Glomerular Diseases Across Lifespan: Key Differences in Diagnostic and Therapeutic Approaches

Seminars in Nephrology, vol. 43, pp. 151435

Abstract

Glomerular diseases are common causes of chronic kidney disease in childhood, adolescence, and adulthood. The epidemiology of glomerular diseases differs between different age groups, with minimal change disease being the leading cause of nephrotic syndrome in childhood, while membranous nephropathy and focal segmental glomerulosclerosis are more common in adulthood. IgA vasculitis is also more common in childhood. Moreover, there is a difference in disease severity with more children presenting with a relapsing form of nephrotic syndrome and a more acute presentation of antineutrophil cytoplasmic antibody-associated vasculitis and concomitant glomerulonephritis, as highlighted by the higher percentage of cellular crescents on kidney biopsy specimens in comparison with older patients. There is also a female preponderance in antineutrophil cytoplasmic antibody-associated vasculitis and more children present with tracheobroncholaryngeal disease. This article aims to summarize differences in the presentation of different glomerular diseases that are encountered commonly by pediatric and adult nephrologists and potential differences in the management.

Authors 8

1. Martin Windpessl

   Johannes Kepler University of Linz · Klinikum Wels-Grieskirchen

   Affiliation as printed

   Section of Nephrology, Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria; Medical Faculty, Johannes Kepler University Linz, Linz, Austria

   Medical Faculty, Johannes Kepler University Linz, Linz, Austria

   Section of Nephrology, Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria

2. Balazs Odler

   Medical University of Graz · University of Cambridge · Addenbrooke's Hospital

   Affiliation as printed

   Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, United Kingdom; Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria

   Department of Medicine, University of Cambridge, Cambridge, United Kingdom

   Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria

   Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, United Kingdom

3. Ingeborg M. Bajema Aachen Department of Pathology, Leiden University Medical Center

   University Medical Center Groningen · University of Groningen · Leiden University Medical Center

   Affiliation as printed

   Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Pathology and Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands

   Department of Pathology and Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands

   Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands

4. Duvuru Geetha

   Johns Hopkins University · Johns Hopkins Medicine

   Affiliation as printed

   Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD

5. Marcus D. Säemann

   Sigmund Freud Privatuniversität Wien

   Affiliation as printed

   6th Medical Department, Nephrology and Dialysis, Clinic Ottakring, Vienna, Austria; Sigmund Freud University, Medical School, Vienna, Austria

   6th Medical Department, Nephrology and Dialysis, Clinic Ottakring, Vienna, Austria

   Sigmund Freud University, Medical School, Vienna, Austria

6. Jiwon M. Lee

   Korea Disease Control and Prevention Agency

   Affiliation as printed

   Division of Rare Disease Management, Korea Disease Control and Prevention Agency, Cheongju-si, Republic of Korea

7. Augusto Vaglio

   Meyer Children's Hospital · University of Florence

   Affiliation as printed

   Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Firenze, Nephrology Unit, Meyer Children's Hospital, Firenze, Italy

8. Andreas Kronbichler corresponding

   Innsbruck Medical University · Universität Innsbruck · University of Cambridge · Addenbrooke's Hospital

   Affiliation as printed

   Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria. Electronic address: ak2283@cam.ac.uk

   Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria

   Department of Medicine, University of Cambridge, Cambridge, United Kingdom

   Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, United Kingdom