Guidelines for Glomerulonephritis: Their Importance in Diagnosis and Designing a Management Strategy
There is a wide variety of disorders which affect the glomeruli, the basic filtering units of the kidney. Clinical diagnosis of specific glomerular diseases is difficult because the same glomerular disease can manifest in different ways and different glomerular disease can produce the same clinical manifestations. Several findings are common to many glomerular diseases. They include the findings of dysmorphic erythrocytes in the urinary sediment and the presence of large amounts of albuminuria. Renal function may be increased, normal or decreased. The various combination of these signs give rise to a number of distinct clinical syndromes, namely, asymptomatic proteinuria or haematuria, nephrotic syndrome, acute glomerulonephritis, rapidly progressive glomerulonephritis and chronic glomerulonephritis. Renal biopsy is often required for a definitive diagnosis. Clinical features, such as severe or prolonged nephrosis, renal insufficiency or hypertension predict a high likelihood of progression to end-stage renal disease. The treatment of glomerulonephritis will depend on the aetiology and the clinical presentation. It may be considered in 2 broad categories: the specific treatment for the renal injury and the management of pathophysiological consequences of glomerular disease, such as fluid retention, hypertension, hyperkalaemia and uraemia.
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