2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T76a,Focal segmental glomerulosclerosis (FSGS) is a podocytopathy that is diagnosed based on characteristic histopathological lesions. Certain forms of FSGS with underlying genetic variants associated with the disease, including variants in podocyte proteins, as well as apolipoprotein L1 (APOL1) risk alleles, and variants in collagen type IV (COL4) α3, α4, and α5 (COL4A3-5) proteins, are typically resistant to current treatments. The DUPLEX clinical trial assessed the efficacy and safety of sparsentan, a dual endothelin angiotensin receptor antagonist (DEARA), in patients with biopsy-proven or genetic FSGS and demonstrated a greater antiproteinuric effect over 108 weeks compared to the active control irbesartan. This post hoc, exploratory analysis assessed the efficacy of sparsentan in the subset of patients enrolled in DUPLEX who had pathogenic variants in genes coding for podocyte proteins, COL4A3-5 variants, and APOL1 high-risk genotypes, altogether referred to as genetic FSGS (gFSGS). Next-generation sequencing identified 31 patients with podocyte gene variants, 25 with COL4A3-5 gene variants, and 14 with APOL1 high-risk genotypes. Baseline characteristics varied between genetic subgroups, with slightly younger patients, on average, in the podocyte gene variant group, and more African American patients in the APOL1 high-risk genotype group. In this exploratory analysis, sparsentan treatment resulted in substantial and sustained proteinuria reductions and numerically more frequent complete remission of proteinuria compared with irbesartan, consistent with observations in the full DUPLEX study population. Moreover, a lower proportion of sparsentan- vs irbesartan-treated patients reached composite kidney endpoints. These findings support sparsentan's antiproteinuric benefit in patients with gFSGS, a subgroup that is often resistant to other therapeutic interventions.31:Tc8d, Background: Focal segmental glomerulosclerosis (FSGS) is a podocytopathy that is diagnosed based on characteristic histopathological lesions. Certain forms of FSGS with underlying genetic variants associated with the disease, including variants in podocyte proteins, as well as apolipoprotein L1 ( APOL1 ) risk alleles, and variants in collagen type IV (COL4) α3, α4, and α5 ( COL4A3-5 ) proteins, are typically resistant to current treatments. Methods: The DUPLEX clinical trial assessed the efficacy and safety of sparsentan, a dual endothelin angiotensin receptor antagonist (DEARA), in patients with biopsy-proven or genetic FSGS and demonstrated a greater antiproteinuric effect over 108 weeks compared to the active control irbesartan. This post hoc, exploratory analysis assessed the efficacy of sparsentan in the subset of patients enrolled in DUPLEX who had pathogenic variants in genes coding for podocyte proteins, COL4A3-5 variants, and APOL1 high-risk genotypes, altogether referred to as genetic FSGS (gFSGS). Results: Next-generation sequencing identified 31 patients with podocyte gene variants, 25 with COL4A3-5 gene variants, and 14 with APOL1 high-risk genotypes. Baseline characteristics varied between genetic subgroups, with slightly younger patients, on average, in the podocyte gene variant group, and more African American patients in the APOL1 high-risk genotype group. In this exploratory analysis, sparsentan treatment resulted in substantial and sustained proteinuria reductions and numerically more frequent complete remission of proteinuria compared with irbesartan, consistent with observations in the full DUPLEX study population. Moreover, a lower proportion of sparsentan- vs irbesartan-treated patients reached composite kidney endpoints. Conclusions: These findings support sparsentan’s antiproteinuric benefit in patients with gFSGS, a subgroup that is often resistant to other therapeutic interventions. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Focal Segmental Glomerulosclerosis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Focal Segmental Glomerulosclerosis (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Focal%20Segmental%20Glomerulosclerosis\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Focal Segmental Glomerulosclerosis\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Focal%20Segmental%20Glomerulosclerosis\"}]}}"}}]],["$","$L2f",null,{"title":"Focal Segmental Glomerulosclerosis: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Focal Segmental Glomerulosclerosis with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1093/ckj/sfag283","pmid":null,"title":"B- and plasma cell-targeting therapies for podocytopathies: state of the art and the New Gaslini Protocol","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-08-21T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag283","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-08-27T06:17:10.308Z","updated_at":"2026-08-27T06:17:10.308Z","tags":[{"paper_doi":"10.1093/ckj/sfag283","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"brand","value":"Gazyva","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Idiopathic Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Podocytopathy","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"generic","value":"obinutuzumab","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"No sample size tag applied — this is a review article with no single study population.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"Obinutuzumab brand name 'Gazyva' is its approved oncology brand; nephrology use is off-label.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"The 'practice_changing' impact flag reflects a novel proposed protocol (New Gaslini Protocol); it is not yet validated by randomized controlled trials.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"The review covers both pediatric and adult populations but does not consistently stratify findings by age group; 'mixed' age group assigned.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the role of humoral immunity (B cells, plasma cells, autoantibodies) in podocytopathies—MCD, FSGS, and INS—and examines the evidence for B cell– and plasma cell–targeting therapies, culminating in a proposed treatment framework called the New Gaslini Protocol.","key_result":"Anti-CD20 therapies improve outcomes in steroid-dependent/frequently relapsing disease but show limited efficacy in steroid-resistant forms and post-transplant recurrence; combined sequential targeting of CD20⁺ B cells (obinutuzumab) and CD38⁺ plasma cells (daratumumab) may achieve deeper, more sustained control in refractory and recurrent cases.","limitations":"This is a narrative review without systematic meta-analysis; evidence for combined CD20/CD38 targeting is drawn from limited, heterogeneous case series with no randomized trial data; variability in treatment protocols across centers limits generalizability.","practice_takeaway":"For patients with refractory or frequently relapsing podocytopathies, consider sequential CD20 and CD38 targeting rather than anti-CD20 monotherapy alone, as long-lived plasma cells likely sustain disease despite B-cell depletion. The proposed New Gaslini Protocol offers a mechanistically grounded framework to standardize this approach pending trial validation."}},{"doi":"10.1093/ndt/gfag187","pmid":"42616010","title":"How to treat „FSGS“? A conceptual framework","journal_title":"Nephrology Dialysis Transplantation","journal_issn":"0931-0509","published_at":"2026-08-19T00:00:00.000Z","url":"https://doi.org/10.1093/ndt/gfag187","source_score":20,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-23T07:33:11.560Z","updated_at":"2026-08-23T07:33:11.560Z","tags":[{"paper_doi":"10.1093/ndt/gfag187","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag187","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag187","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag187","tag_type":"study_design","value":"Review / Conceptual Framework","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag187","tag_type":"warning","value":"Full paper text was not provided — only bibliographic metadata (title, DOI, journal, date) was available. All structured outputs are based solely on the title and publication context. No specific results, populations, methods, or recommendations could be extracted. Clinicians should consult the full article directly at https://doi.org/10.1093/ndt/gfag187.","value_numeric":null}],"summaries":{"what_studied":"This paper proposes a conceptual framework for how to approach and treat focal segmental glomerulosclerosis (FSGS), likely addressing the heterogeneity of FSGS as a pathological pattern versus a disease entity.","limitations":"Only a DOI and bibliographic metadata were provided; the full text was not available for extraction of specific data, results, or recommendations."}},{"doi":"10.1016/j.kint.2026.07.008","pmid":null,"title":"Podocin Oligomerization links Slit Diaphragm Architecture and NPHS2 Genetics","journal_title":"Kidney International","journal_issn":"0085-2538","published_at":"2026-08-06T00:00:00.000Z","url":"https://doi.org/10.1016/j.kint.2026.07.008","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:13.107Z","updated_at":"2026-08-17T13:33:13.107Z","tags":[{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"condition","value":"Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"generic","value":"podocin","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"study_design","value":"Basic Science Study","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"warning","value":"Only the paper title, DOI, journal, and publication date were provided — no abstract, methods, results, or conclusions were available. All summary fields requiring specific findings, sample sizes, or limitations have been left null to avoid speculation.","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"warning","value":"Publication date is August 6, 2026, which is 11 days before today's date — this appears to be a very recently published article; full-text access may be limited.","value_numeric":null},{"paper_doi":"10.1016/j.kint.2026.07.008","tag_type":"warning","value":"Study design tag is a best guess based on the basic science/structural biology nature implied by the title; the actual methodology (e.g., structural, in vitro, animal model) could not be confirmed.","value_numeric":null}],"summaries":{"what_studied":"This study examined how podocin oligomerization relates to slit diaphragm architecture and how mutations in NPHS2 (the gene encoding podocin) affect this process, with implications for genetic forms of nephrotic syndrome."}},{"doi":"10.1681/asn.0000001195","pmid":"42490149","title":"Anti-podocin and Anti-KIRREL1 Antibodies and Steroid Resistance, FSGS, and Disease Recurrence after Transplantation in Autoimmune Podocytopathies","journal_title":"Journal of the American Society of Nephrology","journal_issn":"1046-6673","published_at":"2026-07-23T00:00:00.000Z","url":"https://doi.org/10.1681/asn.0000001195","source_score":14,"is_retracted":false,"is_open_access":null,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":false},"created_at":"2026-07-31T13:37:18.559Z","updated_at":"2026-07-31T13:37:18.559Z","tags":[{"paper_doi":"10.1681/asn.0000001195","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"condition","value":"Autoimmune Podocytopathy","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"condition","value":"Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"modality","value":"Autoantibody Serology","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"modality","value":"Super-Resolution Microscopy","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"sample_size","value":"n=471","value_numeric":471},{"paper_doi":"10.1681/asn.0000001195","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"study_design","value":"Multicenter Observational Study","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"warning","value":"No branded therapeutics or generic drugs were evaluated; modality tags reflect diagnostic tools only.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"warning","value":"Super-resolution microscopy was the reference standard; ELISA sensitivity was lower, meaning serum-only testing may miss some antibody-positive cases.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"warning","value":"The level of evidence is rated 3 (observational multicenter study); no randomization or blinding to treatment was performed.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001195","tag_type":"warning","value":"The transplant recurrence subgroup is small (n=26), so the 83% recurrence rate should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"This multicenter study evaluated clinical phenotypes and long-term outcomes associated with anti-nephrin, anti-podocin, and anti-KIRREL1 autoantibodies in 213 patients with autoimmune podocytopathies (minimal change disease or FSGS), using serology and super-resolution microscopy across 471 samples including 146 kidney biopsies and 61 paired specimens.","key_result":"Anti-nephrin alone correlated with minimal change disease (91%), steroid sensitivity (88%), and no CKD over 120 months. Anti-podocin and/or anti-KIRREL1 antibodies correlated with FSGS (84%), steroid resistance (58%), CKD progression (36%), and kidney failure (24%). In transplant recipients with FSGS, post-transplant recurrence occurred in 83% of autoantibody carriers vs. 5% of non-carriers; recurrent cases carried anti-podocin/KIRREL1 antibodies.","limitations":"ELISA showed high specificity but lower sensitivity than super-resolution microscopy, potentially underestimating autoantibody prevalence. The study is observational and multicenter, so treatment protocols were not standardized across sites. The transplant subgroup was small (n=26), limiting generalizability of recurrence findings.","practice_takeaway":"Testing for anti-podocin and anti-KIRREL1 antibodies in nephrotic syndrome may help identify patients at high risk for steroid resistance, FSGS, and post-transplant recurrence before immunosuppression is chosen. Patients with FSGS who carry these antibodies should be counseled about a very high recurrence risk after kidney transplant (83%)."}},{"doi":"10.1093/ndt/gfag137","pmid":"42340364","title":"Prevalence of anti-rituximab antibodies in autoimmune forms of glomerulonephritis and podocytopathies","journal_title":"Nephrology Dialysis Transplantation","journal_issn":"0931-0509","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1093/ndt/gfag137","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-28T13:27:17.438Z","updated_at":"2026-06-28T13:27:17.438Z","tags":[{"paper_doi":"10.1093/ndt/gfag137","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"condition","value":"ANCA-Associated Vasculitis","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"condition","value":"Membranous Nephropathy","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"sample_size","value":"n=300","value_numeric":300},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"study_design","value":"Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"warning","value":"Age group tagged as 'adult' based on typical autoimmune nephrology populations; the paper does not explicitly state age inclusion criteria.","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"warning","value":"The brand tag 'Rituxan' is used as the canonical branded form of rituximab; biosimilars may also have been used and are not specified in the abstract.","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag137","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — while findings highlight diagnosis-specific ADA patterns, the study could not directly link ADA titers to clinical outcomes, which limits definitive practice change.","value_numeric":null}],"summaries":{"limitations":"Clinical response could not be reliably correlated with ADA formation, as some patients achieved robust responses despite unmeasurably high ADA titers; the study is observational without a control arm; and the heterogeneous patient population may confound cross-diagnosis comparisons.","what_studied":"This study evaluated anti-drug antibody (ADA) formation against rituximab (RTX) in 300 patients (1,312 blood samples) with autoimmune kidney diseases — including membranous nephropathy (MN), ANCA-associated vasculitis (AAV), focal segmental glomerulosclerosis (FSGS), SLE, and minimal change disease — to describe ADA frequency and titers across diagnoses.","key_result":"ADAs were detected in 54 of 300 patients (18%) and were significantly more frequent in diagnoses with worse RTX response (MN, SLE, FSGS) than in standard-response diagnoses (AAV, minimal change disease); ADA patterns varied — low/transient in AAV, higher/sustained in MN, and sometimes unmeasurably high/early in FSGS.","practice_takeaway":"ADA formation against rituximab varies substantially by diagnosis, so clinicians should not apply a uniform ADA monitoring threshold across autoimmune kidney diseases. Monitoring B-cell reconstitution alongside ADA titers may help guide re-dosing decisions, particularly in FSGS and MN where ADAs tend to be higher and more sustained."}},{"doi":"10.1001/jama.2026.9923","pmid":"42246414","title":"Finerenone in Patients With Chronic Kidney Disease Due to Glomerular Diseases","journal_title":"JAMA","journal_issn":"0098-7484","published_at":"2026-06-05T00:00:00.000Z","url":"https://doi.org/10.1001/jama.2026.9923","source_score":202,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:40.857Z","updated_at":"2026-06-10T14:23:40.857Z","tags":[{"paper_doi":"10.1001/jama.2026.9923","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"brand","value":"Kerendia","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"condition","value":"Glomerular Disease","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"condition","value":"IgA Nephropathy","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"condition","value":"Membranous Nephropathy","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"generic","value":"finerenone","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"modality","value":"Mineralocorticoid Receptor Antagonist","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"sample_size","value":"n=903","value_numeric":903},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"warning","value":"Brand name 'Kerendia' assigned based on known finerenone branding; the paper itself does not mention a brand name.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"warning","value":"Level of evidence tagged as '2' reflects the RCT design, but the subgroup/exploratory nature slightly reduces certainty compared to a primary powered trial.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"warning","value":"The main FIND-CKD trial results (Heerspink et al., NEJM, June 5, 2026) are referenced but not fully reproduced here; findings in the broader nondiabetic CKD population may differ.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.9923","tag_type":"warning","value":"This is a prespecified exploratory subgroup analysis, not the primary trial report; causal conclusions should be interpreted cautiously despite the consistency of findings.","value_numeric":null}],"summaries":{"what_studied":"Prespecified exploratory subgroup analysis of the FIND-CKD phase 3 RCT evaluating finerenone (10–20 mg/day orally) vs placebo in 903 adults with nondiabetic CKD due to glomerular diseases (46% IgA nephropathy, 24% FSGS, 10% membranous nephropathy), all on maximum-tolerated RAS inhibitor, followed up to 32 months across 24 countries.","key_result":"Finerenone slowed eGFR decline by 0.73 mL/min/1.73 m² per year vs placebo (−3.50 vs −4.23; 95% CI 0.22–1.24), reduced albuminuria by 42% at 12 months (95% CI 35%–48%), and cut the risk of kidney failure or ≥40% eGFR decline by 26% (HR 0.74; 95% CI 0.57–0.97; 7.42 vs 9.60 events/100 patient-years). Effects were consistent across all glomerular disease subtypes and regardless of baseline SGLT2 inhibitor use.","limitations":"- Exploratory subgroup analysis; trial not powered for clinical outcomes in the glomerular disease subgroup or by subtype.\n- ~20% of glomerular disease cases lacked kidney biopsy confirmation (though results held in biopsy-confirmed analyses).\n- Patients on immunosuppression and those with lupus nephritis or ANCA vasculitis were excluded, limiting generalizability to these groups.","practice_takeaway":"Consider adding finerenone to RAS inhibitor therapy for patients with CKD due to glomerular diseases (IgA nephropathy, FSGS, membranous nephropathy) to slow kidney function loss and reduce albuminuria, even in those already on SGLT2 inhibitors. Monitor potassium; serious hyperkalemia rates were low and similar between arms (0.9% each)."}},{"doi":"10.1080/09273948.2026.2679855","pmid":"42206750","title":"Atypical COQ2-Related Retinopathy in Identical Twins with Nephropathy Mimicking Intermediate Uveitis","journal_title":"Ocular Immunology and Inflammation","journal_issn":"0927-3948","published_at":"2026-05-28T00:00:00.000Z","url":"https://doi.org/10.1080/09273948.2026.2679855","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-07T13:26:38.633Z","updated_at":"2026-06-07T13:26:38.633Z","tags":[{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"brand","value":"Avastin","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"condition","value":"COQ2-Related Retinopathy","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"condition","value":"Cystoid Macular Oedema","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"condition","value":"Intermediate Uveitis","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"condition","value":"Primary Coenzyme Q10 Deficiency","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"generic","value":"acetazolamide","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"generic","value":"bevacizumab","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"generic","value":"coenzyme Q10","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"generic","value":"dorzolamide","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"modality","value":"Anti-VEGF","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"modality","value":"Mitochondrial Supplement","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"sample_size","value":"n=2","value_numeric":2},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"warning","value":"Electrophysiological improvement after CoQ10 supplementation fell within normal test-retest variability; efficacy conclusion is tentative.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"warning","value":"Only 2 patients reported (identical twins sharing the same variant); phenotypic conclusions are highly preliminary.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"warning","value":"The Avastin (bevacizumab) brand tag is inferred from context; the paper does not explicitly name the brand formulation used.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2679855","tag_type":"warning","value":"The bilateral CMO response to unilateral bevacizumab is intriguing but spontaneous fluctuation cannot be ruled out given the small sample.","value_numeric":null}],"summaries":{"what_studied":"This retrospective case report describes two 33-year-old identical male twins with a homozygous COQ2 variant (c.683A>G, p.Asn228Ser) presenting with bilateral cystoid macular oedema (CMO), vitreous cells, and retinal microangiopathy mimicking intermediate uveitis, alongside nephropathy (FSGS) but no neurological involvement.","key_result":"Whole-exome sequencing confirmed primary CoQ10 deficiency type 1; electrophysiology showed severely abnormal EOG with only borderline ERG changes, indicating predominant RPE dysfunction. CMO worsened with topical corticosteroids but improved bilaterally after a single unilateral intravitreal bevacizumab injection. After one year of oral CoQ10 supplementation (10 mg/kg/day, then 5 mg/kg/day), EOG and ERG parameters showed slight but uncertain improvement within test-retest variability.","limitations":"- Only 2 patients (identical twins); findings may not generalize to other COQ2 variants or presentations.\n- Electrophysiological improvement after CoQ10 supplementation was within expected intra-individual test-retest variability (25–40% for ERG, ~10% for EOG), making true benefit unclear.\n- Spontaneous fluctuation cannot be excluded as an explanation for the bilateral CMO response to unilateral bevacizumab.","practice_takeaway":"In young patients with CMO resembling intermediate uveitis—especially when paired with unexplained nephropathy—consider genetic testing for COQ2 and related mitochondrial disorders before initiating corticosteroids, which may worsen CMO. Early CoQ10 supplementation and anti-VEGF therapy (rather than steroids) may be more appropriate in confirmed cases."}},{"doi":"10.1093/ndt/gfag108","pmid":"42148809","title":"Kidney biopsy during pregnancy: indications, complications, results and therapeutic impact","journal_title":"Nephrology Dialysis Transplantation","journal_issn":"0931-0509","published_at":"2026-05-18T00:00:00.000Z","url":"https://doi.org/10.1093/ndt/gfag108","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-21T13:21:04.574Z","updated_at":"2026-05-21T13:21:04.574Z","tags":[{"paper_doi":"10.1093/ndt/gfag108","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"brand","value":"Benlysta","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"IgA Nephropathy","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Kidney Disease In Pregnancy","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Lupus Nephritis","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Membranous Nephropathy","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"condition","value":"Preeclampsia","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"generic","value":"belimumab","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"BLyS Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Diagnostic Procedure","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"modality","value":"Immunosuppressant","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"sample_size","value":"n=76","value_numeric":76},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"warning","value":"No control group of pregnant women with similar kidney disease who did not undergo biopsy was available, so the independent effect of KB on outcomes cannot be isolated.","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"warning","value":"The high rates of adverse obstetric outcomes (e.g., preterm birth 65%, intrauterine fetal death 9%) likely reflect the severity of the underlying kidney diseases rather than a complication of the biopsy itself — clinicians should not interpret these as procedural risks.","value_numeric":null},{"paper_doi":"10.1093/ndt/gfag108","tag_type":"warning","value":"The study is limited to French centers; practice patterns and case selection may not generalize to other health systems.","value_numeric":null}],"summaries":{"what_studied":"A French nationwide retrospective survey evaluated the indications, complications, histological diagnoses, treatments initiated, and obstetric outcomes of 76 pregnant women who underwent native kidney biopsy (KB) between 2006 and 2025, with KB performed at a median gestational age of 13.5 weeks.","key_result":"KB yielded a diagnosis in 94.7% of cases; the most common diagnoses were lupus nephritis (43%), FSGS (13%), membranous nephropathy (13%), and IgA nephropathy (12%). Only 1 patient had a major bleeding complication requiring transfusion. Specific treatment was started in 63.2% of patients post-biopsy. Adverse obstetric outcomes were frequent: preterm birth 65.0%, low birth weight 56.7%, small for gestational age 21.3%, preeclampsia 16.4%, and intrauterine fetal death 9.0%.","limitations":"- Retrospective, observational design with no control group, limiting causal inference about KB-related versus disease-related obstetric outcomes.\n- Small sample size (n=76) with likely selection bias, as only cases where clinicians judged KB necessary were included.\n- No standardized follow-up protocol across participating French centers.","practice_takeaway":"Kidney biopsy in the first two trimesters of pregnancy appears safe (low procedural complication rate) with a high diagnostic yield (~95%), and directly changes management in nearly two-thirds of cases. Clinicians should weigh this favorable risk/benefit profile when KB is needed to guide treatment of nephrotic syndrome or significant proteinuria in pregnancy."}},{"doi":"10.1007/s00467-026-07307-5","pmid":"42045692","title":"Reassessing the role of kidney biopsy in early idiopathic steroid-resistant nephrotic syndrome among children and young adults","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-026-07307-5","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:42.269Z","updated_at":"2026-05-08T13:23:42.269Z","tags":[{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"condition","value":"Steroid-Resistant Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"generic","value":"cyclosporine","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"sample_size","value":"n=55","value_numeric":55},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"warning","value":"Full text was not accessible; structured data are based solely on the abstract and results section provided.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"warning","value":"Membranous nephropathy represented only 4% of cases (approx. 2 patients); conclusions about this subgroup are unreliable.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the authors themselves call for multicenter validation before changing practice; the finding challenges current guidelines but is from a single small retrospective study.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07307-5","tag_type":"warning","value":"The 'mixed' age group spans children through young adults (1–21 years), so findings may not apply uniformly across this wide range.","value_numeric":null}],"summaries":{"what_studied":"Retrospective chart review of 55 patients aged 1–21 years with newly diagnosed idiopathic steroid-resistant nephrotic syndrome (SRNS) at a single US center (2000–2024), examining whether kidney biopsy findings changed immunosuppressive management.","key_result":"Biopsy diagnoses were FSGS (72%), minimal change disease (24%), and membranous nephropathy (4%); yet 96% of patients received calcineurin inhibitors (CNIs) post-biopsy regardless of histology, and 96% remained on CNIs at one year. Biopsy-related complications included flank/back pain in 71% and hematoma in 15%, with 84% requiring overnight admission.","limitations":"- Single-center retrospective design limits generalizability.\n- Small sample (n=55) reduces statistical power to detect management differences by histologic subtype.\n- No control group of SRNS patients managed without biopsy for outcome comparison.","practice_takeaway":"In children and young adults with newly diagnosed idiopathic SRNS and no atypical features, kidney biopsy rarely changes the decision to start CNI therapy and carries real procedural risk — clinicians should weigh whether routine biopsy is warranted before initiating treatment. Larger multicenter studies are needed before changing standard practice."}},{"doi":"10.1007/s00467-026-07292-9","pmid":"42026266","title":"Anti-nephrin antibodies in pediatric nephrotic syndrome: a new paradigm","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-04-23T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-026-07292-9","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:16.215Z","updated_at":"2026-05-09T13:22:16.215Z","tags":[{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"condition","value":"Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"modality","value":"Autoantibody Biomarker","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"warning","value":"No primary new data are presented; all quantitative findings are drawn from previously published studies cited within the review.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"warning","value":"Prevalence figures vary widely across studies due to non-standardized assays; the highest rates (up to 90%) come from the authors' own cohort using a more sensitive immunoprecipitation method.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"warning","value":"Several senior authors hold pending patents on anti-nephrin antibody measurement and have multiple industry consulting relationships, which may influence interpretation of the evidence.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"warning","value":"The post-transplant recurrence finding (100% antibody positivity in relapsing patients) is from a single small study and has not been independently replicated.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07292-9","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the paradigm shift in understanding pathophysiology, not a change in current treatment guidelines—anti-nephrin testing is not yet standard of care.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the role of circulating anti-nephrin autoantibodies as pathogenic mediators and biomarkers in pediatric nephrotic syndrome (NS), covering prevalence across disease states, diagnostic and prognostic potential, post-transplant recurrence risk, mechanisms of podocyte injury, and implications for B-cell–targeting therapies such as rituximab.","key_result":"Anti-nephrin antibodies were detected in up to ~90% of children with active, untreated NS (vs. ~44% of adults with MCD); positivity was far more common in steroid-sensitive NS (82% of 28 active cases) than in steroid-resistant non-genetic NS (14% of 91) or genetic NS (2% of 46). In a post-transplant cohort, all 11 of 11 relapsing FSGS patients were antibody-positive, and pre-transplant positivity predicted recurrence (38% of 21 positive patients relapsed vs. 0% of 17 negative patients). A small pilot (n=17 children) treated with first-line rituximab (4×375 mg/m²) achieved complete remission in 12, sustained for 78 weeks, with only 1 relapse at 85 weeks.","limitations":"All key data come from retrospective or small observational cohorts; no prospective randomized trials have validated anti-nephrin antibody testing for clinical decision-making. Assay methods are not standardized (ELISA vs. immunoprecipitation/Western blot), leading to wide variation in reported prevalence across centers. Several authors hold patents or commercial relationships related to anti-nephrin antibody measurement, introducing potential conflict of interest.","practice_takeaway":"Anti-nephrin antibody testing is not yet ready for routine clinical use and should not delay or alter standard steroid therapy; it remains a research-grade biomarker. Clinicians should watch for upcoming prospective trials that may validate its use for risk stratification, pre-transplant recurrence prediction, and selection of B-cell–depleting therapy in antibody-positive children."}},{"doi":"10.1016/j.ekir.2026.106566","pmid":null,"title":"Sparsentan Versus Irbesartan in Pediatric Patients With FSGS","journal_title":"Kidney International Reports","journal_issn":"2468-0249","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1016/j.ekir.2026.106566","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:34:57.845Z","updated_at":"2026-05-26T13:34:57.845Z","tags":[{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"brand","value":"Filspari","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"generic","value":"irbesartan","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"generic","value":"sparsentan","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"modality","value":"Angiotensin Receptor Blocker","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"modality","value":"Endothelin Receptor Antagonist / Angiotensin Receptor Blocker","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"warning","value":"Study design, sample size, and level of evidence could not be determined from the available metadata.","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"warning","value":"The brand name 'Filspari' is associated with sparsentan in adults; its approved status or labeling for pediatric use could not be verified from this source alone.","value_numeric":null},{"paper_doi":"10.1016/j.ekir.2026.106566","tag_type":"warning","value":"The provided source contains only the paper title, DOI, journal, and publication date — no abstract, methods, results, or conclusions are available. All summary fields requiring specific data (key results, limitations, practice takeaway) have been set to null due to insufficient source content. Full text access is required for a complete structured extraction.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated sparsentan compared to irbesartan in pediatric patients with focal segmental glomerulosclerosis (FSGS), assessing efficacy and safety outcomes."}},{"doi":"10.2215/cjn.0000000948","pmid":"41433094","title":"Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated Focal Segmental Glomerulosclerosis Enrolled in the DUPLEX Trial","journal_title":"Clinical Journal of the American Society of Nephrology","journal_issn":"1555-9041","published_at":"2025-12-23T00:00:00.000Z","url":"https://doi.org/10.2215/cjn.0000000948","source_score":31,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-24","doi":"10.2215/cjn.0000000948","days":"30","issn":"1555-9041","rank":"5","field":"Clinical Medicine","score":"31","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.2215/CJN.0000000948","title":"Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated Focal Segmental Glomerulosclerosis Enrolled in the DUPLEX Trial.","journal":"Clinical journal of the American Society of Nephrology : CJASN","methods":"","results":"Next-generation sequencing identified 31 patients with podocyte gene variants, 25 with COL4A3-5 gene variants, and 14 with APOL1 high-risk genotypes. Baseline characteristics varied between genetic subgroups, with slightly younger patients, on average, in the podocyte gene variant group, and more African American patients in the APOL1 high-risk genotype group. In this exploratory analysis, sparsentan treatment resulted in substantial and sustained proteinuria reductions and numerically more frequent complete remission of proteinuria compared with irbesartan, consistent with observations in the full DUPLEX study population. Moreover, a lower proportion of sparsentan- vs irbesartan-treated patients reached composite kidney endpoints.","abstract":"$30","keywords":[],"pubmed_id":"41433094","conclusions":"","publication_date":"2025-12-23T00:00:00"},"crossref":{"DOI":"10.2215/cjn.0000000948","URL":"https://doi.org/10.2215/cjn.0000000948","ISSN":["1555-9041","1555-905X"],"link":[{"URL":"https://journals.lww.com/10.2215/CJN.0000000948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated Focal Segmental Glomerulosclerosis Enrolled in the DUPLEX Trial"],"author":[{"given":"Jennifer","family":"Yee","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA"}]},{"given":"Wu","family":"Gong","sequence":"additional","affiliation":[{"name":"Travere Therapeutics, Inc., San Diego, CA, USA"}]},{"given":"Jula","family":"Inrig","sequence":"additional","affiliation":[{"name":"Travere Therapeutics, Inc., San Diego, CA, USA"}]},{"given":"Michelle N","family":"Rheault","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA"}]},{"given":"Angela J","family":"Gruber","sequence":"additional","affiliation":[{"name":"PreventionGenetics, Marshfield, WI, USA"}]},{"given":"Patricia W","family":"Bedard","sequence":"additional","affiliation":[{"name":"Travere Therapeutics, Inc., San Diego, CA, USA"}]},{"given":"Radko","family":"Komers","sequence":"additional","affiliation":[{"name":"Travere Therapeutics, Inc., San Diego, CA, USA"}]},{"given":"Howard","family":"Trachtman","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA"}]}],"issued":{"date-parts":[[2025,12,23]]},"member":"276","prefix":"10.2215","source":"Crossref","volume":null,"created":{"date-time":"2025-12-23T17:00:44Z","timestamp":1766509244000,"date-parts":[[2025,12,23]]},"indexed":{"date-time":"2025-12-23T17:18:17Z","timestamp":1766510297847,"date-parts":[[2025,12,23]]},"license":[{"URL":"http://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000,"date-parts":[[2025,12,23]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.2215/CJN.0000000948"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2025-06-26"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","value":"2025-12-18"}],"deposited":{"date-time":"2025-12-23T17:00:44Z","timestamp":1766509244000,"date-parts":[[2025,12,23]]},"issn-type":[{"type":"print","value":"1555-9041"},{"type":"electronic","value":"1555-905X"}],"published":{"date-parts":[[2025,12,23]]},"publisher":"Ovid Technologies (Wolters Kluwer Health)","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1097/lww.0000000000001000","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Clinical Journal of the American Society of Nephrology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,12,23]]},"references-count":0,"short-container-title":["CJASN"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.2215/cjn.0000000948","is_oa":true,"title":"Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated Focal Segmental Glomerulosclerosis Enrolled in the DUPLEX Trial","updated":"2025-12-24T00:55:44+00:00","published_date":"2025-12-23","best_oa_location":{"url":"https://doi.org/10.2215/cjn.0000000948","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.2215/cjn.0000000948"}}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.2215/cjn.0000000948","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"generic","value":"irbesartan","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"generic","value":"sparsentan","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"modality","value":"Angiotensin Receptor Blocker","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"modality","value":"Dual Endothelin Angiotensin Receptor Antagonist","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"study_design","value":"Post Hoc Analysis","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"warning","value":"No numeric effect sizes or event counts were provided in the abstract.","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"warning","value":"Results are from an exploratory post hoc subgroup analysis of an RCT.","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"warning","value":"Subgroup counts may overlap; total N for genetic FSGS was not specified.","value_numeric":null},{"paper_doi":"10.2215/cjn.0000000948","tag_type":"warning","value":"Timeframe for subgroup outcomes was not explicitly stated.","value_numeric":null}],"summaries":{"what_studied":"Post hoc, exploratory analysis of DUPLEX evaluated sparsentan versus irbesartan in participants with genetic-associated FSGS, including podocyte gene variants (n=31), COL4A3-5 variants (n=25), and APOL1 high-risk genotypes (n=14).","key_result":"Sparsentan produced substantial, sustained reductions in proteinuria, with numerically more complete remissions versus irbesartan, and a lower proportion reached composite kidney endpoints; no effect sizes were reported.","limitations":"Post hoc exploratory design with small genetic subgroups; baseline differences between groups (younger in the podocyte-variant group; more African American participants in the APOL1 group) may confound results.","practice_takeaway":"Findings support an antiproteinuric benefit of sparsentan in genetic FSGS, consistent with DUPLEX overall, but conclusions should be cautious due to exploratory subgroup analysis and small numbers."}}],"initialOffset":12,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Focal Segmental Glomerulosclerosis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Focal Segmental Glomerulosclerosis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Focal Segmental Glomerulosclerosis"}}}]]

Papers