Core Curriculum in Nephrology
Installments of the Core Curriculum in Nephrology provide trainees in nephrology with a strong knowledge base in core topics in the specialty by providing an overview of the topic and citing key references, including the foundational literature that led to current clinical approaches.
- The management of immunosuppression utilized in glomerular diseases requires highly nuanced care. Timely recognition and management of these disorders is essential to mitigate the extent of kidney damage. This involves being cognizant of the various classes of immunosuppression, which includes alkylating agents, antimetabolites, calcineurin inhibitors, anti-CD20 therapy, complement inhibitors, corticosteroids, and intravenous immunoglobulin. The mechanisms of action of these drugs, along with associated pharmacokinetics and pharmacodynamics, facets of monitoring, and adverse effects are important aspects with which nephrologists are required to be well versed.
- Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide. The diagnostic histologic hallmark is dominant or codominant IgA staining on kidney biopsy; however, patients may present with various clinical syndromes ranging from asymptomatic abnormalities noted on urinalysis to rapidly progressive glomerulonephritis. Given substantial heterogeneity in the clinical course of disease, online risk calculators are available that may assist in prognostication and inform discussions with patients.