Glomerulonephritis

Abstract

The term glomerulonephritis is used to identify a group of renal disorders in which the major injury involves the glomerulus rather than the tubules, interstitial tissue, or vasculature. Primary glomerulonephritis (GN) refers to disorders that occur solely or primarily in the kidney in contrast to those associated with systemic diseases (ie secondary GN) (see Table 1).The adjective acute (acute glomerulonephritis [AGN]) defines a characteristic clinicopathologic association with distinctive features of etiology, pathology, course, and prognosis. The majority of instances of AGN appear to occur after infection, and a number of bacterial and viral infections have been etiologically incriminated (Table 2).Post streptococcal AGN (PSAGN) is the most common type. The clinical picture of AGN due to other infections may be indistinguishable from that usually associated with PSAGN. Only the absence of a prior streptococcal illness as evidenced by bacteriologic and serologic studies, and the temporal association with a viral syndrome distinguish such a patient. As the immediate and long-term prognosis of nonstreptococcal AGN is not as well known as that of PSAGN, a diligent effort should be made to identify the etiologic agent.CLINICAL CHARACTERISTICSAGN can be asymptomatic and only evident by laboratory findings. This has been the presentation in at least 50% of cases of PSAGN.