Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY.
Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY.
Am J Kidney Dis. 2014 Apr;63(4):656-66. doi: 10.1053/j.ajkd.2013.09.019. Epub 2013 Nov 14.
Glomerular diseases historically have been challenging disorders to comprehend and treat for patients and physicians alike. Kidney biopsy is the gold standard of diagnosis, but the link between pathophysiology and the histologic representation of kidney injury has remained elusive in many of these diseases. As a result, treatment of glomerular disease usually involves therapies that are not specific to disease pathogenesis, such as blockade of the renin-angiotensin-aldosterone system and various immunosuppression regimens. Recent research has resulted in greater insight into some glomerular diseases, leading to the hope that new diagnostic tests and treatments targeting disease-specific mechanisms are on the horizon. We review recent progress on the understanding, diagnosis, and treatment of 4 glomerular diseases: immunoglobulin A nephropathy, focal segmental glomerulosclerosis, the C3 glomerulopathies, and idiopathic membranous nephropathy.
肾小球疾病一直以来都是令患者和医生都难以理解和治疗的疾病。肾活检是诊断的金标准，但在许多这类疾病中，病理生理学和肾脏损伤的组织学表现之间的联系仍然难以捉摸。因此，肾小球疾病的治疗通常涉及针对疾病发病机制不特异的治疗方法，如肾素-血管紧张素-醛固酮系统阻断和各种免疫抑制方案。最近的研究使我们对一些肾小球疾病有了更深入的了解，这使我们有希望获得针对特定疾病机制的新的诊断测试和治疗方法。我们综述了在理解、诊断和治疗 4 种肾小球疾病方面的最新进展：免疫球蛋白 A 肾病、局灶节段性肾小球硬化症、C3 肾小球病和特发性膜性肾病。
