Glomerular Disease

Abstract

Renal diseases can often be divided into glomerular and nonglomerular disorders on the basis of etiology, histology or major alterations in physiology. From the clinical standpoint, however, such a distinction is more subtle and may be difficult to make. Although somewhat artificial, this distinction serves a useful purpose in the approach to patient care, treatment and prognosis. Hypertension and edema occur more frequently and there is greater likelihood and severity of reduced renal function in glomerular disease. Although the clinical picture may be helpful in differentiating various glomerular diseases from each other and from nonglomerular disorders, often a renal biopsy is required to arrive at the exact diagnosis (1,2). In this chapter, we will outline the workup of the child with glomerular disease. Nephritis associated with Henoch-Schönlein purpura, hemolytic uremic syndrome and systemic and collagen diseases, as well as rapidly progressive glomerulonephritis, are discussed in Chapter 19.