New approaches to the treatment of dense deposit disease

PubMed, the Internet portal of biomedical and life sciences literature, indexed an interesting article, entitled “New Approaches to the Treatment of Dense Deposit Disease.” (J Am Soc Nephrol. 2007 Aug 5). Authors are Smith RJ, Alexander J, Barlow PN, et al.. The development of clinical treatment protocols usually relies on evidence-based guidelines that focus on randomized, controlled trials. For rare renal diseases, such stringent requirements can represent a significant challenge. Dense deposit disease (DDD; also known as membranoproliferative glomerulonephritis type II) is a prototypical rare disease. It affects only two to three people per million and leads to renal failure within 10 yr in 50% of affected children. On the basis of pathophysiology, this article presents a diagnostic and treatment algorithm for patients with DDD. Treatment options include aggressive BP control and reduction of proteinuria, and on the basis of pathophysiology, animal data, and human studies, plasma infusion or exchange, rituximab, sulodexide, and eculizumab are additional options. To access the full abstract of the article, click here.