Glomerular Diseases in Kidney Disease Classification

Classification Framework

Glomerular diseases are classified based on their temporal presentation and progression pattern within the kidney disease continuum that includes AKI, Acute Kidney Disease (AKD), and CKD 1, 2
AKI is defined as kidney dysfunction occurring over less than 7 days, characterized by rapid increases in serum creatinine or decreased urine output 3
AKD represents kidney dysfunction present for 7 days to 3 months, bridging the gap between AKI and CKD 2, 3
CKD is defined as kidney dysfunction persisting for more than 3 months 2, 3

When glomerular diseases persist beyond 3 months with ongoing kidney dysfunction, they are classified as CKD 1, 2
Chronic glomerulonephritis is a common cause of CKD, characterized by persistent proteinuria, hematuria, and progressive decline in GFR 2
The CKD classification system recommends cause-specific classification (including glomerular diseases) in combination with GFR and albuminuria staging 1

Glomerular diseases may initially present as AKI but transition to CKD if kidney function does not recover within 3 months 1

Invasive diagnostic workup (kidney biopsy) should be considered for unresolving AKI/AKD, which might be due to underlying glomerular disease 1

Management of glomerular diseases differs based on whether they present as AKI, AKD, or CKD 1, 2
For glomerular diseases causing AKI, immediate interventions focus on treating the underlying cause and preventing further kidney damage 2
For glomerular diseases causing CKD, long-term strategies focus on slowing progression and managing complications 2
Medication dosing should be adjusted based on current kidney function in patients with glomerular diseases 1, 4

Overlooking the need for kidney biopsy in cases of unexplained AKI, which may reveal underlying glomerular pathology 1