Abstract
Glomerular diseases occurring in the absence of a known systemic process are called primary. This review focuses on the approach and diagnosis of primary glomerular disease. Inflammatory and/or noninflammatory insults to glomeruli results in a multiplicity of signs and symptoms of diseases, including hematuria, proteinuria, azotemia, edema, and hypertension. Patients with glomerular diseases generally present with one of the following clinical syndromes: asymptomatic urinary abnormalities, nephrotic syndrome, acute nephritic syndrome, rapidly progressive glomerulonephritis, or chronic glomerulonephritis. The urinalysis, the degree of proteinuria, the estimated glomerular filtration rate, and patient characteristics often allow the differential diagnosis of glomerular disease prior to renal biopsy. However, a renal biopsy is usually required to establish diagnosis and treatment of most glomerular disease.
