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Time to stop using immunosuppressive agents in chronic glomerulonephritis

Usama AA Sharaf El Din, Mona M Salem, Dina O Abdulazim

Chronic glomerulonephritis is the third most important cause of end stage renal disease worldwide. Most of the patients suffering different types of glomerulonephritis are prescribed different immunosuppressive agents aiming at complete or partial remission in order to stop or muffle the progression of chronic kidney disease. Although the initial injury in case of glomerulonephritis is the glomerulus, the best predictor of renal survival is the amount of tubulointerstitial fibrosis. Recent trials have proved the efficacy of the anti-diabetic sodium glucose cotransporters-2 inhibitors in non-diabetic chronic kidney disease to significantly decrease the renal end points. Chronic glomerulonephritis represented a considerable bulk of nondiabetic cases recruited in these studies. This success should stimulate clinical Nephrologists to consider these agents in the newly diagnosed cases suffering increased urine protein excretion instead of immunosppressive treatment. In this review we will try to elucidate the value of these agents in management of patients presenting with different types of chronic glomerulonephritis

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