Treatment of secondary<unk>  nephropathy is guided by the treatment of the original disease. For treatment of idiopathic<unk>  nephropathy, the treatment options include immunosuppressive drugs and non-specific anti-proteinuric measures such as ACE inhibitors or angiotensin II receptor blockers. Given spontaneous remission is common, international guidelines recommend a period of watchful waiting before considering immunosuppressive treatment. Likelihood of achieving spontaneous remission is much higher if anti-proteinuric therapy with ace inhibitors or angiotensin II receptor blockers is commenced. Recommended first line immunosuppressive therapy often includes: cyclophosphamide alternating with a corticosteroid, also known as the Ponticelli regime. Immunosuppressive therapy options # Corticosteroids: They have been tried with mixed results, with one study showing prevention of progression to kidney failure without improvement in proteinuria. # Chlorambucil # Cyclosporine # Tacrolimus # Cyclophosphamide # Mycophenolate mofetil # Rituximab Perhaps the most difficult aspect of<unk>  is deciding which people to treat with immunosuppressive therapy as opposed to simple "background" or anti-proteinuric therapies. A large part of this difficulty is due to a lack of ability to predict which people will progress to end-stage kidney disease, or kidney disease severe enough to require dialysis. Because the above medications carry risk, treatment should not be initiated without careful consideration as to risk/benefit profile. Of note, corticosteroids (typically Prednisone) alone are of little benefit. They should be combined with one of the other 5 medications, each of which, along with prednisone, has shown some benefit in slowing down progression of<unk>  nephropathy. It must be kept in mind, however, that each of the 5 medications also carry their own risks, on top of prednisone. The twin aims of treating<unk>  nephropathy are first to induce a remission of the nephrotic syndrome and second to prevent the development of end-stage kidney failure. A meta-analysis of four randomized controlled trials comparing treatments of<unk>  nephropathy showed that regimes comprising chlorambucil or cyclophosphamide, either alone or with steroids, were more effective than symptomatic treatment or treatment with steroids alone in inducing remission of the nephrotic syndrome.
Membranous glomerulonephritis
Membranoproliferative glomerulonephritis
Focal proliferative nephritis
Transplant glomerulopathy
Mesangial proliferative glomerulonephritis
Diffuse proliferative nephritis
Minimal mesangial glomerulonephritis
IgA nephropathy