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In 1765, Domenico Cotugno described a soldier with dropsy (the nephrotic syndrome) who had a response to treatment with potassium bitartrate. Dr. Cotugno was apparently satisfied, and on the basis of this case, he concluded that he had made the right therapeutic decision. For a long time thereafter, many nephrologists, like Dr. Cotugno, treated glomerular diseases with corticosteroids, immunosuppressants, plasma exchange, or other methods without having a solid scientific basis for such treatments. In fact, the effectiveness of these treatments remains uncertain and controversial.
In recent years, there has been progress in understanding the pathogenesis of glomerulonephritis. Some new diagnostic
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