Epidemiology

• most common type of glomerulonephritis in adults
• There is a bimodal peak in age in the 20s and 60s
• 3rd most common cause of ESRF

Causes

• Idiopathic: Due to anti-phospholipase A2 antibodies
• Infections: Hep B, malaria, syphillis
• Malignancy (in 5-20%): prostate lung, lymphoma, leukemia
• drugs: gold, penicillamine, NSAIDs
• Autoimmune diseases: SLE, thyroiditis, rheumatoid

PC

• Usually presents with nephrotic syndrome or proteinuria

Investigations

• Renal biopsy - electron microscopy: the basement membrane is thickened with subepithelial electron dense deposits. This creates a 'spike and dome' appearance

  IgG and complement deposits on the basement membrane

Management

• all patients should receive an ACE inhibitor or an angiotensin II receptor blocker (ARB):
  • these have been shown to reduce proteinuria and improve prognosis