Diseases We Treat

“Glomeruli” are tiny, microscopic filters in the kidney where blood is cleaned and processed and the waste products removed into the urine. Injury to glomeruli can come from many different causes, including immune system problems, genetic diseases, infections, and malignancies. We offer expertise in the diagnosis and management of these rare conditions.

Nephrotic Syndrome is the loss of large quantities of protein into the urine (proteinuria). Also typically leads to low albumin (a type of protein) levels in the blood, and high levels of cholesterol. Common causes include minimal change disease, focal segmental glomerulosclerosis (FSGS), membranous nephropathy, and amyloidosis.

Inflammation of the glomeruli causes decreased kidney function, blood in the urine (hematuria), and high blood pressure. Common causes include IgA nephropathy, lupus nephritis, and Antineutrophil Cytoplasmic Antibodies (ANCA) associated with vasculitis.

Injury to a type of kidney cell (podocytes) that makes up a critical layer of the glomerular filter can cause nephrotic syndrome. This condition is typically responsive to immunosuppression but may relapse, and some patients need prolonged maintenance and treatment to prevent relapses. This condition often presents in childhood, but adults can develop it as well.

FSGS is a type of scarring injury of the kidney filters, that may be produced by various causes including genetic, autoimmune, and infections, among others. “Primary FSGS” is a disease where a circulating factor in the blood injures the kidney and typically leads to nephrotic syndrome. This condition may respond to immunosuppression but can be difficult to treat and may lead to progressive kidney failure requiring dialysis or kidney transplantation.

Antibodies produced target one of the layers of the glomerular kidney filters, damaging them and causing protein to leak into the urine. Several of these antibodies can now be detected on kidney biopsy, and some can be measured by blood tests as well.

Membranous nephropathy is a frequent cause of nephrotic syndrome. Some people with membranous nephropathy recover completely, but others may progress to kidney failure if the condition is not alleviated.

The kidneys are frequently affected in patients with Systemic Lupus Erythematosus (SLE). This can produce glomerulonephritis and/or nephrotic syndrome, and if left untreated it almost invariably leads to progressive kidney failure. Several types of immunosuppressive medications can help alleviate Lupus Nephritis.

ANCA vasculitis can cause acute kidney injury and kidney failure within a short period, and timely treatment can save kidney function. This condition also has other organ involvement (especially the lungs and respiratory tract) and can relapse over time; therefore careful monitoring with experienced providers is essential.

Anti-GBM glomerulonephritis is typically a very aggressive type of kidney inflammation that can rapidly lead to kidney failure and sometimes lung injury as well. Appropriate treatment may preserve kidney function, but timely initiation of therapy is crucial.

MPGN and C3 Glomerulopathy are related forms of glomerulonephritis that often lead to progressive kidney injury. Various causes have been recognized, both acquired (e.g, chronic infections or hematologic disease) and intrinsic (e.g. genetic mutations of immune system proteins). We have contributed to understanding and improvement in the care of C3 glomerulopathy.

Fibrillary glomerulonephritis is a rare type of glomerulonephritis and its pathogenesis still remains unclear. Diagnosis requires specialized stains and examinations of biopsied kidney tissue, which our pathologists have expertise in performing.

Certain type of glomerular injury is secondary to genetic variation. There are treatments we can use to delay the progression of kidney disease. We partner with world-renowned genetic labs at Columbia specializing in hereditary kidney disease.

Excessive production of a single type of antibody or piece of an antibody by cells of the bone marrow can lead to deposition in the kidney and associated damage called “monoclonal gammopathies” or“paraproteins”. This can be seen in hematological diseases like multiple myeloma and amyloidosis, among others. Our nephrologists collaborate with colleagues in the Columbia Amyloidosis Multidisciplinary Program to comprehensively manage patients affected by these conditions.