Purpose of review: The purpose of this commentary is to address the challenges of implementing the evolving Kidney Disease Improving Global Outcomes (KDIGO) glomerulonephritis (GN) guidelines within the Canadian health care context, highlighting barriers to adoption of the guidelines and discussing contextual issues unique to Canada. Sources of information: The KDIGO 2021 guidelines with 2024 updates in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and lupus nephritis, as well as the 2025 updated guideline for immunoglobulin A (IgA) nephropathy. Methods: A Canadian Society of Nephrology (CSN) working group with expertise in GN was formed, representing nephrologists, pathologists, pharmacists, and patient partners with geographic representation from across Canada. Recommendations and practice points were reviewed by member surveys, with discussions to reach consensus and frame the commentary. Key findings: The commentary highlights diagnostic investigations, the role of immune treatments for primary glomerular diseases, and the growing role of conservative kidney therapies. Limitations: A review of the quality of evidence was not undertaken. Implementation and uptake of the guidelines will vary across each province given drug availability and cost. Implications: The commentary aims to provide tailored guidance to enhance the care of Canadians living with glomerular disease.
Jauhal et al. (Sun,) studied this question.