The classification of the glomerulonephritides is based on the causes (aetiology) or histology and is complex and complicated – even most doctors struggle with this.
The so-called ‘primary glomerulonephritides’ are diseases where most (if not all) of the pathology is localised to the kidneys. There can be systemic complications of the disease process, but the kidneys remain the main organ system involved. Dysfunction of the immune system is the underlying cause in most of these conditions. If no specific underlying cause for this can be identified, as is often the case, ‘idiopathic’ (primary) glomerulonephritis is diagnosed. (An example would then be ‘idiopathic membranous glomerulone
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phritis’). The primary glomerulonephritides are subdivided by clinical and pathological means into various subtypes. For an accurate diagnoses a renal biopsy (to attain a histological specimen) is usually necessary.
Histologically (by looking at cell types) the primary (and secondary) glomerulonephritides can be subdivided into:
Many other diseases can secondarily affect the kidneys, giving rise to most of the histological subtypes (or combinations thereof) listed above. In these diseases the renal pathology may be an incidental finding, being overshadowed by the other manifestations of the systemic diseases, or it may the main manifestation and even cause of death. (An example would be ‘membranous nephropathy secondary to Hepatitis B infection’.)
An abbreviated aetiological classification of the secondary glomerulonephritides:
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