Classification, etiologies, and clinical features of glomerulopathies

Table 11.3-1. Classification, etiologies, and clinical features of glomerulopathies
Glomerulopathy		Etiology/secondary causes	Clinical features
Postinfectious GN		– Primarily streptococcal and staphylococcal infections – Less commonly gram-negative bacteria, viral, fungal, or protozoal	Nephritic syndrome ~1-3 weeks after streptococcal infection, 4 weeks after staphylococcal infection
IgA nephropathy		– Seen with Henoch-Schönlein purpura – Associated with cirrhosis, celiac disease, inflammatory bowel disease, HIV, and seronegative arthritis	Microscopic hematuria, “synpharyngitic” gross hematuria, hypertension, proteinuria
Membranoproliferative GN
	Immune complex–mediated	Hepatitis C with cryoglobulinemia, hepatitis B, HIV, endocarditis, shunt nephritis, malaria, schistosomiasis, autoimmune disorders (SLE, Sjögren syndrome), malignancies (dysproteinemias, rarely lymphomas, carcinomas)	Varied presentation: microscopic hematuria and nonnephrotic proteinuria, nephrotic syndrome, occasionally rapidly progressive renal failure, commonly hypertension
	Complement-mediated	C3 nephritic factor, factor H deficiency (inherited or autoimmune)
Minimal change disease		– Most commonly primary/idiopathic – Secondary causes include NSAIDs, interferon, lithium, gold, lymphoproliferative disorders (Hodgkin lymphoma)	Nephrotic syndrome
Membranous nephropathy		– Most commonly primary/idiopathic – Secondary causes include autoimmune conditions (primarily SLE), infections (hepatitis B and C), medications (NSAIDs, gold, penicillamine), malignancies	Nephrotic syndrome
FSGS		– Primary/idiopathic – Secondary causes include HIV, parvovirus B19, CMV, EBV, pamidronate, heroin, lithium, obesity, reflux, sickle cell disease	Hypertension, proteinuria, and microscopic hematuria; nephrotic syndrome and abrupt development more common in primary/idiopathic FSGS
CMV, cytomegalovirus; EBV, Epstein-Barr virus; FSGS, focal segmental glomerulosclerosis; GN, glomerulonephritis; NSAID, nonsteroidal anti-inflammatory drug; SLE, systemic lupus erythematosus.