Glomerulonephritis

The glomerulonephritides are a group of conditions in which glomerular injury is characterized by:

• an immunological component to the pathogenesis which often results in glomerular injury
• further glomerular damage by one or more of complement activation, platelet aggregation, neutrophil infiltration, fibrin deposition and activation of the kinin system

Glomerulonephritis may occur in isolation (primary glomerular disease) or as part of multisystem disease such as polyarteritis nodosa and SLE (secondary glomerular disease).

Both kidneys are involved to similar degrees.

The cardinal feature of all glomerulonephritides is haematuria (microscopic or macroscopic) with red cell casts in the urine.

Glomerulonephritis may present clinically in one of a number of ways:

• nephrotic syndrome
• nephritic syndrome
• acute or chronic renal failure
• asymptomatic haematuria and/or proteinuria