Glomerular inflammation causing haematuria, proteinuria, hypertension and declining GFR — a nephritic syndrome.
Causes
- • Post-streptococcal
- • IgA nephropathy
- • ANCA-associated vasculitis
- • Anti-GBM disease
- • Lupus nephritis
Investigations
- • Urine microscopy — dysmorphic RBCs and red cell casts
- • ANCA, anti-GBM, ANA, dsDNA, complement C3/C4, ASOT
- • Renal ultrasound, urgent biopsy for rapidly progressive disease
Management
- • Blood pressure control and salt restriction
- • Immunosuppression per cause: steroids + cyclophosphamide/rituximab for ANCA vasculitis
- • Plasma exchange for anti-GBM disease or pulmonary haemorrhage
- • Dialysis if refractory uraemia/hyperkalaemia
Clinical pearls
- • Creatinine doubling over days = rapidly progressive GN — nephrology emergency
- • Low C3 narrows the differential (post-infectious, lupus, MPGN)
Educational — verify locally.
