Overview
Glomerulonephritis
1. Clinical Overview
Summary
Glomerulonephritis encompasses immune-mediated diseases affecting glomeruli. Presentation includes nephritic syndrome (haematuria, proteinuria, hypertension, oliguria, AKI) or nephrotic syndrome (heavy proteinuria, hypoalbuminaemia, oedema). Primary causes include IgA nephropathy, minimal change disease, FSGS, and membranous nephropathy. Secondary causes include lupus nephritis, post-infectious GN, and ANCA-associated vasculitis. Diagnosis requires renal biopsy in most cases. Treatment depends on cause and may include steroids, immunosuppression, or plasma exchange for ANCA GN.
Key Facts
- Classification: Nephritic vs nephrotic syndrome; Primary vs secondary
- Diagnosis: Renal biopsy (gold standard)
- Common causes: IgA nephropathy (most common primary), minimal change, FSGS, membranous
2. Syndromes
| Syndrome | Features |
|---|---|
| Nephritic | Haematuria, RBC casts, mild proteinuria, AKI, HTN, oliguria |
| Nephrotic | Heavy proteinuria (greater than 3.5g/day), hypoalbuminaemia, oedema, hyperlipidaemia |
3. Key Causes
| Type | Presentation | Treatment |
|---|---|---|
| IgA nephropathy | Nephritic, recurrent gross haematuria | ACEi, steroids if progressive |
| Minimal change | Nephrotic (children/adults) | Steroids (responds well) |
| FSGS | Nephrotic | Steroids, immunosuppression |
| Membranous | Nephrotic | ACEi, rituximab, steroids |
| ANCA vasculitis | RPGN | Cyclophosphamide/rituximab + steroids |
| Lupus nephritis | Variable | MMF or cyclophosphamide |
4. References
- KDIGO Clinical Practice Guideline for Glomerulonephritis. 2021.
Last Reviewed: 2026-01-01 | MedVellum Editorial Team