Glomerulonephritis

Definition

Glomerulonephritis (GN) presents with hematuria, oliguria, hypertension, and volume overload.

  1.  Acute GN (AGN) is associated with inflammation and proliferation of the glomerular tuft. AGN may be rapidly progressive (RPGN).

  2.  Chronic GN (CGN) implies that permanent damage has occurred.

Causes

    •  Low serum complement level: Systemic diseases

-        Vasculitis and autoimmune disease, e.g., systemic lupus erythematosus (SLE)

-        Subacute bacterial endocarditis (SBE)

-        Shunt nephritis

-        Cryoglobulinemia

    •  Low serum complement level: Renal diseases

-        Acute poststreptococcal GN (APSGN)

-        Membranoproliferative glomerulonephritis (types 1, 2, and 3)

   •  Normal serum complement level: Systemic diseases

-        Polyarteritis nodose group

-        Wegener vasculitis

-        Henoch-Schonlein purpura

-        Hypersensitivity vasculitis

-        Visceral abscess

•    Normal serum complement level: Renal diseases

-        IgA nephropathy

-        Idiopathic rapidly progressive glomerulonephritis

-        Immune-complex disease

-        Pauci-immune glomerulonephritis

COMPLICATIONS

1.  Acute renal failure

2.  Hyperkalemia

3.  Hypertension

4.  Volume overload (congestive cardiac failure, pulmonary edema, hypertension)

5.  Chronic renal failure

PROGNOSIS

1.  Prognosis is excellent in APSGN and variable for other causes of GN in childhood.