Glomerulonephritis

1. Big picture

In pediatrics, glomerulonephritis usually appears in the exam as an acute nephritic syndrome:

cola-colored urine + edema + hypertension + oliguria ± renal dysfunction

The classic disease is acute post-streptococcal glomerulonephritis, but you must also recognize IgA vasculitis nephritis, IgA nephropathy, lupus nephritis, membranoproliferative glomerulonephritis, and rapidly progressive glomerulonephritis.

The examiner wants you to say:

1. This is glomerular inflammation, not urinary tract infection.
2. The urine is usually sterile, but contains blood, red cell casts, and protein.
3. The danger is not the hematuria itself; the danger is hypertension, pulmonary edema, hyperkalemia, acute kidney injury, uremia, and encephalopathy.
4. Management is mostly supportive and complication-focused, with disease-specific therapy when indicated.

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