Acute glomerulonephritis, vasculitis, and pulmonary renal syndrome

Abstract

Inflammatory diseases of glomeruli (glomerulonephritis [GN]) and renal vessels (vasculitis) are important causes of intrinsic acute kidney failure (ARF), accounting for approximately 10% of cases. Both acute glomerulonephritis and vasculitis (particularly ANCA-associated vasculitis) are more common in the elderly while poststreptococcal GN causing ARF is relatively more common in children than in adults. The clinical presentation is often that of a rapidly progressive glomerulonephritis (RPGN) with or without signs and symptoms of extrarenal manifestations. The diagnostic workup must include an immunologic screening for autoantibodies (ANA, anti-ds DNA antibodies, ANCA, anti-GBM antibodies, and cryoglobulins). Patients with hematuria/proteinuria, active urinary sediment, and/or acute renal dysfunction with or without systemic symptoms must be subjected to renal biopsy for the precise diagnosis. Early recognition is essential because treatment may result in preservation or recovery of renal function. © Springer-Verlag Berlin Heidelberg 2010.