Standardized Classification and Reporting of Glomerulonephritis

Sanjeev Sethi; Fernando C. Fervenza


Nephrol Dial Transplant. 2019;34(2):193-199. 

In This Article

How Active Is the Lesion?

The Answer Lies in the Pattern of Injury

After the diagnosis is made, the next logical step is to ascertain the activity of the lesion. This is where the pattern of injury comes in. In general, crescentic and necrotizing lesions indicate a severe and acute GN. Diffuse proliferative and exudative lesions also indicate an active GN. Membranoproliferative lesions indicate both an active and chronic GN. Mesangial proliferative lesions indicate milder yet active lesions. Sclerosing lesions indicate an irreversible chronic GN. Thus it is important to identify the pattern of injury to determine the severity of the lesion, keeping in mind that multiple patterns of injury might be present.