Glomerular Disease Care

Glomerular Disease Diagnosis and Treatment in Boston

At Beth Israel Deaconess Medical Center (BIDMC), our Glomerular Disease Center specializes in the diagnosis and treatment of complex kidney conditions that affect the glomeruli, the tiny filters in the kidneys that remove waste and extra fluid from the blood.

Our team of kidney specialists, pathologists, rheumatologists and researchers works together to provide expert, coordinated care for people with glomerular disease. This team-based approach and strong commitment to research help us better understand these rare kidney conditions and offer patients access to the latest treatments, clinical trials and specialized expertise.

Our physicians were integral in discovering the APOL1 gene which is a primary driver in the development of glomerular disease in certain patient groups. Here in our Glomerular Disease Center, you will receive expert, cutting-edge care from world-renowned nephrologists who are consistently striving to improve treatment of these complex conditions.

What is Glomerular Disease?

Glomerular disease refers to a group of kidney disorders that damage the glomeruli, the tiny filters in your kidneys that clean your blood. These filters remove waste and extra fluid while keeping important proteins in your body and sending waste into your urine.

When the glomeruli become damaged, they cannot work properly. This can lead to protein in the urine, blood in the urine, swelling and a decline in kidney function over time.

Many glomerular diseases are rare and can be caused by autoimmune disease, infections or other underlying health conditions, making them more difficult to diagnose and treat.

Types of Glomerular Disease We Treat

At BIDMC, we diagnose and treat many types of glomerular disease, including:

• IgA nephropathy (Berger’s disease): A kidney disease caused by a buildup of an antibody called IgA in the glomeruli, which can lead to inflammation and damage.
• Lupus nephritis: Kidney inflammation caused by lupus, an autoimmune disease in which the immune system attacks healthy tissues.
• Focal segmental glomerulosclerosis (FSGS): A disease that causes scarring in parts of the kidney’s filtering units, which can lead to protein loss and reduced kidney function.
• Membranous nephropathy (MN): A condition that causes the filters in the kidneys to thicken, making it harder for them to work properly.
• Minimal change disease (MCD): A common cause of nephrotic syndrome where kidney damage is not easily seen under a regular microscope but can cause heavy protein loss in the urine.
• ANCA-associated vasculitis (AAV): An autoimmune disease that causes inflammation in small blood vessels, including those in the kidneys.
• Podocyte- and APOL1-associated diseases (podocytopathies): Conditions that damage podocytes, specialized cells in the kidney filters that help keep protein in the blood and out of the urine.
• Complement-mediated kidney diseases (CMKDs), including thrombotic microangiopathies and C3 glomerulopathy: Rare diseases caused by problems in the immune system’s complement pathway, which can damage the kidneys.
• Alport syndrome and other collagen-associated kidney diseases (including anti-glomerular basement membrane (GBM) disease): Conditions that affect unique collagens, important components in the kidney filters, which can lead to kidney damage over time.
• Cancer-related kidney diseases: Kidney problems that develop because of cancer itself or as a side effect of cancer treatment.

Glomerular Disease Symptoms

Glomerular disease does not always cause symptoms early on and is often found during routine blood or urine tests. When symptoms do appear, they may include:

Because glomerular disease can get worse over time, it is important to see a kidney specialist early. Finding and treating the disease sooner can help protect your kidneys and prevent more damage.

Diagnosing Glomerular Disease

Diagnosing glomerular disease starts with a careful evaluation and kidney testing. This often includes urine tests to check for signs of kidney damage, such as protein, blood or inflammation.

At BIDMC, our kidney specialists review these early signs closely to help identify the cause and guide treatment. In many cases, a kidney biopsy is needed to confirm the diagnosis. During this outpatient procedure, a small sample of kidney tissue is taken by your Nephrologist and examined by expert pathologists, who specialize specifically in glomerular disease.

Because our nephrology, rheumatology and pathology teams work closely together, patients often get answers faster and receive a more personalized treatment plan.

Glomerular Disease Treatment Options

Treatment for glomerular disease depends on the type of condition, how serious it is and what is causing the kidney damage. At BIDMC, we create personalized treatment plans based on each patient’s needs, symptoms and long-term kidney health.

Because many glomerular diseases are linked to the immune system, treatment often focuses on lowering inflammation and protecting kidney function. This may include immunosuppressive medications or other advanced therapies that help slow the disease and prevent more damage.

As research continues to advance, new treatment options are becoming available. We also continue to develop new treatments through groundbreaking clinical trials which you may have the opportunity to be involved in. Some patients may go into remission, while others may need long-term care to manage symptoms, monitor kidney function and support their overall health.

World-Class Glomerular Disease Care at BIDMC

Being diagnosed with glomerular disease can feel overwhelming, especially when the condition is rare or complex. At BIDMC, our Glomerular Disease Clinic provides specialized care designed to support patients through every stage of diagnosis and treatment.

Our multidisciplinary team of nephrologists, pathologists, rheumatologists and researchers works together to review each case and create individualized care plans tailored to each patient’s needs.

We also offer second opinions for patients seeking more clarity or reassurance about their diagnosis or treatment options.

Through expert care, advanced treatment options and ongoing research, BIDMC provides compassionate, personalized glomerular disease care in Boston.