Panoramic Insights
Glomerular diseases are undergoing one of the most transformative periods in recent nephrology history, driven by rapid advances in diagnostics, targeted therapies, and clinical research. Dr. Marc Richards, Head of the Glomerulonephritis (GN) Center of Excellence at Florida Kidney Physicians (FKP), breaks down these developments and highlights the work being done within community nephrology.
Dr. Richards brings specialized training from the renowned University of North Carolina Kidney Center in Chapel Hill. He has spent more than a decade treating complex glomerular conditions, including IgA nephropathy, lupus nephritis, Focal Segmental Glomerulosclerosis (FSGS), and Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis (ANCA-associated vasculitis).
In this interview, he discusses his background, the mission of the GN Center of Excellence, innovations showcased at the American Society of Nephrology Kidney Week 2025, and how partnerships with organizations like Panoramic Science are expanding clinical research access for GN patients.
MR: I completed my internal medicine residency and nephrology fellowship at the UNC Kidney Center in Chapel Hill, North Carolina, where I was introduced to the field of nephrology during my very first month of internship. That rotation on the inpatient nephrology service under Dr. Ronald Falk – a world-renowned expert in ANCA vasculitis – was transformative.
Throughout fellowship, I continued to learn from leading clinicians in glomerular disease, including Dr. Falk and Dr. Patrick Nachman, during my time rotating in glomerulonephritis clinics. Watching these physicians navigate complex cases while building deep, longitudinal relationships with their patients had a profound impact on me and further solidified my desire to build a career treating patients with glomerular diseases.
MR: The Florida Kidney Physicians Glomerulonephritis Center of Excellence offers a rare combination of access, expertise, and innovation for patients with complex glomerular diseases. Our location in Boca Raton allows patients to receive super specialized care close to home, without the need to travel to an academic medical center more than 50 miles away. We also benefit from proximity to hospitals capable of performing timely kidney biopsies, supported by highly respected academic nephropathologists who help ensure rapid and accurate diagnoses.
In addition, our partnership with Panoramic Science enhances the care we can provide. Through this collaboration, eligible patients have access to clinical trials and emerging therapies that reflect the most current advances in glomerular disease management.
MR: The landscape for treating glomerular diseases has changed dramatically since I completed fellowship in 2013. New therapies are now being approved at a pace that would have been unimaginable a decade ago. For many conditions where we once had little to offer, we now have targeted, evidence-based options.
For example, this progress is striking in the field of IgA nephropathy. As recently as the 2021 Kidney Disease Improving Global Outcomes (KDIGO) guidelines, therapy centered primarily on RAAS inhibition and, in select cases, steroids. In just a few years, that paradigm has shifted, and we now have five novel agents approved to manage IgAN.
Even in rare diseases like C3 glomerulopathy, where we previously relied on broad, unproven immunosuppression, we now have two FDA-approved complement inhibitors that allow for a more precise and mechanistically grounded approach to care.
MR: We continue to see excellent data on emerging therapies for IgA nephropathy, and this year’s ASN Kidney Week reinforced just how quickly the treatment landscape is evolving. Phase 3 results for atacicept, a dual BAFF/APRIL inhibitor, demonstrated meaningful reductions in proteinuria, adding to the growing evidence supporting B-cell–targeted approaches. Similarly, the APRIL inhibitor sibeprenlimab received FDA approval in late November 2025, marking another major step forward for patients with IgAN.
KDIGO now emphasizes optimizing foundational, non–immunosuppressive therapy — including agents like sparsentan or atrasentan, often combined with SGLT2 inhibitors — while also considering newer immunomodulatory options such as targeted-release corticosteroids, iptacopan, or sibeprenlimab to reduce production of galactose-deficient IgA1. Each of these therapies shows clear advantages over the historical standard of care, which relied heavily on RAAS inhibition alone.
However, because these agents are unlikely to be studied head-to-head, determining the best therapeutic sequence or combination for an individual patient will remain a clinical challenge. Over the next few years, I expect real-world experience, rather than direct comparative trials, to guide how we integrate these innovations into practice.
MR: Panoramic Science brings tremendous value to the FKP GN Center of Excellence by expanding our ability to connect patients with rare or complex glomerular diseases to clinical research. These conditions are uncommon, which makes it challenging for any single practice to enroll enough patients to adequately power studies. By centralizing a larger GN population within our Center of Excellence, we can more efficiently identify eligible patients and offer them access to promising investigational therapies.
Beyond our own practice, Panoramic Science’s national network significantly amplifies this capability. Its partnerships with large nephrology groups across the country create a broader pool of patients, strengthening enrollment for rare-disease trials that typically struggle to recruit.
At ASN Kidney Week, I met with several pharmaceutical companies developing new therapies in the glomerular disease space. It was clear that the scale and organization of our GN population — combined with Panoramic Science’s infrastructure — position us as an attractive and reliable partner for upcoming studies.
MR: Identifying early glomerulonephritis can be challenging because most patients with kidney-related symptoms do not have a glomerular disease. That said, there are several warning signs that should prompt further evaluation. New swelling, particularly in the legs, ankles, or around the eyes, or new-onset or worsening hypertension should lead to basic laboratory testing, including serum chemistries to assess kidney function and a urinalysis to screen for blood or protein.
Proteinuria (elevated protein levels in the urine), especially in a patient without diabetes, is a key red flag and should trigger referral to a nephrologist for more detailed evaluation. Hematuria can also be an important early clue.
Primary-care physicians should also consider screening for GN in patients with symptoms suggestive of systemic autoimmune disease, such as lupus or ANCA-associated vasculitis. This may include findings like rash, oral ulcers, nosebleeds, recurrent sinus or upper-respiratory issues, or other inflammatory symptoms. In these contexts, even subtle abnormalities on urinalysis warrant early nephrology involvement.
MR: I think we have a unique opportunity to provide tertiary, academic-center-level care to patients within a community setting. One of my goals is for our Center to become a true hub for education: a place where medical students, residents, and nephrology fellows can learn the subtleties of diagnosing and managing complex glomerular diseases. Building that next generation of expertise is essential as the science rapidly evolves.
Equally important, our partnership with Panoramic Science allows us to play a meaningful role in advancing the field itself. By enrolling patients in clinical trials, we can contribute to the development of new therapies and help shape future treatment paradigms. Ultimately, I hope our Center will be recognized not only for exceptional patient care but also for driving innovation and expanding access to emerging therapies for glomerular disease patients.
As glomerular disease research accelerates, the need for specialized, coordinated, and research-ready nephrology care has never been greater. Dr. Marc Richards and the FKP GN Center of Excellence are at the forefront of bringing academic-level expertise, evidence-based treatment pathways, and emerging clinical trials to patients across the region.
Through continued collaboration with Panoramic Health and Panoramic Science, Dr. Richards is helping to expand access to innovation while strengthening a nationally aligned network focused on improving outcomes for glomerular disease patients.
To learn more about glomerulonephritis care, clinical trial opportunities, or to refer a patient to the GN Center of Excellence, please contact Florida Kidney Physicians.
*The content presented in this article is for informational use only and should not be construed as medical advice or replace the medical advice of a qualified physician.
Panoramic Health is kidney care’s leading integrated provider group, supporting a network of aligned nephrology practices across the U.S. treating hundreds of thousands of patients. Our mission is to slow disease progression and improve quality of life by empowering nephrologists with state-of-the-art clinical, operational, and financial solutions.
Founded by nephrologists, for nephrologists, Panoramic Health has a deep commitment to preserving clinical autonomy while supporting practice growth and reducing administrative burden. Our integrated model is built around the needs of complex kidney patients and enables partner practices to enhance care quality, reduce total cost of care, and access new revenue opportunities.