KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

The Kidney Disease: Improving Global Outcomes (KDIGO) 2021 Clinical Practice Guideline for the Management of Glomerular Diseases is an update to the KDIGO 2012 guideline on the topic. The aim is to assist clinicians caring for individuals with glomerular disease, both adults and children. The scope includes various glomerular diseases, including IgA nephropathy (IgAN) and IgA vasculitis (IgAV), membranous nephropathy, nephrotic syndrome in children, minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), infection-related glomerulonephritis (GN), antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, lupus nephritis, and anti-glomerular basement membrane (anti-GBM) antibody GN. In addition, this guideline will be the first to address the subtype of complement-mediated diseases. Each chapter follows the same format providing guidance related to diagnosis, prognosis, treatment, and special situations. The goal of the guideline is to generate a useful resource for clinicians and patients by providing actionable recommendations with valuable infographics based on a rigorous formal systematic literature review. Another aim is to propose research recommendations for areas where there are gaps in knowledge. The guideline targets a broad audience of clinicians treating glomerular disease while being mindful of implications for policy and cost. Development of this guideline update followed an explicit process of evidence review. Treatment approaches and guideline recommendations are based on systematic reviews and evidence synthesis of relevant studies, and appraisal of the quality of the evidence and the strength of recommendations followed the “Grading of Recommendations Assessment, Development, and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, with areas of future research also presented.