Differentials
Focal segmental glomerulosclerosis
SIGNS / SYMPTOMS
More common in black people. Clinically indistinguishable, as presents with nephrotic syndrome characteristics.
INVESTIGATIONS
Renal biopsy shows glomerulosclerosis on light microscopy in a focal and segmental pattern. Immunofluorescence usually negative.
Minimal change disease
SIGNS / SYMPTOMS
More common in children. Clinically indistinguishable, as presents with nephrotic syndrome characteristics.
INVESTIGATIONS
Electron microscopy of biopsy shows diffuse podocyte effacement. Light microscopy and immunofluorescence normal.
Mesangioproliferative glomerulonephritis
SIGNS / SYMPTOMS
Presents with nephrotic syndrome. Haematuria may also be present.
INVESTIGATIONS
Renal biopsy; light and electron microscopy show pattern of cellular proliferation; immunofluorescence microscopy may show patterns of immune complex deposition.
Complement levels more commonly low, and cryoglobulins may be present.
Amyloidosis
SIGNS / SYMPTOMS
Can affect other organ systems such as heart and peripheral nerves. Hypotension may be present.
INVESTIGATIONS
Light microscopy reveals glomerular amyloid deposits with Congo red staining under polarised light. Electron microscopy shows deposition of protein fibrils.
Diabetic nephropathy
SIGNS / SYMPTOMS
History of diabetes mellitus.
INVESTIGATIONS
Renal biopsy: mesangial expansion, fibrosis, and classic Kimmelstiel-Wilson nodules.
Use of this content is subject to our disclaimer