TY - CHAP M1 - Book, Section TI - Glomerular Diseases A1 - Hogan, Jonathan J. A1 - Lau, Alan H. A2 - DiPiro, Joseph T. A2 - Yee, Gary C. A2 - Posey, L. Michael A2 - Haines, Stuart T. A2 - Nolin, Thomas D. A2 - Ellingrod, Vicki PY - 2020 T2 - Pharmacotherapy: A Pathophysiologic Approach, 11e AB - KEY CONCEPTSGlomerular diseases are a collection of diseases that affect the filters of the kidney and are mediated by different immunologic pathogenic mechanisms, resulting in varied clinical presentation and therapeutic outcomes.The signs and symptoms associated with glomerular diseases are commonly nephritic (reflecting inflammatory injury) or nephrotic (reflecting noninflammatory injury) in nature, and are characterized by hematuria and proteinuria.Supportive treatments for edema, hypertension, hyperlipidemia, and intravascular thrombosis are important in reducing the complications associated with glomerular diseases. These are especially important since specific and effective therapy for many types of glomerular diseases is not available. Reduction of proteinuria can often improve long-term kidney and patient outcomes.To maximize therapeutic benefits and minimize drug-induced complications, patients have to be monitored closely to assess their therapeutic responses as well as the development of any treatment-induced toxicity.Among all the types of glomerulonephritis, minimal-change nephropathy is most responsive to treatment. Steroids can induce good responses in most patients during initial treatment as well as relapse.Because of the lack of consistently effective treatment for primary focal segmental glomerular sclerosis, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers are commonly used for patients with mild disease to control symptoms. Steroids and immunosuppressive agents are reserved for the management of patients with severe disease.The optimal treatment for lupus nephritis depends on the underlying lesion and disease activity, as well as the severity and duration of the patient’s condition.The treatment of poststreptococcal glomerulonephritis is mainly supportive and symptomatic. Antibiotic therapy does not prevent subsequent disease development but may reduce the severity. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1182442436 ER -