Introduction
Glomerular diseases exist on two opposing spectrums based on proteinuria (nephrotic spectrum) and hematuria (nephritic spectrum).
When strictly referring to glomerular diseases:
- Proteinuria is present in most glomerular diseases.
- Hematuria is only present in inflammatory glomerular diseases (glomerulonephritis).
The two extremes of these spectrums describe two clinical syndromes:
- Nephrotic syndrome which encompasses severe proteinuria (>3.5g/day) along with edema, hypoalbuminemia, hyperlipidemia, and oval fat bodies in the urine, seen in degenerative glomerular diseases (conditions without inflammation).
- Nephritic syndrome which encompasses hematuria along with with hypertension, azotemia, oliguria, and mild proteinuria (rarely absent).
Some glomerular diseases, however, may manifest with symptoms that overlap both nephrotic and nephritic syndrome, for example:
- Lupus nephritis
- Membranoproliferative glomerulonephritis (MGN)
Glomerular diseases can be classified into primary (idiopathic) and secondary (diabetes, HTN, SLE, PSGN) glomerular diseases.