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Chronic GN

This is characterized by persistent urinary abnormalities, slow progressive impairment renal function, symmetrically contracted kidneys, moderate to heavy proteinuria, abnormal urinary sediment (especially RBC casts)


The time to progression to ESRD is variable, hastened by uncontrolled hypertension and infections.


Drug – Induced Glomerular Disease

Morphologic Lesion Causative Agent
1. Minimal change diseases (usually with interstitial nephritis)  i. NSAID
ii. Recombinant interferon α
iii.  Rifampin
iv.  Ampicillin
2. Membranous nephropathy i.  Penicillamine
ii.  Gold
iii. Mercury
iv. Trimethadione
v.  Captopril
vi Clomethiazole
3.  Focal segmental glomerulosclerosis i. Heroin
4.  Pauci – immune necrotizing GN i. Ciprofloxacin
ii. Hydralazine
5. Proliferative GN with vasculitis i. Allopurinol
ii. Penicillin
iii. Sulfonamides
iv. Thiazides
v. Intravenous amphetamines
6.  RPGN i. Rifampin
ii. Warfarin
iii. Carbimazole
iv. Amoxicillin
v. Penicillamine

Glomerular Lesion Associated with Infections Diseases

Glomerular Lesion Associated with Infections Diseases  
Morphologic Lesion Common Disease or Inciting Organism
1. Diffuse proliferative glomerulo    –       
nephritis (classic postinfectious glomerulonephritis)
Streptococcal pharyngitis
Acute/subacute bacterial endocarditis
Visceral sepsis
Typhoid fever
Leptospirosis (Mycobacterium leprae)
Falciparum malaria
Plasmodium falciparum
Varicella, mumps, echovirus, Coxsackie virus,
Infectious mononucleosis
Hepatitis B and C
2. Membranoproliferative glomerulonephritis Subacute bacterial endocarditis
Ventriculoatrial shunt infection
Visceral sepsis
Hepatitis C infection
Hepatitis B infection
P. falciparum
3. Mesangial proliferative Recovery phase of postinfectious
4. Membranous nephropathy Hepatitis C infection
Hepatitis B infection
Hydatid disease
Plasmodium malariae
Enterococcal endocarditis
5. Focal segmental glomerulosclerosis HIV infection
6. Renal amyloidosis Any chronic infection

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