Kidney Week 2025 Annual Meeting-Immune-Mediated Kidney Diseases in Children

Video Transcription

Video Summary

The session reviewed immune-mediated pediatric kidney diseases and highlighted new guidelines and emerging therapies. Susan Samuel presented IPNA pediatric guidelines for IgA nephropathy (IgAN) and IgA vasculitis nephritis (IgAVN), emphasizing that these are not benign diseases in children and often show progression into adulthood, making transition care critical. The guidelines were developed through structured PICO questions, evidence review, Delphi voting, and external review. Clinically, management centers on monitoring, renin–angiotensin system (RAS) blockade for proteinuria, and kidney biopsy when proteinuria increases or to exclude mimics (e.g., podocytopathy, COL4 mutations). Steroids/immunosuppression are not recommended routinely, reflecting limited high-quality pediatric evidence; biopsy activity scores may help guide selective use.<br /><br />Mary Beth Sun reviewed pediatric lupus nephritis, noting children often have more severe disease and steroid toxicity. New 2024 ACR and KDIGO guidance increasingly supports “triple therapy” (glucocorticoids + mycophenolate + belimumab or a calcineurin inhibitor) while pushing for lower steroid exposure. She highlighted promising new data for obinutuzumab and early reports of CD19 CAR-T approaches producing drug-free remission, though safety and access remain concerns.<br /><br />Khalid presented advances in STEC-HUS: supportive care remains standard, but early aggressive hydration may reduce dialysis and complications; an NIH cluster trial is underway. Eculizumab trials showed no clear acute benefit. Anti–Shiga toxin polyclonal antibodies show a possible signal and are being tested in phase 3.<br /><br />Michelle Rowe discussed nephrotic syndrome, focusing on anti-nephrin (slit diaphragm) antibodies as a potential paradigm shift toward personalized classification and treatment, with commercial assays anticipated soon.

Asset Subtitle

Moderator(s): Tammy Brady, Joshua Zaritsky

Presentation(s):

Navigating the New Pediatric Guidelines for IgAN and IgA Vasculitis - Susan Samuel
Lupus Nephritis in Children: Is It Time for a Practice Change? - Mary Beth Son
Hemolytic Uremic Syndrome: Advances in Diagnostics and Treatment Approaches - Myda Khalid
Nephrotic Syndrome: Not the Usual Suspects - Michelle Rheault

Support for all sessions in the Glomerular Diseases Learning Pathway is provided by an educational grant from Vera Therapeutics, Inc.

Meta Tag

Date 11/6/2025

Pathway 1 Glomerular Diseases

Pathway 2 Pediatric Nephrology

Session ID 507761

Keywords

immune-mediated pediatric kidney diseases

IPNA pediatric guidelines

IgA nephropathy (IgAN)

IgA vasculitis nephritis (IgAVN)

renin–angiotensin system (RAS) blockade

pediatric kidney biopsy indications

pediatric lupus nephritis

triple therapy (glucocorticoids mycophenolate belimumab/calcineurin inhibitor)

steroid-sparing strategies

STEC-HUS supportive care and hydration

anti–Shiga toxin antibodies

anti-nephrin antibodies in nephrotic syndrome