How to classify primary glomerular disease

How to classify primary glomerular disease

Primary glomerular disease is confined to the glomerular lesion or kidney disease is a group of glomerular damage. Primary glomerular disease is mostly idiopathic (i.e. unknown etiology), partly induced by bacterial infection or drug. The classification of primary glomerular diseases from two aspects, i.e. the clinical types and pathological types.

According to the clinical classification criteria of primary glomerular disease in 1992, it can be pided into:

(1) acute glomerulonephritis

Acute onset, hematuria, proteinuria, edema and hypertension as the main performance, and there is a group of diseases of azotemia. In streptococcal infection, other bacterial, viral and parasitic infections can also cause.

(2) mesangial proliferative glomerulonephritis.

The onset of the disease is similar to that of acute glomerulonephritis, but the renal function is very bad, and the early appearance of oliguria acute renal failure is characterized by a large number of crescent formation

(3) chronic glomerulonephritis

For persistent disease, disease progression is slow, will eventually develop into a group of glomerular diseases and chronic renal failure. The clinical with edema, hypertension, proteinuria, hematuria and renal dysfunction as the basic performance, but because of the different pathological type and stage of disease, mainly they can be different in various ways.

(4) nephrotic syndrome

Mainly for the "three high and one low", namely high edema, proteinuria (3.5 g / day), hyperlipidemia and hypoproteinemia (plasma albumin less than 30 g / L). As long as having proteinuria and hypoalbuminemia diagnosis can be established.

(5) latent glomerular disease

In asymptomatic proteinuria (proteinuria <; 1 g / day, mainly to albumin) and (or) simple hematuria (persistent or intermittent hematuria, and occasionally hematuria, the nature of glomerular) is a group of glomerular diseases. Clinical manifestations of patients without edema, high blood pressure and impaired renal function.

According to the pathological classification criteria of primary glomerular disease in 1982, WHO can be pided into:

Minimal glomerular disease;

Focal segmental lesions;

The diffuse glomerulonephritis: including membranous nephropathy, proliferative glomerulonephritis (the latter can be pided into: mesangial proliferative glomerulonephritis, capillary proliferative glomerulonephritis, mesangiocapillary glomerulonephritis and dense deposit nephritis and crescentic glomerulonephritis) and sclerosing glomerulonephritis.

Unclassified glomerulonephritis

Some glomerular diseases can also be diagnosed by immunohistochemistry based on immunofluorescence and / or immunohistochemical findings, such as IgA nephropathy and IgM nephropathy

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