Clinical presentation & management of glomerular diseases: hematuria, nephritic & nephrotic syndrome

Area of Science:

• Nephrology
• Internal Medicine
• Pathology

Background:

• Glomerulonephritis (GN) presents a broad differential diagnosis.
• A systematic classification schema is essential for identifying GN causes.
• GN can be primary (kidney-restricted) or secondary (systemic disease-related).

Purpose of the Study:

• To outline a classification schema for glomerulonephritis.
• To differentiate GN based on clinical presentation and histopathology.
• To provide an overview of nephrotic, nephritic, and chronic GN syndromes.

Main Methods:

• Classification of GN by clinical presentation: nephrotic, nephritic, rapidly progressive GN, and chronic GN.
• Classification of GN by histopathology.
• Defining key features of nephrotic syndrome (proteinuria, hypoalbuminemia, edema) and nephritic syndrome (hematuria, proteinuria, hypertension).

Main Results:

• Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, edema, and potential hyperlipidemia/thrombotic disease.
• Nephritic syndrome involves hematuria, proteinuria, abnormal kidney function, and hypertension, often with a poorer prognosis.
• Minimal change disease is the primary cause of nephrotic syndrome in children; post-infectious GN, IgA nephropathy, and lupus nephritis are common causes of nephritic syndrome.

Conclusions:

• Chronic GN is a slowly progressive condition associated with hypertension and declining kidney function.
• Treatment strategies focus on managing hypertension, edema, and proteinuria.
• Disease-modifying immunosuppression is a crucial component of GN management.