Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Evaluation of a child with glomerular disease

Patrick Niaudet, MD
Section Editor
F Bruder Stapleton, MD
Deputy Editor
Melanie S Kim, MD


There are numerous causes of glomerular diseases in children. Many of these conditions vary in their presentation with mild or no symptoms, to serious renal disease with life-threatening complications. As a result, the diagnosis of a specific glomerular disease is challenging in children but important so that therapy, if helpful and needed, can be initiated.

The diagnostic evaluation of children with glomerular disease will be reviewed here. The evaluation of children with nonglomerular causes of isolated hematuria or proteinuria is discussed separately. (See "Evaluation of microscopic hematuria in children" and "Evaluation of gross hematuria in children" and "Evaluation of proteinuria in children".)


Numerous primary (renal disease alone) and secondary (due to systemic autoimmune disorders, vasculitis, or infection) disorders produce glomerular disease (table 1).

Findings suggestive of a glomerular disease include proteinuria, hematuria (which may be microscopic or macroscopic), nephrotic syndrome, arterial hypertension, and renal insufficiency. The presence of these manifestations and their severity can be used to describe several different clinical patterns that often correspond to different underlying etiologies.

An acute nephritic syndrome pattern is associated with active urine sediment with red cells, white cells, granular and often red cell and other cellular casts, and a variable degree of proteinuria including nephrotic range proteinuria, and often elevated blood pressure. Histologic examination demonstrates inflammation. This pattern is most often seen in children with poststreptococcal glomerulonephritis, but may also be secondary to a membranoproliferative glomerulonephritis. (See "Overview of the pathogenesis and causes of glomerulonephritis in children" and "Poststreptococcal glomerulonephritis".)

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Nov 18, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.