In November 2017, the Kidney Disease: Improving Global Outcomes (KDIGO) initiative brought a diverse panel of experts in glomerular diseases together to discuss the 2012 KDIGO glomerulonephritis guideline in the context of new developments and insights that had occurred over the years since its publication. During this KDIGO Controversies Conference on Glomerular Diseases, the group examined data on disease pathogenesis, biomarkers, and treatments to identify areas of consensus and areas of controversy. This report summarizes the discussions on primary podocytopathies, lupus nephritis, anti-neutrophil cytoplasmic antibody-associated nephritis, complementmediated kidney diseases, and monoclonal gammopathies of renal significance.

Background: Until now, a normal reference range for glomerular filtration rate (GFR) in adult Indian potential kidney donors has not been determined and values from a western population are being used as reference. Aim: To determine the reference range of GFR in healthy adult Indian potential kidney donors. Basic Procedures: GFR was measured in 610 (250 male, 360 female, average age 35.16 years) healthy potential kidney donors using the ^99mTc-DTPA (diethylenetriamine pentaacetic acid) two-plasma sample method of Russell. Results: The mean body surface area (BSA)-normalized GFR value of a young healthy Indian adult potential kidney donor was calculated as 81.4 ± 19.4 ml/min/1.73 m² BSA – for males it was 82.3 ± 21.3 ml/min/1.73 m² BSA and for females 80.8 ± 18.1 ml/min/1.73 m² BSA. There was no significant difference between derived mean GFR values in males and females with a p value of 0.37. Conclusions: The normal GFR value for the healthy Indian adult potential kidney donor appears to be much lower than the accepted value for a western population. The mean GFR value of a young healthy Indian adult potential kidney donor is 81.4 ± 19.4 ml/min/1.73 m² BSA, which is significantly different from the normal value of 109–125 ml/min derived from a western population. These findings might be useful in deciding on a suitable kidney donor in an Indian context.

Objectives ANCA-associated vasculitis (AAV) can affect all age groups. We aimed to show that differences in disease presentation and 6 month outcome between younger- and older-onset patients are still incompletely understood. Methods We included patients enrolled in the Diagnostic and Classification Criteria for Primary Systemic Vasculitis (DCVAS) study between October 2010 and January 2017 with a diagnosis of AAV. We divided the population according to age at diagnosis: <65 years or ≥65 years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative). Results A total of 1338 patients with AAV were included: 66% had disease onset at <65 years of age [female 50%; mean age 48.4 years (s.d. 12.6)] and 34% had disease onset at ≥65 years [female 54%; mean age 73.6 years (s.d. 6)]. ANCA (MPO) positivity was more frequent in the older group (48% vs 27%; P = 0.001). Younger patients had higher rates of musculoskeletal, cutaneous and ENT manifestations compared with older patients. Systemic, neurologic,cardiovascular involvement and worsening renal function were more frequent in the older-onset group. Damage accrual, measured with the Vasculitis Damage Index (VDI), was significantly higher in older patients, 12% of whom had a 6 month VDI ≥5, compared with 7% of younger patients (P = 0.01). Older age was an independent risk factor for early death within 6 months from diagnosis [hazard ratio 2.06 (95% CI 1.07, 3.97); P = 0.03]. Conclusion Within 6 months of diagnosis of AAV, patients >65 years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients.

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We have demonstrated that patients with thyrotoxicosis continue to gain weight for at least 6 months even after becoming euthyroid. Patients with Graves' disease were more likely to gain weight compared to others. Smokers gained least weight. Preventing this weight gain warrants further investigation.