title: Back to the future: therapies for idiopathic nephrotic syndrome.
abstract: BACKGROUND
  Roughly 20-40% of individuals with idiopathic nephrotic syndrome will fail to respond to standard therapies and have a high risk of progression to end stage kidney disease (ESKD). In the last 50 years, no new therapies have been approved specifically for the treatment of these individuals with recalcitrant disease.
  
  
  CONCLUSIONS
  Recent in vitro, translational, and clinical studies have identified novel targets and pathways that not only expand our understanding of the complex pathophysiology of proteinuric disease but also provide an opportunity to challenge the tradition of relying on histologic classification of nephrotic diseases to make treatment decisions.
  
  
  CONCLUSIONS
  The traditional methods of directing the care of individuals with nephrotic syndrome by histological classification or deciding second line therapies on the basis of steroid-responsiveness may soon yield customizing therapies based on our expanding understanding of molecular targets. Important non-immunologic mechanisms of widely used immunosuppressive therapies may be just as important in palliating proteinuric disease as proposed immunologic functions.
authors: University of North Carolina Kidney Center, Chapel Hill, N.C., USA.
authors: Keisha L
authors: KL
authors: Gibson
authors: Dorey
authors: D
authors: Glenn
authors: Maria E
authors: ME
authors: Ferris
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003348:Cortisone / Q000627:therapeutic use; D003521:Cyclopropanes / Q000627:therapeutic use; D006652:Histological Techniques; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D058990:Molecular Targeted Therapy; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D057285:Precision Medicine; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use
chemical_list: C543534:6-(5-((cyclopropylamino)carbonyl)-3-fluoro-2-methylphenyl)-N-(2,2-dimethylprpyl)-3-pyridinecarboxamide; D000893:Anti-Inflammatory Agents; D003521:Cyclopropanes; D007166:Immunosuppressive Agents; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D000324:Adrenocorticotropic Hormone; D000068879:Adalimumab; D003348:Cortisone