The glomerulonephritides

The glomerulonephritides are a group of disorders characterized by intraglomerular inflammation. The clinical presentation is variable, ranging from asymptomatic microscopic haematuria to sudden onset frank haematuria with rapidly deteriorating renal function. Proteinuria, oedema, and hypertension are often associated. The most common underlying aetiology is acute post streptococcal glomerulonephritis (APSGN). Other aetiologies include Henoch–Schonlein purpura (HSP), IgA nephropathy, juvenile systemic lupus erythematous (JSLE) and membranoproliferative glomerulonephritis (MPGN). Focussed clinical evaluation and investigations are key to establishing a timely diagnosis. Management and prognosis is dependent upon the underlying cause. APSGN and HSP nephritis require mainly supportive treatment and having excellent outcomes. In contrast, it is crucial to recognise and promptly refer children with rapidly progressive crescentic nephritis in order to preserve renal function.