Abstract
The essential therapeutic approach for the treatment of chronic glomerulonephritides (GN) is based on conclusions of the meta-analyses of therapeutic trials with a cohort of placebo-treated patients. In a clinical praxis, we have to frequently modify these approaches according to the general condition of a patient and clinical and morphological presentation of GN.
In renal biopsy, many findings are on the boundaries of the classical forms of GN or even on an overlap between these forms. Then, dilemma may exist which approach to apply.
In chronic GNs, proteinuria and its severity is the basic symptom to treat. Its partial remission slows down the progression of GNs, its disappearance usually means clinical remission.
Results presented in therapeutic studies are usually expressed as an average response of proteinuria (partial or complete remission) and as a rate of kidney function decrease in a cohort of patients. This response may not necessarily appear in an individual patient.
Therefore, we choose the type of therapy only after a detailed clinical- morphological consultation in the presence of a nephropathologist. In this review we provide our concept of immunosuppressant use in classical forms of chronic primary GNs.