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A new ASN compendium curates scattered GN care guidance into one living resource, says nephrologist George Vasquez-Rios, MD
Closing the gap in glomerular disease care means addressing not a shortage of research, but its fragmentation, scattered across specialties, guidelines, and clinical settings without one place to bring it together.¹
George Vasquez-Rios, MD, MSCR, FASN, Director of the Glomerular and Genetic Diseases Center at Renal Medicine Associates, discussed the origins and structure of the American Society of Nephrology (ASN)'s Glomerular Diseases Collaborative (GD-C) Compendium in an interview with HCPLive.
The GD-C is an initiative within ASN built around a specific problem. According to Vasquez-Rios, there is not a shortage of information, but a fragmentation across the different points where a patient might enter the health system, whether through an internist, a general nephrologist, or a GN specialist.
"I think that the problem was never the lack of information. As a matter of fact, we live in an era where there's a lot of information, there are great articles out there. The issue is the fragmentation," Vasquez-Rios said. "The compendium is trying to serve as a platform that has curated information, carefully reviewed by a board committee, that represents what we think is the most substantial and relevant information to guide the management of patients."
Vasquez-Rios explained that the compendium is not a substitute for clinical guidelines, or a vehicle for new findings, but rather, it's designed to keep pace with new research for clinical management.
"We are not coming up with newer information," Vasquez-Rios said. "We intentionally are broader than the clinical guidelines, because they take some time to actually develop. We intend to provide information and education to guide clinical management as much as we can for this novel and very dynamic field."
The compendium's professional resources are organized around 5 conditions, ANCA-associated vasculitis, IgA nephropathy (IgAN), lupus nephritis, C3 glomerulopathy (C3G), and membranous nephropathy, alongside a dedicated recognition-to-referral pathway and a separate set of patient education materials.¹
"We have a glomerular disease recognition-to-referral [section], which is intended to guide general nephrologists, clinicians, even internal medicine doctors, on how to recognize an active glomerular disease, what tests to start taking on these patients, and when to make referrals," Vasquez-Rios said.
The compendium also curates landmark studies and clinical trials, an intentional response, he said, to how much is now being published in a field where clinicians have little time to keep up.
Access is a recurring theme because several glomerular disease therapies are highly effective but complex to prescribe. Thus, the compendium includes practical guidance on prior authorizations, referrals, and appeals.
"We provided tips and tricks to navigate these issues all the way from prior authorizations, referrals, appeals, and even provide some documentation that can help busy clinicians with this aspect of care," Vasquez-Rios said.
Vasquez-Rios described the compendium as intentionally built for 2 different audiences with 2 different sets of questions. A general nephrologist or primary care physician, he said, is often asking whether a case is a glomerular disease at all, how active it appears to be, and how to begin testing or management. A GN specialist is typically further along, asking what the latest therapies are, what evidence supports them, and how to monitor a patient's response.
"What we're trying to do with this compendium is try to homogenize a little bit the management of these patients, regardless of where the point of entry to the healthcare system was," Vasquez-Rios said. "We recognize that glomerular disease patients are seen by a wide array of specialties, so it is important to have some practical foundations and information about how to approach these patients."
The compendium is meant to function less like a static reference and more like a living resource clinicians return to, Vasquez-Rios said, with content he expects to update roughly every 6 months, faster for disease areas advancing quickly, such as IgAN and lupus nephritis.
"We're living a unique era in nephrology, especially in the management of glomerular diseases... there's a lot of unknowns as well in the management of these patients and the use of these medications," Vasquez-Rios said. "As therapies become available, we intend not only to include the scientific evidence, but also some practical information."
That update process, he said, is built around a feedback loop rather than a fixed editorial board, with contributions from physicians, general practitioners, GN experts from both community practice and academia, and researchers.
"That allows us to really build up more solid information... It’s all a process of learning, trial, error, learning again, and doing it better the next time," Vasquez-Rios said.
Editor's Note: Vasquez-Rios reports no relevant disclosures.
