KDIGO 2021 Glomerular Diseases

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

The 2021 glomerular-diseases guideline is the umbrella document for the whole group — minimal-change disease, FSGS, membranous nephropathy, IgA nephropathy, lupus nephritis, ANCA-associated vasculitis, anti-GBM disease, membranoproliferative patterns and infection-related GN — organised around biopsy-anchored diagnosis, immunosuppression and supportive care. KDIGO is retiring it chapter by chapter, and four chapters are already superseded: lupus nephritis and ANCA-associated vasculitis (both 2024), IgA nephropathy/IgA vasculitis and childhood nephrotic syndrome (both 2025). For those diseases the newer standalone guidelines govern. The membranous, FSGS, minimal-change, C3G/MPGN, infection-related and anti-GBM chapters remain in force. Register trials are grouped by disease below; the ones published after 2021 — and therefore not available to this guideline — are listed separately.

This guideline cites 8 of the 58 landmark trials in our Nephrology register.

Source
Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. Kidney Int. 2021;100(4S):S1–S276. · Kidney International

Membranous nephropathy2

  • 2019MENTORNephrology · Glomerular · Membranous nephropathyMembranous Nephropathy Trial of Rituximab
  • 1984PonticelliNephrology · Glomerular · Membranous nephropathyPonticelli Regimen for Idiopathic Membranous Nephropathy

Lupus nephritis3

  • 2021AURORA 1Nephrology · Glomerular · Lupus nephritisVoclosporin for Lupus Nephritis (AURORA 1)
  • 2020BLISS-LNNephrology · Glomerular · Lupus nephritisBelimumab in Lupus Nephritis
  • 2009ALMSNephrology · Glomerular · Lupus nephritisAspreva Lupus Management Study

ANCA-associated vasculitis3

  • 2021ADVOCATENephrology · Glomerular · ANCA vasculitisAvacopan for ANCA-Associated Vasculitis
  • 2020PEXIVASNephrology · Glomerular · ANCA vasculitisPlasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis
  • 2010RAVENephrology · Glomerular · ANCA vasculitisRituximab versus Cyclophosphamide for ANCA-Associated Vasculitis

Published since the guideline4

  • 2025APPLAUSE-IgANNephrology · Glomerular · IgA nephropathyIptacopan in Primary IgA Nephropathy
  • 2023NefIgArdNephrology · Glomerular · IgA nephropathyNefecon in Patients with Primary IgA Nephropathy
  • 2023PROTECTNephrology · Glomerular · IgA nephropathySparsentan in IgA Nephropathy
  • 2023DUPLEXNephrology · Glomerular · FSGSSparsentan in Focal Segmental Glomerulosclerosis