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

Glomerular disease: Evaluation and differential diagnosis in adults

Jai Radhakrishnan, MD, MS
Section Editors
Richard J Glassock, MD, MACP
Brad H Rovin, MD
Deputy Editor
Albert Q Lam, MD


Glomerular disease can result from many inherited or acquired disorders and can manifest in a variety of ways, ranging in severity from asymptomatic urinary abnormalities to acute kidney injury (AKI) or end-stage renal disease.

A kidney biopsy is often required to secure the underlying diagnosis in a patient with suspected glomerular disease, particularly in patients with nephrotic syndrome or suspected glomerulonephritis. Rarely, a biopsy cannot be performed or is not needed to secure a diagnosis. As examples:

A biopsy may be deferred if the procedural risk is prohibitive or if the patient is uncooperative or unwilling. In such cases, a presumptive diagnosis can sometimes be made without a biopsy to facilitate the initiation of therapy. However, a biopsy should often be performed at a later date if it becomes feasible. (See "Indications for and complications of renal biopsy".)

A biopsy may not be required if a definitive diagnosis can be made by serology (eg, patients with nephrotic syndrome due to membranous nephropathy associated with anti-phospholipase A2 receptor [anti-PLA2R] autoantibodies). (See "Causes and diagnosis of membranous nephropathy".)

More than one glomerular disease can be present in the same individual (eg, underlying diabetic nephropathy with superimposed 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: Sep 26, 2017.
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.