1. Acute Glomerulonephritis
Investigations

2. Urinalyis
MSU
Biopsy

3. Urinalysis Urine is dark. Specific gravity is greater than 1020 osm.
Proteinuria is observed.
Haematuria
RBCs and red cell casts are present on microscopy
(Perform FBE to check for anaemia)
Leukocytes
Creatinine level increased

4. Asymptomatic urinary abnormalities
Isolated proteinuria without haemturia
May be early sign of glomerular lesion- i.e. membranous GN, IgA nephropathy, diabetic nephropathy or amyloidosis
Haematuria with/without sub-nephrotic range proteinuria
SLE, Henoch-Schonlein purpura, post-infectious GN

5. Blood FBE ESR, CRP for inflammation U + E’s LFT’s
Serum albumin (low in nephrotic syndrome)
Glucose- to exclude diabetes
Serum complement (low in SLE)
Auto-antibodies: serum immunoglobulins, ANCA (Wegener’s granulomatosus, anti-ss-DNA (SLE)

6. Imaging Chest radiography
needed in patients with a cough, with or without haemoptysis (ie, Wegener granulomatosis, Goodpasture syndrome, pulmonary congestion).
Abdominal CT is needed if visceral abscesses are suspected; also look for chest abscesses.
Echo
For pts with new cardiac murmur or a positive blood culture
rules out endocarditis or a pericardial effusion.
Renal US:
to evaluate kidney size as well as to determine the extent of fibrosis.
A kidney size of less than 9 cm is suggestive of extensive scarring and a low likelihood of reversibility
CT scan of the head for patient with malignant hypertension or altered mental status.

7. Biopsy Candidates for biopsy:
individual or family history of renal disease, atypical presentation:
massive proteinuria
nephrotic syndrome
rapid rise in creatinine level without resolution.

8. Post-strep GN
Biopsy shows diffuse, florid, acute inflamm at the glomerulus
No necrosis, but occaisonal crescents
Neutrophils and deposition of IgG and complement
Light microscopy of biopsy sample shows acute inflammation of glomerulus with neutrophils

9. http://www. health-res

10. IgA nephropathy (commonest form of GN)
Elevated IgA complex in mesangium
Biopsy shows mesangial cell proliferation and increased matrix

12. Wegener’s granulomatosus
C- ANCA that reacts with proteinase 3