The role of glucocorticoids in the treatment of glomerular nephropathies

Abstract

Background. Glomerular nephropathies are a diverse group of kidney disorders, many involving immune or inflammatory processes. Glucocorticoids are a mainstay of treatment due to their powerful anti-inflammatory effects, but treatment response varies by subtype and long-term use can cause serious side effects. Objective(s). This thesis highlights the importance of personalized treatment by exploring the mechanisms, indications, benefits, and limitations of glucocorticoid therapy in various glomerular nephropathies. Materials and methods. A literature review from 2013 to 2025 was conducted using PubMed, Google Scholar, Medline, and other databases. Keywords included “glucocorticoids,” “glomerulonephritis,” “nephropathy,” and diseases like “FSGS,” “IgA nephropathy,” and “lupus nephritis.” Only English articles and clinical trials were included to ensure quality and relevance. Results. In minimal change disease (MCD), glucocorticoids induce remission in most cases, especially in children. In focal segmental glomerulosclerosis (FSGS), efficacy is noted in idiopathic cases but limited in genetic or maladaptive forms. IgA nephropathy and lupus nephritis show favorable outcomes in proteinuria reduction and disease stabilization when steroids are used judiciously. Conversely, membranous nephropathy and C3 glomerulopathy often require combination therapy. Resistance and adverse effects - metabolic, psychiatric, and infectious - remain key challenges, often linked to receptor polymorphisms and dosing issues. Conclusion(s). Glucocorticoids are essential for treating glomerular nephropathies, but it’s important to tailor the treatment to each patient’s specific disease type, severity, and overall health. This personalized approach helps get the best Results. s while reducing side effects and risks.