Masterclass 15 - Management of Glomerulonephritis and Diabetic Kidney Disease in 2024

IgA nephropathy is the most common cause of primary glomerulonephritis whilst membranous nephropathy is the most common cause of nephrotic syndrome in non-diabetic adults. This presentation will delve into the paradigm shifts in management over time and speculate on the future therapeutic landscape. In particular, this presentation will elaborate important practice points in the management of these entities.

The incidence of type 2 diabetes and end stage kidney disease ESKD secondary to diabetic kidney disease is increasing at an alarming rate globally. The situation is no better in Hong Kong where over half of incident cases of ESKD were attributed to diabetes, as confirmed to be among the top 5 regions (in terms of percentage of incident cases attributed to diabetes) from the USRDS data.
In parallel with the tsunami of diabetic kidney disease, there has been a beacon of hope for the treatment of diabetic kidney disease. The increasing number of new approved therapy, after a nearly 20 years of drought, is best illustrated by the surge in publication of clinical practice guidelines since 2022. 
To update on the new landscape of treating diabetic kidney disease, this lecture will include and highlight changes in treatment, with special focus on the Kidney Disease Improving Global Outcomes KDIGO 2022 update. Three important drugs, namely, sodium/glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonist, and glucagon-like receptor agonist, will be addressed. Notably, the practical tips on using the drugs and the impact on outcomes will be discussed. Furthermore, challenges in the implementing the use of new drugs will be covered.