Immunological Renal Diseases

Abstract Immunological renal diseases are caused mainly by disordered humoral immunity and the multiplicity of immune amplification and regulatory systems. Recently there has been considerable progress in our understanding of the pathogenesis of a number of glomerulopathies and greater insight into clinical and histological phenotypes of these diseases. Corticosteroids and broad-spectrum immunosuppressive drugs are standard approaches to the treatment of most immune-mediated renal diseases. However, a plethora of new biological agents and small-molecule inhibitors of mediator pathways have become available, and the hope is that these will target disease-specific mechanisms while minimizing side effects and translate into better outcomes. In this chapter, we review the clinical signs and diagnosis as well as recent progress on the understanding and treatment of a variety of glomerular diseases, including focal segmental glomerulosclerosis, minimal change disease (MCD), immunoglobulin A nephropathy(IgAN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), C3 glomerulopathy, antineutrophil cytoplasmic antibody (ANCA)–associated renal vasculitis, and lupus nephritis.