Minimal glomerular lesions: and what if the evolution of kidney function wasn't all it was cracked up to be?

Idiopathic nephrotic syndrome is a glomerular nephropathy defined by abundant proteinuria associated with hypoalbuminemia, without renal inflammatory lesions or deposits of circulating immune complexes.In fact, several clinical and therapeutic arguments make NIS an immune disease in which the kidney is the exclusive functional target. The progressive use of cytotoxic immunosuppressants such as nitrogen mustards, inhibitors of lymphocyte activation such as calcineurin antagonists, and inhibitors of lymphocyte proliferation such as mycophenolic acid in the relapse prevention strategy for corticosteroid-dependent patients has further supported the existence of a dysimmunity.