Glomerulonephritis (GN)

Glomerulonephritis (GN)

Glomerulonephritis (GN)	Urinalysis , urine protein; urine microscopy (fresh specimen examined for casts and dysmorphic red cells). Electrolytes, creatinine, urea. Diagnosis is established by renal biopsy with IF, IH and electron microscopy. The possibility of underlying systemic disease should be considered.
Presentations
Haematuria
Hypertension
Nephritic syndrome
Nephrotic syndrome
Proteinuria
Renal failure
Causes
Primary renal disease eg
IgA nephropathy
Membranous GN
Minimal change disease
Post-infectious GN	Throat swab , skin lesions - bacterial culture. Antistreptolysin O titre , antideoxyribonuclease B antibodies .
Mesangiocapillary GN	Complement components C3 and C4 ; C3 nephritic factor .
Crescentic GN	Glomerular basement membrane antibodies , antineutrophil cytoplasmic antibodies .
Associated with systemic disease eg
SLE
Goodpasture syndrome
Vasculitis syndromes esp
Microscopic polyarteritis
Wegener’s granulomatosis
Henoch-Schönlein purpura
Malignancy
Chronic infection-associated GN eg
Hepatitis B virus infection
Hepatitis C virus infection
Endocarditis
Malaria