Standardized Classification and Reporting of Glomerulonephritis

Sanjeev Sethi; Fernando C. Fervenza


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

In This Article


Multiple diagnoses in addition to GN may be present and it may be difficult to determine a single primary diagnosis. For example, infection related–GN may occur in the setting of diabetic glomerulosclerosis, ANCA-associated GN may occur on a background of IgA nephropathy, both anti-GBM and ANCA-associated GN may coexist or in some cases C3 GN may be difficult to distinguish from an infection-related GN. In such instances, one may list the multiple diagnoses as the primary diagnosis with an explanation in the comment section. Limited biopsy samples also often preclude use of the full biopsy report format. In such instances, one may limit the biopsy report to the pertinent section with an explanation in the comment section. Finally, in some cases an etiology may not be determined in spite of detailed evaluation. This is particularly true in the rare cases of immune complex GN, where even after detailed evaluation there is no evidence of infection, autoimmune disease or a monoclonal gammopathy. Labelling these cases as idiopathic immune complex GN as the primary diagnosis appears reasonable until an etiology can be determined.