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Was ist gesichert in der Therapie der Glomerulonephritis?

What is certain in the treatment of glomerulonephritis?

  • Schwerpunkt: Was ist gesichert in der Therapie?
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Zusammenfassung

Glomerulonephritiden stellen praktisch ausnahmslos seltene Erkrankungen dar, sind aber unter anderem der häufigste Grund, warum junge Erwachsene dialysepflichtig werden. Neben der bioptischen, spezifischen Diagnosesicherung stellt die Abschätzung der Prognose einen entscheidenden Schritt dar, da nur so beurteilt werden kann, ob eine vergleichsweise nebenwirkungsarme, aber hocheffektive „supportive“ Therapie ausreichend ist oder ob zusätzlich eine immunsuppressive Behandlung notwendig wird. Letzteres wird hier für die häufigsten europäischen Glomerulonephritisformen diskutiert: Immunglobulin-A-Nephropathie, membranöse Glomerulonephritis, Minimal-change-Nephropathie und fokal-segmentale Glomerulosklerose.

Abstract

Glomerulonephritides essentially all belong to the rare diseases; however, they are the most common cause of end-stage renal disease in young adults. Besides obtaining a specific diagnosis via a renal biopsy, assessing the prognosis constitutes the other essential step in the work-up, since this enables a decision to be made on whether supportive care with relatively few adverse effects is sufficient or whether additional immunosuppressive therapy is required. The latter is discussed focusing on the most common European types of glomerulonephritis: immunoglobulin A nephropathy, membranous glomerulonephritis, minimal change nephropathy and focal segmental glomerulosclerosis.

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Authors and Affiliations

  1. Klinik für Nieren- und Hochdruckkrankheiten, Uniklinik der RWTH Aachen, Aachen, Deutschland

    J. Floege & M. J. Moeller

  2. Institut für Pathologie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52057, Aachen, Deutschland

    P. Boor

Authors
  1. J. Floege
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  2. P. Boor
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  3. M. J. Moeller
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Correspondence to J. Floege.

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Interessenkonflikt

J. Floege ist als Berater im Rahmen klinischer Studien für Chugai, Calliditas, Omeros, Alnylam und Retrophin tätig. P. Boor und M.J. Moeller geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. Haller, Hannover

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Floege, J., Boor, P. & Moeller, M.J. Was ist gesichert in der Therapie der Glomerulonephritis?. Internist 59, 1268–1278 (2018). https://doi.org/10.1007/s00108-018-0500-8

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  • DOI: https://doi.org/10.1007/s00108-018-0500-8

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