From: Do clinical guidelines facilitate or impede drivers of treatment in Fabry disease?
Histological damage (kidney biopsy) | Podocyte inclusions | Proteinuria | Elevated urine ACR (including microalbuminuria) | Abnormal GFRa | Decline in iohexol GFR | Renal dialysis or transplant | |
---|---|---|---|---|---|---|---|
PREDICT-FDb [11] | + | + | – | + | + | + | – |
EFWGc [1] | No consensus | No consensus | M, I; F, IIB | M, I; F, IIB | CKD stage 2: cM, I; ncM, IIA; cF, IIA; ncF, IIB CKD stage 3: cM, I; ncM, IIB; cF, IIB; ncF, IIB | – | Dialysis, do not withhold treatment Transplant, NA |
Australia [24] | Alld | – | M, > 150 mg/d F, > 300 mg/d | Me,f > ULN | – | – | – |
Canadag [21] | M, Fh | Renal pathology: M, major criterion F, minor criterion | All, ≥ 500 mg/di All, ≥ 300 mg/di | – | All, CKD stage ≥ 2j | Decline in mGFR | All (considered CKD stage 5) |
Catalonia (Spain) | – | – | All, > 300 mg/d | All | All, CKD stage ≥ 2k | – | All |
F | – | F, > 1 g/d | – | F, moderate-to-severe | – | All | |
Portugal [22] | Confirmatory biopsy if needed, all asymptomatic | Confirmatory biopsy if needed, all asymptomatic | All | All | All, CKD stage ≥ 2 | – | – |
Slovenia (FCGHSG) | Confirmatory biopsy if needed in cF and in late-onset adultsm | – | All | All | All CKD | – | – |
Switzerlandn | Fo | Fn | F, > 300 mg/dp | – | – | – | Alln |
UKq [26] | – | – | All, > 300 mg/dr | – | All, CKD stage 2 and 3s | – | – |