New approaches to the treatment of glomerular diseases

The treatment of primary glomerular diseases has previously focused on relatively toxic immunosuppressive regimens. We are now seeing a paradigm shift from these toxic 'nonspecific' therapies to selective immunomodulating and immunosuppressive regimens. In this article, the experience with these newer agents including mycophenolate, rituximab, sirolimus, calcineurin inhibitors, and eculizumab are described.