Fortnightly Review: Glomerulonephritis: diagnosis and treatment

points * Glomerulonephritis presents in many different ways and an accurate diagnosis cannot be made clinically * Dipstix testing of urine is a sensitive way of detecting occult glomerulonephritis once infection has been excluded * Early referral of patients for assessment and renal biopsy is essential to detect treatable conditions * Early treatment is more likely to result in preservation of or improvement in renal function * Patients with glomerular disease of whatever type and severity require long term follow up while urinary abnormalities persist * Assiduous blood pressure control (aiming for < 145/90 mm Hg) is vital to minimise the rate ofprogression of renal failure * Consider antithrombotic and anti-infection prophylaxis in patients with severe and refractory nephrotic syndrome * Specific treatment may be indicated depend- ing on the disease Box 1-Manifestations ofglomerular disease * Asymptomatic proteinuria * Asymptomatic haematuria * The nephrotic syndrome * The nephritic syndrome * Acute/rapidly progressive renal failure * End stage chronic renal failure * Hypertension