Idiopathic nodular glomerulosclerosis: a case report

TL;DR

This paper reports a case of a rare kidney disease and highlights treatment strategies and risk factors for better outcomes.

Contribution

The paper presents a clinical case of idiopathic nodular glomerulosclerosis and its management with specific therapies.

Findings

Conservative treatment with angiotensin-2 receptor antagonist and dapagliflozin showed favorable disease progression.

Smoking cessation and weight loss are recommended as part of the management strategy.

Regular diabetes screening is crucial due to its potential role in disease progression.

Abstract

Idiopathic nodular glomerulosclerosis (ING) is a rare condition characterized by poor renal prognosis. The pathophysiology remains incompletely understood. Histologically, it closely resembles diabetic nephropathy. The development of this disease seems to be influenced by factors such as metabolic syndrome, particularly hypertension and glucose intolerance, along with active smoking. We report a case of ING in an obese 71-year-old male patient who had a long history of untreated hypertension and smoking. The patient underwent conservative treatment involving the administration of an angiotensin-2 receptor antagonist and dapagliflozin, resulting in favorable disease progression. Additional therapeutic measures, such as discontinuation of smoking and efforts toward weight loss, are strongly advised. Furthermore, regular screening for diabetes in the follow-up is crucial, as it can play a pathophysiological role in the disease and may manifest at a later stage, as observed in our clinical case.

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