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Glomerulonephritiden

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Book cover Therapie innerer Krankheiten

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Zusammenfassung

In Deutschland werden zur Zeit ca.25% der terminalen Nierenversagen durch primäre oder sekundäre Glomerulonephritiden verursacht.Glomerulonephritiden stellen damit nach der diabetischen Nephropathie die zweithäufigste Ursache einer dialysepflichtigen Niereninsuffizienz dar.

Vor einer Diskussion von therapeutischen Ansätzen scheint eine kurze Passage zu begrifflichen Definitionen sinnvoll.Von entzündlichen Glomerulonephritiden werden formal nichtentzündliche Glomerulopathien unterschieden (dieser Übergang ist jedoch fließend, sodass vielfach, z.B. bei der membranösen Glomerulonephritis, die Begriffe Glomerulonephritis und Glomerulopathie synonym gebraucht werden). Auch die klassische Einteilung in primäre, d.h.renal limitierte, und sekundäre Glomerulonephritiden im Gefolge von Systemerkrankungen bzw. als Begleiterkrankung ist nicht immer eindeutig, da sich bei verfeinerter Suche oft auch systemische, jedoch klinisch inapparente, Manifestationen nachweisen lassen (z.B. extrarenale, vaskuläre IgA-Ablagerungen bei IgA-Nephropathie). Zudem können gleichartige renale Krankheitsbilder sowohl als primäre, idiopathische Glomerulonephritis als auch sekundär auftreten (z.B.idiopathische membranöse Glomerulonephritis, membranöse Glomerulonephritis bei Lupus erythematodes und membranöse Glomerulonephritis bei Hepatitis B).

Obwohl in diesem Abschnitt nur die primären Glomerulonephritiden besprochen werden, ergeben sich daher auch für dieTherapie sekundärer Glomerulonephritiden oftmals wichtige Aspekte. Vorwiegend aus historischen Gründen wird in diesem Kapitel auch die peri- bzw.postinfektiöse und hier besonders die Poststreptokokken-Glomerulonephritis abgehandelt.

Abschnitt 30.1, Primäre Glomerulonephritiden

Abschnitt 30.2, Systemerkrankungen mit glomerulärer Beteiligung

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Literatur

  • Austin HA, Klippel JH, Balowet JE et al. (1986) Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. N Engl J Med 314:614–619

    Article  PubMed  Google Scholar 

  • Ballardie FW, Roberts IS (2002) Controlled prospective trial of prednisolone and cytotoxics in progressive IgA nephropathy. J Am Soc Nephrol 13:142–148

    PubMed  CAS  Google Scholar 

  • Boletis JN, Joannidis JP, Boki KA, Moutsopoulos HM (1999) Intravenous immunoglobulin compared with cyclophosphamide for prolifrative lupus nephritis. Lancet 354:569–570

    Article  PubMed  CAS  Google Scholar 

  • Branten AJ, Wetzels JF (2001) Short-and long-term efficacy of oral cyclophosphamide and steroids in patients with membranous nephropathy and renal insufficiency. Study Group. Clin Nephrol 56:1–9

    PubMed  CAS  Google Scholar 

  • Burgess E (1999) Management of focal segmental glomerulosclerosis: evidence-based recommendations. Kidney int Suppl 70: S26–S32

    Article  PubMed  CAS  Google Scholar 

  • Cade R, Mars D, Privette M, Thompson R, Croker B, Peterson J, Campbell K (1986) Effect of long-term azathioprine administration in adults with minimal-change glomerulonephritis and nephrotic syndrome resistant to corticosteroids. Arch Intern Med 146: 737–741

    Article  PubMed  CAS  Google Scholar 

  • Cattran DC, Greenwood C, Ritchie S, Bernstein K, Churchill DN, Clark WF, Morrin PA, Lavoie S (1995) A controlled trial of cyclo-sporine in patients with progressive membranous nephropathy. Canadian Glomerulonephritis Study Group. Kidney Int 47: 1130–1135

    Article  PubMed  CAS  Google Scholar 

  • Cattran DC, Appel GB, Hebert LA, Hunsicker LG, Pohl MA, Hoy WE, Maxwell DR, Kunis CL (2001) Cyclosporine in patients with steroid-resistant membranous nephropathy: a randomized trial. Kidney Int 59:1484–1490

    Article  PubMed  CAS  Google Scholar 

  • Chan TM, Li FK, Tang CS, Wong RW, Fang GX, Ji YL, Lau CS, Wong AK, Tong MK, Chan KW, Lai KN (2000) Efficacy of mycophenolate mofetil on patients with diffuse proliferative lupus nephritis. N Engl J Med 343:1156–1162

    Article  PubMed  CAS  Google Scholar 

  • Chevrel G, Jenvrin C, McGregor B, Miossec P (2001) Renal type AA amyloidosis associated with rheumatoid arthritis: a cohort study showing improved survival on treatment with pulse cyclophosphamide. Rheumatology 40:821–825

    Article  PubMed  CAS  Google Scholar 

  • D-Amico G (1998) Renal involvement in hepatitis C infection: Cryo-globulinemic glomerulonephritis. Kidney Int 54:650–671

    Article  CAS  Google Scholar 

  • de Groot K, Reinhold-Keller E, Tatsis E, Paulsen J, Heller M, Nolle B, Gross WL (1996) Therapy for the maintenance of remission in sixty-five patients with generalized Wegener’s granulomatosis. Arthritis Rheum 39:2052–2061

    Article  PubMed  Google Scholar 

  • Dillon JJ (1997) Fish oil therapy for IgA nephropathy: efficacy and interstudy variability. J Am Soc Nephrol 8:1739–1744

    PubMed  CAS  Google Scholar 

  • Donadio JV Jr, Offord KP (1989) Reassessment of treatment results in membranoproliferative glomerulonephritis, with emphasis on life-table analysis. Am J Kidney Dis 14:445–451

    PubMed  Google Scholar 

  • Ducloux D, Bresson-Vautrin C, Chalopin J (2001) Use of pentoxifylline in membranous nephropathy. Lancet 357:1672–1673

    Article  PubMed  CAS  Google Scholar 

  • Falk RH, Comenzo RL, Skinner M (1997) The systemic amyloidoses. N Engl J Med 337:898–899

    Article  PubMed  CAS  Google Scholar 

  • Feld SM, Figueroa P, Savin V, Nast CC, Sharma R, Sharma M, Hirschberg R, Adler SG (1998) Plasmapheresis in the treatment of steroid-resistant focal segmental glomerulosclerosis in native kidneys. Am J Kidney Dis 32:230–237

    Article  PubMed  CAS  Google Scholar 

  • Floege J (2003) Evidence-based recommendations for immunosuppression in IgA-nephropathy: handle with caution. Nephrol Dial Transplant: im Druck

    Google Scholar 

  • Floege J, Feehally J (2000) IgA nephropathy: recent developments. J Am Soc Nephrol 11:2395–2403

    PubMed  CAS  Google Scholar 

  • Fuiano G, Mazza G, Comi N, Caglioti A, De Nicola L, Lodice C, Andreucci M, Andreucci VE (2000) Current indications for renal biopsy: a questionnaire-based survey. Am J Kidney Dis 35:448–457

    Article  PubMed  CAS  Google Scholar 

  • Fujimoto S, Yamamoto Y, Hisanaga S, Morita S, Eto T, Tanaka K (1991) Minimal change nephrotic syndrome in adults: response to corticosteroid therapy and frequency of relapse. Am J Kidney Dis 17: 687–692

    PubMed  CAS  Google Scholar 

  • Hahn BH (1998) Mechanisms of disease: Antibodies to DNA. N Engl J Med 338:1359–1368

    Article  PubMed  CAS  Google Scholar 

  • Hebert LA, Wilmer WA, Falkenhain ME, Ladson-Wofford SE, Nahman NS Jr, Rovin BH (2001) Renoprotection: one or many therapies? Kidney Int 59:1211–1226

    Article  PubMed  CAS  Google Scholar 

  • Hogan SL, Muller KE, Jennette JC, Falk RJ (1995) A review of therapeutic studies of idiopathic membranous glomerulopathy. Am J Kidney Dis 25:862–875

    Article  PubMed  CAS  Google Scholar 

  • Jayne DR, Chapel H, Adu D, Misbah S, O’Donoghue Scott D, Lockwood CM (2000) Intravenous immunoglobulin for ANCA-associated systemic vasculitis with persistent disease activity. Q J Med 93: 433–439

    Article  CAS  Google Scholar 

  • Jennette JC, Falk RJ (1997) Small-vessel vasculitis. N Engl J Med 337: 1512–1523

    Article  PubMed  CAS  Google Scholar 

  • Kobayashi Y, Hiki Y, Kokubo T, Horii A, Tateno S (1996) Steroid therapy during the early stage of progressive IgA nephropathy. A 10-year follow-up study. Nephron 72:237–242

    Article  PubMed  CAS  Google Scholar 

  • Lee GSL, Choong HL, Chiang GSC, Woo KT (1997) Three year randomized controlled trial of dipyridamole and low-dose warfarin in patients with IgA nephropathy and renal impairment. Nephrology 3:117–121

    Article  CAS  Google Scholar 

  • Levin A (1999) Management of membranoproliferative glomerulonephritis: evidence-based recommendations. Kidney Int Suppl 70:S41–S46

    Article  PubMed  CAS  Google Scholar 

  • Lien JW, Mathew TH, Meadows R (1979) Acute post-streptococcal glomerulonephritis in adults: a long-term study. Q J Med 48:99–111

    PubMed  CAS  Google Scholar 

  • Merkel F, Netzer KO, Gross O, Marx M, Weber M (1998) Therapeutic options for critically ill patients suffering from progressive lupus nephritis and Goodpasture’s syndrome. Kidney Int 53 (Suppl 64): 31–38

    Google Scholar 

  • Meyrier A, Noel LH, Auriche P, Callard P (1994) Long-term renal tolerance of cyclosporin A treatment in adult idiopathic nephrotic syndrome. Collaborative Group of the Societe de Nephrologie. Kidney Int 45:1446–1456

    Article  PubMed  CAS  Google Scholar 

  • Muirhead N (1999) Management of idiopathic membranous nephropathy: evidence-based recommendations. Kidney Int Suppl 70: S47–S55

    Article  PubMed  CAS  Google Scholar 

  • Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T (2003) Combination treatment of angiotensin-ll receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial. Lancet 361: 117

    Article  PubMed  CAS  Google Scholar 

  • Nolasco F, Cameron JS, Heywood EF, Hicks J, Ogg C, Williams DG (1986) Adult-onset minimal change nephrotic syndrome: a long-term follow-up. Kidney Int 29:1215–1223

    Article  PubMed  CAS  Google Scholar 

  • Nolin L, Courteau M (1999) Management of IgA nephropathy: evidence-based recommendations. Kidney Int Suppl 70: S56–S62

    Article  PubMed  CAS  Google Scholar 

  • Nowack R, Gobel U, Klooker P, Hergesell O, Andrassy K, van der Woude FJ (1999) Mycophenolate mofetil for maintenance therapy of Wegener’s granulomatosis and microscopic polyangiitis: a pilot study in 11 patients with renal involvement. J Am Soc Nephrol 10: 1965–1971

    PubMed  CAS  Google Scholar 

  • Obrador GT, Pereira BJ (1998) Early referral to the nephrologist and timely initiation of renal replacement therapy: a paradigm shift in the management of patients with chronic renal failure. Am J Kidney Dis 31:398–417

    Article  PubMed  CAS  Google Scholar 

  • Orth SR, Stockmann A, Conradt C, Ritz E, Ferro M, Kreusser W, Piccoli G, Rambausek M, Roccatello D, Schafer K, Sieberth HG, Wanner C, Watschinger B, Zucchelli P (1998) Smoking as a risk factor for end-stage renal failure in men with primary renal disease. Kidney Int 54:926

    Article  PubMed  CAS  Google Scholar 

  • Pedrini MT, Levey AS, Lau J, Chalmers TC, Wang PH (1996) The effect of dietary protein restriction on the progression of diabetic and nondiabetic renal diseases: a meta-analysis. Ann Intern Med 124: 627–632

    Article  PubMed  CAS  Google Scholar 

  • Ponticelli C, Edefonti A, Ghio L, Rizzoni G, Rinaldi S, Gusmano R, Lama G, Zacchello G, Confalonieri R, Altieri P (1993) Cyclosporin vs. cyclophosphamide for patients with steroid-dependent and frequently relapsing idiopathic nephrotic syndrome: a multicentre randomized controlled trial. Nephrol Dial Transplant 8: 1326–1332

    PubMed  CAS  Google Scholar 

  • Ponticelli C, Zucchelli P, Passerini P, Cesana B, Locatelli F, Pasquali S, Sasdelli M, Redaelli B, Grassi C, Pozzi C (1995) A 10-year follow-up of a randomized study with methylprednisolone and chlorambucil in membranous nephropathy. Kidney Int 48:1600–1604

    Article  PubMed  CAS  Google Scholar 

  • Ponticelli C, Altieri P, Scolari F, Passerini P, Roccatello D, Cesana B, Melis P, Valzorio B, Sasdelli M, Pasquali S, Pozzi C, Piccoli G, Lupo A, Segagni S, Antonucci F, Dugo M, Minari M, Scalia A, Pedrini L, Pisano G, Grassi C, Farina M, Bellazzi R (1998) A randomized study comparing methylprednisolone plus chlorambucil vs. methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy. J Am Soc Nephrol 9:444–450

    PubMed  CAS  Google Scholar 

  • Pozzi C, Bolasco PG, Fogazzi GB, Andruili S, Altieri P, Ponticelli C, Locatelli F (1999) Corticosteroids in IgA nephropathy: a randomised controlled trial. Lancet 353:883–887

    Article  PubMed  CAS  Google Scholar 

  • Reichert LJ, Huysmans FT, Assmann K, Koene RA, Wetzeis JF (1994) Preserving renal function in patients with membranous nephropathy: daily oral chlorambucil compared with intermittent monthly pulses of cyclophosphamide. Ann Intern Med 121:328–333

    Article  PubMed  CAS  Google Scholar 

  • Russo D, Minutolo R, Pisani A, Esposito R, Signoriello G, Andreucci M, Balletta MM (2001) Coadministration of losartan and enalapril exerts additive antiproteinuric effect in IgA nephropathy. Am J Kidney Dis 38:18–25

    Article  PubMed  CAS  Google Scholar 

  • Rydel JJ, Korbet SM, Borok RZ, Schwartz MM (1995) Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment. Am J Kidney Dis 25:534–542

    Article  PubMed  CAS  Google Scholar 

  • Sarasin FP, Schifferli JA (1994) Prophylactic oral anticoagulation in nephrotic patients with idiopathic membranous nephropathy. Kidney Int 45:578–585

    Article  PubMed  CAS  Google Scholar 

  • Schieppati A, Mosconi L, Perna A, Mecca G, Bertani T, Garattini S, Remuzzi G (1993) Prognosis of untreated patients with idiopathic membranous nephropathy. N Engl J Med 329:85–89

    Article  PubMed  CAS  Google Scholar 

  • Tarshish P, Bernstein J, Tobin JN, Edelmann CM Jr (1992) Treatment of mesangiocapillary glomerulonephritis with alternate-day prednisone — a report of the International Study of Kidney Disease in Children. Pediatr Nephrol 6:123–130

    Article  PubMed  CAS  Google Scholar 

  • The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (1997) Arch Intern Med 157:2413–2446

    Article  Google Scholar 

  • Weber M, Marx M, Merkel F (1995) Goodpasture Syndrome. In: Schlöndorf D, Bonventre J (eds) Molecular biology of kidney diseases. Marcel Dekker, New York Basel Hong-Kong, pp 809–819

    Google Scholar 

  • Weber M, Marx M, Merkel F (1996) Autoantikörper in der Nephrologie. Internist 36:270–276

    Google Scholar 

  • Winearls CG (1995) Acute myeloma kidney. Kidney Int 48: 1347–1361

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. J. Floege
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  2. E. Schulze-Lohoff
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  3. M. Weber
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Floege, J., Schulze-Lohoff, E., Weber, M. (2003). Glomerulonephritiden. In: Therapie innerer Krankheiten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10475-0_30

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  • DOI: https://doi.org/10.1007/978-3-662-10475-0_30

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