Table 1.

Major advance relevant to common glomerular diseases

Glomerular disease	Major recent advances
Membranoproliferative glomerulonephritis	MPGN is divided into C3 glomerulopathy (including C3 glomerulonephritis and dense deposit disease) and immunoglobulin and C3 positive MPGN due to infections, autoimmune disease or monoclonal gammopathy.
Minimal change disease	MCD is likely due to deficiency of regulatory T cells (Tregs). Rituximab is playing an increasing role in treatment.
Focal segmental glomerulosclerosis	Genetic testing should be done in children because genetic FSGS responds poorly to corticosteroids. High risk APOL1 gene variants is the cause for the increased incidence of primary FSGS in African Americans
Membranous nephropathy	The majority of patients with idiopathic membranous nephropathy have antibodies against M-type phospholipase A2 receptors (PLA2R) in the glomeruli. These antibodies have diagnostic and prognostic value. Rituximab is gradually becoming the standard of care for treatment of MN.
IgA nephropathy	IgAN is attributed to galactose deficient IgA1 which act as an autoantigen. IgAN on renal biopsy is now classified using the Oxford classification system. Corticosteroids are playing a lesser role in the management of IgAN.
Rapidly progressive (crescentic) GN	Pauci-immune ANCA positive RPGN is divided into granulomatosis with polyangiitis (GPA, formerly Wegener granulomatosis) in which ANCAs is directed against proteinase-3 (PR3), and microscopic polyangiitis (MPA) in which ANCA is directed against myeloperoxidase (MPO). Rituximab is playing in increasing role in the induction and maintenance therapy of ANCA positive RPGN.
Lupus nephritis	Renal Pathology Society/International Society of Nephrology classification is used to determine the class of LN on renal biopsy. Mycophenolate mofetil (MMF) is now used as an induction and maintenance therapy of LN. A calcineurin inhibitor is sometimes added to MMF to induce remission.

GN = glomerulonephritis, MPGN = membranoproliferative glomerulonephritis, MCD = minimal change disease, FSGS = focal segmental glomerulosclerosis, MN = membranous nephropathy, IgAN = IgA nephropathy, IgA1 = immunoglobulin A1, ANCA = antineutrophil cytoplasmic antibodies, RPGN = rapidly progressive (crescentic) glomerulonephritis, LN = lupus nephritis