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Novelties in the Treatment of Glomerulonephritis
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Novelties in the Treatment of Glomerulonephritis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 October 2025 | Viewed by 2843

Special Issue Editor

Prof. Dr. Francesco Locatelli

E-Mail Website
Guest Editor
Former Director, Department of Nephrology and Dialysis, Alessandro Manzoni Hospital, 23900 Lecco, Italy
Interests: CKD; proteinuria; hypertension; anemia; ESAS; iron; dialysis; glomerulonephritis; electrolytes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As you well know, primary and secondary glomerulonephritis are related to systemic autoimmune diseases, infections, drugs, or neoplasia and affect a significant percentage of patients of all ages, including children and young adults, where it is the most common cause of end-stage kidney disease. In the past, the therapeutic approach was mostly based on steroids, including boli, eventually alternated each month with alkilants for 6 months or on cyclosporine, depending on the type of glomerulonephritis. Over the last few years, several advancements have been made on the pathogenesis, diagnosis, and treatment of these diseases. In this regard, important steps were made, including the demonstration that primary membranous nephropathy is an autoimmune disease and the increasing recognition of the important pathogenetic role of the complement and of the B cells, leading to the development and use of drugs aiming at this target. It is our pleasure to invite you to contribute to this Special Issue.

Prof. Dr. Francesco Locatelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glomerulonephritis
  • primary and secondary
  • IGA nephritis
  • membranous nephropathy
  • minimal change nephropathy
  • glomerulosclerosis
  • C3 glomerulonephritis
  • vasculitis systemic steroids
  • budesonide
  • alkilants
  • cyclosporine
  • complement
  • rituximab
  • SGLT2
  • sparsentan

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Published Papers (3 papers)

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Review

17 pages, 1468 KiB  
Review
SGLT2 Inhibitors in Glomerulonephritis: Beyond Nephroprotection?
by Lucia Del Vecchio, Silvia Peiti, Giulio Pucci Bella and Francesco Locatelli
J. Clin. Med. 2025, 14(10), 3533; https://doi.org/10.3390/jcm14103533 - 18 May 2025
Viewed by 114
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glycaemic control in type 2 diabetes, have demonstrated substantial renal and cardiovascular protective effects across various chronic kidney diseases (CKD), including glomerulonephritis. Beyond their established haemodynamic and metabolic benefits, recent evidence points to additional mechanisms [...] Read more.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glycaemic control in type 2 diabetes, have demonstrated substantial renal and cardiovascular protective effects across various chronic kidney diseases (CKD), including glomerulonephritis. Beyond their established haemodynamic and metabolic benefits, recent evidence points to additional mechanisms of action potentially relevant to immune-mediated kidney diseases, such as the modulation of inflammation, immunometabolism, and oxidative stress. Randomised clinical trials (DAPA-CKD and EMPA-KIDNEY) and real-world observational studies consistently show that SGLT2 inhibitors reduce proteinuria and slow estimated glomerular filtration rate (eGFR) decline in patients with glomerulonephritis, including IgA nephropathy and focal segmental glomerulosclerosis. These benefits may extend to patients with stable immunosuppression. Further data are needed in this subgroup. Importantly, SGLT2 inhibitors display a favourable safety profile, even among those with immunosuppressed status. Again, further evidence is awaited in this respect. Despite these promising findings, unanswered questions remain regarding their efficacy in nephrotic syndrome, early-stage disease, and in comparison or combination with other supportive therapies. Overall, the evolving evidence supports the inclusion of SGLT2 inhibitors as a key component of supportive therapy in glomerulonephritis, with potential benefits extending beyond proteinuria reduction. Full article
(This article belongs to the Special Issue Novelties in the Treatment of Glomerulonephritis)
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17 pages, 1325 KiB  
Review
The Recurrence of Systemic Diseases in Kidney Transplantation
by Gabriella Moroni, Marta Calatroni and Claudio Ponticelli
J. Clin. Med. 2025, 14(8), 2592; https://doi.org/10.3390/jcm14082592 - 9 Apr 2025
Viewed by 789
Abstract
Kidney transplantation is the most effective replacement therapy for kidney failure, providing the best outcomes in terms of patient survival and offering a better quality of life. However, despite the progressive improvement in kidney survival, the recurrence of original disease remains one of [...] Read more.
Kidney transplantation is the most effective replacement therapy for kidney failure, providing the best outcomes in terms of patient survival and offering a better quality of life. However, despite the progressive improvement in kidney survival, the recurrence of original disease remains one of the most important causes of graft loss and a major challenge that requires clinical vigilance throughout the transplant’s duration. Additionally, the type and severity of recurrence affect both treatment options and graft survival. This is especially true for the recurrence of systemic diseases. In this narrative review, we will discuss the timing, frequency, severity, and treatment of post-transplant recurrence in three systemic diseases: lupus nephritis (LN), Antineutrophil Cytoplasmic Antibodies (ANCA)-associated glomerulonephritis (ANCA-GN), and Henoch–Schönlein purpura (HSP). The recurrence of lupus nephritis is less common than that of primary focal segmental glomerulosclerosis or C3 glomerulopathy. Its severity can range from mild mesangial to diffuse proliferative forms, with varying prognoses and treatment options, much like the original disease. In some patients with LN, as well as in those with ANCA-GN or HSP, the reactivation of the primary disease can affect other organs besides the kidneys, potentially leading to life-threatening conditions. These cases may require a multidisciplinary approach, making these transplants clinically more challenging. Extrarenal flare-ups often necessitate an increase in immunosuppression, which in turn raises the risk of infections. In these autoimmune diseases, the role of immunological tests in determining the timing of kidney transplants remains a topic of ongoing debate. However, elevated levels of certain immunological markers, such as anti-dsDNA antibodies, ANCA titers, or serum immunoglobulin A may indicate a reactivation of the disease, suggesting the need for more intensive patient monitoring. Full article
(This article belongs to the Special Issue Novelties in the Treatment of Glomerulonephritis)
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Figure 1

19 pages, 905 KiB  
Review
Membranous Nephropathy
by Claudio Ponticelli
J. Clin. Med. 2025, 14(3), 761; https://doi.org/10.3390/jcm14030761 - 24 Jan 2025
Viewed by 1479
Abstract
Membranous nephropathy is a glomerular disease that may be caused by exogenous risk factors in genetically predisposed individuals (primary MN) or may be associated with other autoimmune diseases, drug exposure, or cytotoxic agents (secondary MN). Primary membranous nephropathy (PMN) is an autoimmune disease [...] Read more.
Membranous nephropathy is a glomerular disease that may be caused by exogenous risk factors in genetically predisposed individuals (primary MN) or may be associated with other autoimmune diseases, drug exposure, or cytotoxic agents (secondary MN). Primary membranous nephropathy (PMN) is an autoimmune disease in which antigens—mainly the phospholipase A2 receptor—are located in the podocytes and are targeted by circulating antibodies, leading to in situ formation of immune complexes that activate the complement system. Clinically, the disease is characterized by nephrotic syndrome (NS) and associated complications. The outcome of PMN can vary, but untreated patients with NS may progress to end-stage kidney disease (ESKD) in 35–40% of cases within 10 years. Treatment primarily aims to prevent NS complications and progression to ESKD. The most commonly used immunosuppressive drugs are rituximab, corticosteroids, cyclophosphamide, and calcineurin inhibitors. Most patients may experience an improvement of proteinuria, which can sometimes be followed by NS relapse. Fewer than 50% of patients with PMN achieve complete and stable remission. In addition to immunosuppressive therapy, antiproteinuric, anti-lipemic, and anticoagulant medicaments are often required. Full article
(This article belongs to the Special Issue Novelties in the Treatment of Glomerulonephritis)
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