VIDEO: Diagnostic process for glomerular diseases moves into 'a personalized era'

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

It is a great time to be a nephrologist because we not only have a lot more therapies coming down as far as our armamentarium. And we're more targeted. But I think, even the workup process is a bit more personalized than it was let's say five or 10 years ago.

So we traditionally relied on kidney biopsy, which is still a major part of our tools. But it's not terribly risky, but there is some risk associated with it. And some people just can't, for various medical reasons it's not safe to do. But I think, ever since the discovery of antibodies targeting phospholipase A2 receptors in membranous, basically, there's just been an outpouring of additional antibodies in that condition membranous that have been discovered. And those have led to sort of a more targeted approach, thinking about whether this is autoimmune-mediated, malignancy, or even recently, like an association with syphilis, which was long understood, but no one understood mechanistically.

So I think, now, we're moving really into a personalized era where we can make decisions based on a lot of these serological tests. The biopsy is not going away and won't for a while. That really plays a role, for instance, in lupus where often people require multiple biopsies to sort of assess disease activity, see if the treatment is effective. And that guides some of our decision-making. But I think, when we're sort of evaluating these diseases, we're seeing them now through a mix of clinical syndrome, laboratory, and serological evidence pointing you in a direction. And then the biopsy just adds additional level of information.

So all these things are taken together into the big picture of what we're dealing with. So it's really an exciting time. And I mean, this field has been exploding. So you have to imagine five or 10 years from now, there's gonna be really even more personalization, more nuance, and not only more clearer understanding of diagnosis, but that's gonna lead to clearer treatment recommendations.