BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAcute nephritic syndromeGlomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acuteAcute nephritic syndrome is a group of symptoms that occur with some disorders that cause swelling and inflammation of the glomeruli in the kidney, or glomerulonephritis.GlomerulonephritisGlomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged....ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Causes Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.Immune responseThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article Common causes in children and adolescents include:Hemolytic uremic syndrome (disorder that occurs when an infection in the digestive system produces toxic substances that destroy red blood cells and cause kidney injury) Hemolytic uremic syndromeShiga-like toxin producing E coli hemolytic-uremic syndrome (STEC-HUS) is a disorder that most often occurs when an infection in the digestive system...ImageRead Article Now Book Mark Article Henoch-Schönlein purpura (disease that involves purple spots on the skin, joint pain, gastrointestinal problems and glomerulonephritis) Henoch-Schönlein purpuraIgA vasculitis is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis (a type of kidney d...ImageRead Article Now Book Mark Article IgA nephropathy (disorder in which antibodies called IgA build up in kidney tissue) IgA nephropathyIgA nephropathy is a kidney disorder in which antibodies (called IgA) build up in kidney tissue. Nephropathy is damage, disease, or other problems w...ImageRead Article Now Book Mark Article Post-streptococcal glomerulonephritis (kidney disorder that occurs after infection with certain strains of streptococcus bacteria) Post-streptococcal glomerulonephritisPoststreptococcal glomerulonephritis (GN) is a kidney disorder that occurs after infection with certain strains of streptococcus bacteria.ImageRead Article Now Book Mark Article Common causes in adults include:Abdominal abscesses AbscessesAn abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.ImageRead Article Now Book Mark Article Goodpasture syndrome (also called anti-glomerular basement membrane disease in which the immune system attacks the glomerular basement membrane) Goodpasture syndromeAnti-glomerular basement membrane disease (anti-GBM disease) is a rare disorder that can involve quickly worsening kidney failure and lung disease. S...ImageRead Article Now Book Mark Article Hepatitis B or C HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Endocarditis (inflammation of the inside lining of the heart chambers and heart valves caused by a bacterial or fungal infection) EndocarditisEndocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is caused by a bacterial or, rarely, a fu...ImageRead Article Now Book Mark Article Membranoproliferative glomerulonephritis (disorder that involves inflammation and changes to kidney cells) Membranoproliferative glomerulonephritiMembranoproliferative glomerulonephritis is a kidney disorder that involves inflammation and changes to kidney cells. It may lead to kidney failure....ImageRead Article Now Book Mark Article Rapidly progressive (crescentic) glomerulonephritis (a form of glomerulonephritis that leads to a rapid loss of kidney function) Lupus nephritis (kidney complication of systemic lupus erythematosus) Lupus nephritisLupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus.ImageRead Article Now Book Mark Article Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article Vasculitis (inflammation of the blood vessels) VasculitisHypersensitivity vasculitis is an extreme reaction to a drug, infection, or foreign substance. It leads to inflammation and damage to blood vessels,...ImageRead Article Now Book Mark Article Viral diseases such as mononucleosis, measles, and mumpsMononucleosisMononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.ImageRead Article Now Book Mark Article MeaslesMeasles is a very contagious (easily spread) illness caused by a virus.ImageRead Article Now Book Mark Article MumpsMumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...ImageRead Article Now Book Mark Article The inflammation affects the function of the glomerulus. This is the part of the kidney that filters blood to make urine and remove waste. As a result, blood and protein appear in the urine, and excess fluid builds up in the body.Swelling of the body occurs when the blood loses a protein called albumin. Albumin keeps fluid in the blood vessels. When it is lost, fluid collects in the body tissues.Blood loss from the damaged kidney structures leads to blood in the urine. Symptoms Common symptoms of nephritic syndrome are:Blood in the urine (urine appears dark, tea-colored, or cloudy) Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Decreased urine output (little or no urine may be produced) Decreased urine outputDecreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...ImageRead Article Now Book Mark Article Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas SwellingSwelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...ImageRead Article Now Book Mark Article High blood pressureHigh blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Other symptoms that may occur include:Blurred vision, usually from burst blood vessels in the retina of the eye Cough containing mucus or pink, frothy material from fluid buildup in the lungs Shortness of breath, from fluid buildup in the lungs General ill feeling (malaise), drowsiness, confusion, aches and pains, headacheDrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Symptoms of acute kidney failure or long-term (chronic) kidney disease may develop.Acute kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Exams and Tests During an examination, your health care provider may find the following signs:High blood pressure Abnormal heart and lung sounds Signs of excess fluid (edema) such as swelling in the legs, arms, face, and belly Enlarged liver Enlarged liverEnlarged liver refers to swelling of the liver beyond its normal size. Hepatomegaly is another word to describe this problem. If both the liver and ...ImageRead Article Now Book Mark Article Enlarged veins in the neck Tests that may be done include:Blood electrolytes ElectrolytesElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Blood urea nitrogen (BUN) Blood urea nitrogenBUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...ImageRead Article Now Book Mark Article Creatinine CreatinineThe creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine in t...ImageRead Article Now Book Mark Article Creatinine clearance Creatinine clearanceThe creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with...ImageRead Article Now Book Mark Article Urine protein Urine proteinThe urine protein dipstick test measures the presence of all proteins, including albumin, in a urine sample. Albumin and protein can also be measured...ImageRead Article Now Book Mark Article UrinalysisUrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article A kidney biopsy will show inflammation of the glomeruli, which may indicate the cause of the condition.Kidney biopsyA kidney biopsy is the removal of a small piece of kidney tissue for examination.ImageRead Article Now Book Mark Article Tests to find the cause of acute nephritic syndrome may include:ANA titer for lupus Antiglomerular basement membrane antibody Antineutrophil cytoplasmic antibody for vasculitis (ANCA) Blood culture Culture of the throat or skin Culture of the throatA throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...ImageRead Article Now Book Mark Article Serum complement (C3 and C4) Treatment The goal of treatment is to reduce inflammation in the kidney and control high blood pressure. You may need to stay in a hospital to be diagnosed and treated.Your provider may recommend:Bedrest until you feel better with treatment A diet that limits salt, fluids, and potassium Medicines to control high blood pressure, reduce inflammation, or to remove fluid from your body Kidney dialysis, if neededKidney dialysisDialysis treats end-stage kidney disease also called kidney failure. It removes waste from your blood when your kidneys can no longer do their job. ...Read Article Now Book Mark Article Outlook (Prognosis) The outlook depends on the disease that is causing the nephritis. When the condition improves, symptoms of fluid retention (such as swelling and cough) and high blood pressure may go away in 1 or 2 weeks. Urine tests may take months to return to normal.Children tend to do better than adults and usually recover completely. Only rarely do they develop complications or progress to chronic glomerulonephritis and chronic kidney disease.Adults do not recover as well or as quickly as children. Although it is unusual for the disease to return, in some adults, the disease does return and they will develop end-stage kidney disease and may need dialysis or a kidney transplant.End-stage kidney diseaseEnd-stage kidney disease (ESKD) is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's...ImageRead Article Now Book Mark Article Kidney transplantA kidney transplant is surgery to place a healthy kidney into a person with kidney failure.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have symptoms of acute nephritic syndrome. Prevention Often, the disorder cannot be prevented, although treatment of illness and infection may help to reduce the risk.Open ReferencesReferencesRadhakrishnan J, Stokes MB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 107.Saha M, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.AllVideoImagesTogGlomerulus and nephron - illustration The kidneys remove excess fluid and waste from your body. Blood is filtered in the kidneys through nephrons. Each nephron contains a network of small blood vessels, called glomerulus, which are enclosed in a sac called Bowman's capsule. The filtered waste product (urine) flows through tiny tubes and is then passed from the kidneys to the bladder through bigger tubes called ureters.Glomerulus and nephronillustrationKidney anatomy - illustration The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.Kidney anatomyillustrationGlomerulus and nephron - illustration The kidneys remove excess fluid and waste from your body. Blood is filtered in the kidneys through nephrons. Each nephron contains a network of small blood vessels, called glomerulus, which are enclosed in a sac called Bowman's capsule. The filtered waste product (urine) flows through tiny tubes and is then passed from the kidneys to the bladder through bigger tubes called ureters.Glomerulus and nephronillustrationKidney anatomy - illustration The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.Kidney anatomyillustrationRelated Information IgA nephropathy(Condition)IgA vasculitis - Henoch-Schonlein purpura(Condition)Hemolytic-uremic syndrome(Condition)Poststreptococcal glomerulonephritis (GN)(Condition)Systemic lupus erythematosus(Condition)Lupus nephritis(Condition)Membranoproliferative glomerulonephritis(Condition)Hypersensitivity vasculitis(Condition)Anti-glomerular basement membrane disease(Condition)Community-acquired pneumonia in adults(Condition)Systemic lupus erythematosus - InDepth(In-Depth)Pneumonia - InDepth(In-Depth)Hepatitis - InDepth(In-Depth) Review Date: 8/28/2023 Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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Acute nephritic syndromeGlomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acuteAcute nephritic syndrome is a group of symptoms that occur with some disorders that cause swelling and inflammation of the glomeruli in the kidney, or glomerulonephritis.GlomerulonephritisGlomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged....ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Causes Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.Immune responseThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article Common causes in children and adolescents include:Hemolytic uremic syndrome (disorder that occurs when an infection in the digestive system produces toxic substances that destroy red blood cells and cause kidney injury) Hemolytic uremic syndromeShiga-like toxin producing E coli hemolytic-uremic syndrome (STEC-HUS) is a disorder that most often occurs when an infection in the digestive system...ImageRead Article Now Book Mark Article Henoch-Schönlein purpura (disease that involves purple spots on the skin, joint pain, gastrointestinal problems and glomerulonephritis) Henoch-Schönlein purpuraIgA vasculitis is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis (a type of kidney d...ImageRead Article Now Book Mark Article IgA nephropathy (disorder in which antibodies called IgA build up in kidney tissue) IgA nephropathyIgA nephropathy is a kidney disorder in which antibodies (called IgA) build up in kidney tissue. Nephropathy is damage, disease, or other problems w...ImageRead Article Now Book Mark Article Post-streptococcal glomerulonephritis (kidney disorder that occurs after infection with certain strains of streptococcus bacteria) Post-streptococcal glomerulonephritisPoststreptococcal glomerulonephritis (GN) is a kidney disorder that occurs after infection with certain strains of streptococcus bacteria.ImageRead Article Now Book Mark Article Common causes in adults include:Abdominal abscesses AbscessesAn abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.ImageRead Article Now Book Mark Article Goodpasture syndrome (also called anti-glomerular basement membrane disease in which the immune system attacks the glomerular basement membrane) Goodpasture syndromeAnti-glomerular basement membrane disease (anti-GBM disease) is a rare disorder that can involve quickly worsening kidney failure and lung disease. S...ImageRead Article Now Book Mark Article Hepatitis B or C HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Endocarditis (inflammation of the inside lining of the heart chambers and heart valves caused by a bacterial or fungal infection) EndocarditisEndocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is caused by a bacterial or, rarely, a fu...ImageRead Article Now Book Mark Article Membranoproliferative glomerulonephritis (disorder that involves inflammation and changes to kidney cells) Membranoproliferative glomerulonephritiMembranoproliferative glomerulonephritis is a kidney disorder that involves inflammation and changes to kidney cells. It may lead to kidney failure....ImageRead Article Now Book Mark Article Rapidly progressive (crescentic) glomerulonephritis (a form of glomerulonephritis that leads to a rapid loss of kidney function) Lupus nephritis (kidney complication of systemic lupus erythematosus) Lupus nephritisLupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus.ImageRead Article Now Book Mark Article Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article Vasculitis (inflammation of the blood vessels) VasculitisHypersensitivity vasculitis is an extreme reaction to a drug, infection, or foreign substance. It leads to inflammation and damage to blood vessels,...ImageRead Article Now Book Mark Article Viral diseases such as mononucleosis, measles, and mumpsMononucleosisMononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.ImageRead Article Now Book Mark Article MeaslesMeasles is a very contagious (easily spread) illness caused by a virus.ImageRead Article Now Book Mark Article MumpsMumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...ImageRead Article Now Book Mark Article The inflammation affects the function of the glomerulus. This is the part of the kidney that filters blood to make urine and remove waste. As a result, blood and protein appear in the urine, and excess fluid builds up in the body.Swelling of the body occurs when the blood loses a protein called albumin. Albumin keeps fluid in the blood vessels. When it is lost, fluid collects in the body tissues.Blood loss from the damaged kidney structures leads to blood in the urine. Symptoms Common symptoms of nephritic syndrome are:Blood in the urine (urine appears dark, tea-colored, or cloudy) Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Decreased urine output (little or no urine may be produced) Decreased urine outputDecreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...ImageRead Article Now Book Mark Article Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas SwellingSwelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...ImageRead Article Now Book Mark Article High blood pressureHigh blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Other symptoms that may occur include:Blurred vision, usually from burst blood vessels in the retina of the eye Cough containing mucus or pink, frothy material from fluid buildup in the lungs Shortness of breath, from fluid buildup in the lungs General ill feeling (malaise), drowsiness, confusion, aches and pains, headacheDrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Symptoms of acute kidney failure or long-term (chronic) kidney disease may develop.Acute kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Exams and Tests During an examination, your health care provider may find the following signs:High blood pressure Abnormal heart and lung sounds Signs of excess fluid (edema) such as swelling in the legs, arms, face, and belly Enlarged liver Enlarged liverEnlarged liver refers to swelling of the liver beyond its normal size. Hepatomegaly is another word to describe this problem. If both the liver and ...ImageRead Article Now Book Mark Article Enlarged veins in the neck Tests that may be done include:Blood electrolytes ElectrolytesElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Blood urea nitrogen (BUN) Blood urea nitrogenBUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...ImageRead Article Now Book Mark Article Creatinine CreatinineThe creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine in t...ImageRead Article Now Book Mark Article Creatinine clearance Creatinine clearanceThe creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with...ImageRead Article Now Book Mark Article Urine protein Urine proteinThe urine protein dipstick test measures the presence of all proteins, including albumin, in a urine sample. Albumin and protein can also be measured...ImageRead Article Now Book Mark Article UrinalysisUrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article A kidney biopsy will show inflammation of the glomeruli, which may indicate the cause of the condition.Kidney biopsyA kidney biopsy is the removal of a small piece of kidney tissue for examination.ImageRead Article Now Book Mark Article Tests to find the cause of acute nephritic syndrome may include:ANA titer for lupus Antiglomerular basement membrane antibody Antineutrophil cytoplasmic antibody for vasculitis (ANCA) Blood culture Culture of the throat or skin Culture of the throatA throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...ImageRead Article Now Book Mark Article Serum complement (C3 and C4) Treatment The goal of treatment is to reduce inflammation in the kidney and control high blood pressure. You may need to stay in a hospital to be diagnosed and treated.Your provider may recommend:Bedrest until you feel better with treatment A diet that limits salt, fluids, and potassium Medicines to control high blood pressure, reduce inflammation, or to remove fluid from your body Kidney dialysis, if neededKidney dialysisDialysis treats end-stage kidney disease also called kidney failure. It removes waste from your blood when your kidneys can no longer do their job. ...Read Article Now Book Mark Article Outlook (Prognosis) The outlook depends on the disease that is causing the nephritis. When the condition improves, symptoms of fluid retention (such as swelling and cough) and high blood pressure may go away in 1 or 2 weeks. Urine tests may take months to return to normal.Children tend to do better than adults and usually recover completely. Only rarely do they develop complications or progress to chronic glomerulonephritis and chronic kidney disease.Adults do not recover as well or as quickly as children. Although it is unusual for the disease to return, in some adults, the disease does return and they will develop end-stage kidney disease and may need dialysis or a kidney transplant.End-stage kidney diseaseEnd-stage kidney disease (ESKD) is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's...ImageRead Article Now Book Mark Article Kidney transplantA kidney transplant is surgery to place a healthy kidney into a person with kidney failure.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have symptoms of acute nephritic syndrome. Prevention Often, the disorder cannot be prevented, although treatment of illness and infection may help to reduce the risk.Open ReferencesReferencesRadhakrishnan J, Stokes MB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 107.Saha M, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.