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BioMed Research International
Volume 2017, Article ID 7689254, 9 pages
https://doi.org/10.1155/2017/7689254
Review Article

Recent Treatment Advances and New Trials in Adult Nephrotic Syndrome

Department of Nephrology, University Hospital, Medical Faculty, Heinrich-Heine University, Moorenstrasse 5, 40225 Duesseldorf, Germany

Correspondence should be addressed to Lorenz Sellin; ed.frodlesseud-inu.dem@nilles.znerol

Received 28 February 2017; Accepted 12 April 2017; Published 3 May 2017

Academic Editor: Andreas Kronbichler

Copyright © 2017 Eva Königshausen and Lorenz Sellin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The etiology of nephrotic syndrome is complex and ranges from primary glomerulonephritis to secondary forms. Patients with nephrotic syndrome often need immunosuppressive treatment with its side effects and may progress to end stage renal disease. This review focuses on recent advances in the treatment of primary causes of nephrotic syndrome (idiopathic membranous nephropathy (iMN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS)) since the publication of the KDIGO guidelines in 2012. Current treatment recommendations are mostly based on randomized controlled trials (RCTs) in children, small RCTs, or case series in adults. Recently, only a few new RCTs have been published, such as the Gemritux trial evaluating rituximab treatment versus supportive antiproteinuric and antihypertensive therapy in iMN. Many RCTs are ongoing for iMN, MCD, and FSGS that will provide further information on the effectiveness of different treatment options for the causative disease. In addition to reviewing recent clinical studies, we provide insight into potential new targets for the treatment of nephrotic syndrome from recent basic science publications.