarelli, M, Wetzels, JFM, Lytvyn, L, Craig, JC, Tunnicliffe, DJ, Howell, M, Tonelli, MA, Cheung, M, Earley, A & Floege, J 2021, 'Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases', Kidney international, vol. 100, no. 4, pp. 753-779. https://doi.org/10.1016/j.kint.2021.05.015

Rovin, Brad H. ; Adler, Sharon G. ; Barratt, Jonathan ; Bridoux, Frank ; Burdge, Kelly A. ; Chan, Tak Mao ; Cook, H. Terence ; Fervenza, Fernando C. ; Gibson, Keisha L. ; Glassock, Richard J. ; Jayne, David R.W. ; Jha, Vivekanand ; Liew, Adrian ; Liu, Zhi Hong ; Mejía-Vilet, Juan M. ; Nester, Carla M. ; Radhakrishnan, Jai ; Rave, Elizabeth M. ; Reich, Heather N. ; Ronco, Pierre ; Sanders, Jan Stephan F. ; Sethi, Sanjeev ; Suzuki, Yusuke ; Tang, Sydney C.W. ; Tesar, Vladimír ; Vivarelli, Marina ; Wetzels, Jack F.M. ; Lytvyn, Lyubov ; Craig, Jonathan C. ; Tunnicliffe, David J. ; Howell, Martin ; Tonelli, Marcello A. ; Cheung, Michael ; Earley, Amy ; Floege, Jürgen. / Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. In: Kidney international. 2021 ; Vol. 100, No. 4. pp. 753-779.

@article{6aa8b0694d634cc795d69f552ec5318e,

title = "Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases",

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.",

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",

author = "Rovin, {Brad H.} and Adler, {Sharon G.} and Jonathan Barratt and Frank Bridoux and Burdge, {Kelly A.} and Chan, {Tak Mao} and Cook, {H. Terence} and Fervenza, {Fernando C.} and Gibson, {Keisha L.} and Glassock, {Richard J.} and Jayne, {David R.W.} and Vivekanand Jha and Adrian Liew and Liu, {Zhi Hong} and Mej{\'i}a-Vilet, {Juan M.} and Nester, {Carla M.} and Jai Radhakrishnan and Rave, {Elizabeth M.} and Reich, {Heather N.} and Pierre Ronco and Sanders, {Jan Stephan F.} and Sanjeev Sethi and Yusuke Suzuki and Tang, {Sydney C.W.} and Vladim{\'i}r Tesar and Marina Vivarelli and Wetzels, {Jack F.M.} and Lyubov Lytvyn and Craig, {Jonathan C.} and Tunnicliffe, {David J.} and Martin Howell and Tonelli, {Marcello A.} and Michael Cheung and Amy Earley and J{\"u}rgen Floege",

note = "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, Gal{\'a}pagos, 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{\textregistered} 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: {\textcopyright} 2021 International Society of Nephrology",

year = "2021",

month = oct,

doi = "10.1016/j.kint.2021.05.015",

language = "English (US)",

volume = "100",

pages = "753--779",

journal = "Kidney International",

issn = "0085-2538",

publisher = "Nature Publishing Group",

number = "4",

}

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 -

Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases

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