From the Guidelines
To screen for glomerulonephritis, order a comprehensive panel including complete blood count (CBC), comprehensive metabolic panel (CMP), urinalysis with microscopy, urine protein-to-creatinine ratio, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), as well as specific serological tests such as complement levels (C3, C4), anti-nuclear antibody (ANA), anti-neutrophil cytoplasmic antibodies (ANCA), and anti-glomerular basement membrane (anti-GBM) antibodies, as recommended by the most recent guidelines 1.
Key Tests for Glomerulonephritis Screening
- Complete blood count (CBC) to assess for anemia, thrombocytosis, or other abnormalities
- Comprehensive metabolic panel (CMP) to evaluate kidney function and electrolyte balance
- Urinalysis with microscopy to detect hematuria, proteinuria, and cellular casts
- Urine protein-to-creatinine ratio to quantify proteinuria
- ESR and CRP to assess for inflammation
- Complement levels (C3, C4) to evaluate immune complex-mediated disease
- ANA, ANCA, and anti-GBM antibodies to identify specific autoimmune causes
Additional Tests Based on Clinical Context
- Hepatitis B, hepatitis C, and HIV testing if infections are suspected as triggers for glomerulonephritis
- Anti-double stranded DNA and anti-Smith antibodies for suspected lupus nephritis
- Immunoglobulins (IgA, IgG, IgM) to assess for monoclonal gammopathies, as discussed in the evaluation of monoclonal gammopathy of renal significance 1
Importance of Early Diagnosis
Early diagnosis through these blood tests allows for prompt treatment and better preservation of kidney function, emphasizing the importance of a comprehensive screening approach for glomerulonephritis, as supported by recent clinical guidelines and research findings 1.
From the Research
Glomerulonephritis Screening
To screen for glomerulonephritis, the following blood tests can be ordered:
- Full blood count to check for anaemia and infection
- Urea and electrolytes to assess kidney function
- Creatinine to evaluate kidney function
- Electrolyte panel to check for electrolyte imbalances
- Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to assess inflammation
- Autoantibody tests, including:
- Anti-neutrophil cytoplasmic antibodies (ANCA) to diagnose ANCA-associated vasculitis
- Anti-glomerular basement membrane (anti-GBM) antibodies to diagnose anti-GBM disease
- Complement levels (C3 and C4) to diagnose C3 glomerulopathy
- Immunoglobulins (IgA, IgG, IgM) to diagnose immune-complex glomerulonephritis As stated in the study 2, the gold standard for diagnosis is a kidney biopsy, which shows hallmark glomerular inflammation and various histopathological patterns depending on the location and severity of the glomerular injury.
Classification of Glomerulonephritis
Glomerulonephritis can be broadly classified into several categories, including:
- Immune-complex glomerulonephritis (including infection-related glomerulonephritis, IgA nephropathy, lupus nephritis, and cryoglobulinaemic glomerulonephritis)
- Anti-neutrophil cytoplasmic antibodies-associated (pauci-immune) glomerulonephritis
- Anti-glomerular basement membrane glomerulonephritis
- C3 glomerulopathy
- Monoclonal immunoglobulin-associated glomerulonephritis, as discussed in the study 2.