Immunological Aspects of Glomerulonephritis Advances in Diagnosis and Treatment A prospective study

Original Article

Abstract

Background: Glomerulonephritis (GN) refers to an inflammatory disease of the kidneys’ glomeruli and is immunologically induced. New insights in immunology have help in understanding the cause of GN and its progression is used in diagnosis and in the new methods of treatment which has enhanced the quality of life of patients with GN.

Objectives: To identify the immunological markers for the diagnosis of GN and for evaluating the therapeutic outcomes of new immunotherapeutic approaches by evaluating the disease course and the patients’ response to the treatment in a group of GN patients.

Study Design: A prospective study

Place and Duration of Study: Department of Biochemistry, Peshawar Medical College, Peshawar from 10 jan 2023 to 10 june 2024

Methods: A prospective study was also therefore done on 100 patients with GN. Immunological parameters such as CIC and autoantibodies were estimated by ELISA method and immunofluorescence. Remission status was evaluated by using corticosteroids and immunosuppressive medicine. All the data were treated statistically using t-tests with alpha level of 0. 05 used as the threshold level of significance. Clinical assessments were performed in the course of the year from the beginning of the study, and they included changes in renin profiles, proteinuria, and overall staging of renal histopathological changes.

Results: Immunosuppressive therapies were associated with improvement in renal function of patients as indicated in the study conducted. From 4. 5 ± 1. 2 g/day to 1. 8 ± 0. 8 g/day, the amount of proteinuria was reduced by 60% (p < 0. 01). There was a significant improvement in the patients’ renal function as evidenced by the increase in the eGFR by 50 % from 52 ± 10 ml/min/1. 73m² to 78 ± 12 ml/min/1. 73m² (p < 0. 05). Subpopulations of antibodies, as immunological markers, fell in the circulation to 60% post-treatment based on normal range concurrently with carrying better clinical trends.

Conclusions: Serological markers are of great help in diagnosis and subsequent management of GNs. Immune-suppressive treatments are associated with better renal profile for patients in that they reduce levels of proteinuria and help to preserve kidney function. Ongoing investigation of particular immunotherapies might also improve the patients’ outcome and treatment plans even further.

Keywords: Glomerulonephritis, Immunology, Autoantibodies, Proteinuria, Immunosuppressive Therapy.