1. Glomerulonephropathy
Nephritic- proliferative
or
Nephrotic- non-proliferative

2. Nephritic or Nephrotic
 Proteinuria mostly
<3.5 gm per day
 Hematuria
 Active urine
sediment- RBC cast
 HT- common
 Uremia- common
 PSGN, RPGN
 Nephrotic range-
>3.5 gm per day
 Not seen
 Bland urine
sediment
 Uncommon
 Uncommon
 MCD, membranous
nephropathy

3. IgA nephropathy
 Commonest glomerulonephritis
 IgA deposition in glomerular mesangium,
seen in kidney biopsy
 More in young adults, males>females
 Gross or microscopic hematuria,
frequently associated with URI
 ~50% have progressive renal insufficiency
 Rx-
 ACEI to reduce proteinuria
 Steroids, if proteinuria >1 gm/day
 Renal transplantation (recurrence in ~30%)

4. Post-streptococcal GN- PSGN
 Follows infection with type 12 group A
β–hemolytic streptococci
 Onset ~1-3 weeks after infection
 s/s- oliguria, hematuria, edema, HT
 Serum ASO titres- raised
 Biopsy- diffuse proliferative
glomerulonephritis
 Rx- supportive, with appropriate antibiotics
 Px- good in children, adults can have RPGN
or progressive CRI

5. Rapidly progressive GN-
RPGN
 Rapid progression to renal insufficiency, over
few days to weeks
 Urine- active sediment
 Kidney biopsy- crescentic glomerulonephritis
 Types-
 I- anti-GBM- Goodpasture syndrome
 II- immune-complex mediated
 III- pauci-immune or ANCA associated

6. Goodpasture syndrome
 Glomerulonephritis with pulmonary hemorrhage
 Mediated by anti-GBM antibodies
 Males > Females, in 2nd
-3rd
decade
 Preceded by URI in ~50%
 s/s- edema, HT, oliguria, hemoptysis, dyspnea
 Ix-
 Sputum- hemosiderin laden macrophages
 CxR- fleeting pulmonary infiltrates- pulmonary hemorrhage
 Deranged RFT
 Anti-GBM antibodies in serum
 Rx- plasmapheresis,
with steroids & Cyclophosphamide

7. Immune-complex mediated GN
 Seen with SLE, EMC, IE, shunt nephritis
 Due to trapped immune-complexes in
subendo/epithelium or mesangium
 Clinical features of underlying disease, with
rapidly progressive renal dysfunction
 Kidney biopsy shows crescentic GN
 Rx- of underlying disease, with pulse steroids
or Cyclophosphamide ± plasmapheresis

8. Pauci-immune GN
 Seen with Wegener’s granulomatosis, Churg-Strauss
disease, microscopic polyangiitis
 s/s- fever, malaise, respiratory symptoms,
edema, HT, hematuria, oliguria
 Ix-
 Urine- active sediment
 RFT- deranged
 CxR- nodular infiltrates of Wegener’s
 ANCA- C-ANCA- antiproteinase 3, P-ANCA- antimyeloperoxidase
 Rx- oral steroids with pulse Cyclophosphamide
(Azathioprine/mycophenolate)