Often part of a multisystem disorder.
Edema is a sign of severe or chronic disease.
A renal biopsy is the test for definitive diagnosis, although it is not required in all patients.
Treating the underlying disorder and managing hypertension, hyperlipidemia, and proteinuria is the mainstay of therapy.
Some patients may eventually need dialysis or transplant.
Regular, and sometimes frequent, monitoring of renal function is critical.
Glomerulonephritis (GN) denotes glomerular injury and applies to a group of diseases that are generally, but not always, characterized by inflammatory changes in the glomerular capillaries and the glomerular basement membrane (GBM). The injury can involve a part or all of the glomeruli or the glomerular tuft. The inflammatory changes are mostly immune mediated. Diseases include membranous GN, minimal change disease, focal and segmental glomerulosclerosis, immunoglobulin A nephropathy, forms of rapidly progressive GN (vasculitis and anti-GBM disease), and systemic lupus erythematosus nephritis as the more common forms; and glomerular damage in other systemic diseases such as diabetes, amyloidosis, myeloma, and a variety of infections.
History and exam
- group A beta-hemolytic Streptococcus
- respiratory infections
- gastrointestinal infections
- hepatitis B
- hepatitis C
- infective endocarditis
- systemic lupus erythematosus (SLE)
- systemic vasculitis
- Hodgkin lymphoma
- lung cancer
- colorectal cancer
- non-Hodgkin lymphoma
- hemolytic uremic syndrome
- erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
- complement levels
- rheumatoid factor
- antineutrophil cytoplasmic antibody
- antiglomerular basement membrane (GBM) antibody
- antistreptolysin O antibody
- anti-double-stranded DNA
- antinuclear antibody
- hepatitis C virus and hepatitis B virus serology
- HIV serology
- drug screen
- renal biopsy
- antiphospholipase A2 receptor antibodies
- computed tomographic scan of chest and abdomen
Professor of Practice (Medicine)
Director of Clinical Academic Training
Imperial College London
Imperial College Healthcare NHS Trust
JL has received funding from Gilead for delivering and developing educational activities.
Dr Jeremy Levy would like to gratefully acknowledge Dr Padmanabhan Premkumar, Dr Priyanka Sharma, and Dr Ajay Kumar, previous contributors to this topic. PP, PS, and AK declare that they have no competing interests.
Nephrology and Hypertension
Cleveland Clinic Foundation
MS declares that he has no competing interests.
Keele University Medical School
PN declares that he has no competing interests.
Gloucestershire Royal Hospital
RB declares that he has no competing interests.
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