Table 2.
Non-Immune Therapy | Immunosuppressant Therapy | Denote | |||||||
---|---|---|---|---|---|---|---|---|---|
↓Dietary salt/protein SGLT2 inhibitors RAAS blockades Blood pressure Infection prophylaxis (vaccine, antibioticsantiviral agents) Vitamin D + calcium |
Diuretics ↑Oncotic pressure (albumin infusion) Lipid lowering Anticoagulation (prevent or treat thromboembolism) |
Steroids | Calcineurin inhibitors | Antimetabolite | Alkalizing agents | Anti-CD20 | PP | ||
Prednisolone ACTH |
Cyclosporine Tacrolimus |
Mycophenolate Azathioprine |
CYC Chlorambucil |
Rituximab | |||||
MCD | ν | ν | ν | ν | ν | ν | ν | ||
FSGS | ν | ν | ν | ν | ν | Genetic test: Congenital/infantile type, APOL1 (adult) | |||
MN | ν | ν | ν | ν | ν | ν | ν | Serum anti-PLA2R: diagnosis, follow-up and outcomes | |
MPGN | ν | ν | ν | ν | Treat underlying diseases (e.g., MM, lymphoma or HCV) | ||||
IgAN | ν | ν (IgAN+MCD) | ν | ν (some RTCs) | Adjuvant antimalarial Ongoing trial: Fostamatinib, Atacicept, Bortezomib |
||||
LN | ν | ν (class V) | ν | ν | ν | ν | Antimalarial agents AZA for maintenance |
||
AAV | ν | ν | ν | ν | ν severe AKI PH |
Disease activity: chemokine C-X-C motif chemokine ligand 13, matrix metalloproteinase-3, tissue inhibitor of metalloproteinases-1 | |||
Ani-GBM | ν | ν | ν | ν till anti-GBM (-) | Overlap syndrome (ANA, ANCA) | ||||
Common S/E | Rare | Rare | ↑Glucose Cushing ↑BP |
Nephrotoxic | GI upset Leukopenia | Bone marrow suppression Infertility |
Infusion reaction, Infection Cytopenia |
Fever Urticaria |
Denote: AAV: ANCA associated vasculitis, BP: blood pressure, CYC: cyclophosphamide, FSGS: focal segmental glomerulonephropathy, GI: gastrointestinal, GBM: glomerular basement membrane, IgAN: IgA nephropathy, LN: lupus nephritis, MCD: minimal change disease, MM: multiple myeloma, MN: membranous nephropathy, MPGN: membranoproliferative glomerulonephritis, PH: pulmonary hemorrhage, PP: plasmapheresis, RAAS: renin-agiotensin-aldosterone system, SGLT2: sodium glucose cotransporter 2, S/E: side effect.