For example, patients with minimal change disease or primary focal segmental glomerulosclerosis require an instant start of steroids,8 most patients with anti-PLA2R-associated membranous nephropathy are monitored with an initial wait-and-see strategy potentially followed by immunosuppression,8 and underlying disease in secondary forms of nephrotic syndrome such as diabetic nephropathy9 or systemic lupus erythematosus requires distinct treatment of the specific primary disease.10 The gene discussed is PLA2R1; the disease is lipoid nephrosis.