Glomerular Diseases
Expert Care for Complex Kidney Conditions

The glomeruli are the microscopic filtering units of the kidney — tiny capillary networks that filter approximately 180 liters of blood per day. Glomerular diseases are conditions that specifically target and damage these filtering structures, typically through immune-mediated inflammation, abnormal protein deposition, or genetic defects in the glomerular architecture.

These conditions often present with proteinuria (excess protein in the urine), hematuria (blood in the urine), hypertension, and varying degrees of kidney function impairment. Left undiagnosed and untreated, many glomerular diseases progress to end-stage kidney disease — making accurate diagnosis and timely treatment critical.

Glomerular diseases are classified into nephrotic syndromes (characterized primarily by heavy proteinuria, edema, and low albumin) and nephritic syndromes (characterized by hematuria, hypertension, and acute kidney function decline). Many conditions can present features of both.

IgA Nephropathy: The most common primary glomerular disease worldwide, IgA nephropathy is caused by abnormal IgA antibody deposits in the glomeruli. Recent years have seen major breakthroughs in treatment, including SGLT2 inhibitors, sparsentan, and targeted-release budesonide — therapies we incorporate into our management protocols.

Membranous Nephropathy: Now classified into PLA2R antibody-positive and other subtypes, membranous nephropathy is treated based on risk stratification. We use immunosuppressive regimens including rituximab and monitor antibody titers to guide therapy decisions.

Focal Segmental Glomerulosclerosis (FSGS): A heterogeneous condition with primary (immune-mediated), secondary (adaptive), and genetic subtypes requiring different treatments. Accurate subtype classification through kidney biopsy interpretation is essential.

Lupus Nephritis: Kidney involvement occurs in up to 60% of patients with systemic lupus erythematosus and significantly impacts prognosis. We work closely with rheumatology to optimize mycophenolate, belimumab, voclosporin, and other immune therapies.

ANCA-Associated Vasculitis: Microscopic polyangiitis and granulomatosis with polyangiitis cause severe pauci-immune glomerulonephritis that can rapidly destroy kidney function. We provide urgent consultation, induction immunosuppression with rituximab or cyclophosphamide, and long-term remission maintenance.

Many glomerular diseases require a kidney biopsy for definitive diagnosis and treatment planning. Our nephrologists perform the clinical evaluation, determine when biopsy is indicated, coordinate the procedure with interventional radiology, and interpret the complex pathology — including immunofluorescence, electron microscopy, and light microscopy results — in the context of the patient's overall clinical picture.

Accurate biopsy interpretation is a cornerstone of our practice. The same histological finding can arise from very different underlying conditions requiring entirely different treatments. Our experience with glomerular pathology ensures that the right diagnosis drives the right therapy.