[Proceedings: Classification and anatomo-clinical correlations of glomerular nephropathies].

A number of classifications may be proposed according to whether glomerulopathy is defined from a morphological, clinical, etiological or pathogenetic point of view. However, glomerulopathies are now best defined according to histopathological criteria since from a practical point of view this is the only way in which prognosis can be evaluated. We propose a classification of glomeruloneyhritis essentially based on morphology as well as on the etiological circumstances in which the glomerulopathy is discovered. Four types of glomerular lesions (GL) may be disclosed: 1. The pathognomonic GL are rare and include thrombotic microangiography, amyloidosis, diabetic glomerulosclerosis, lupus nephritis with hematoxyphil bodies, etc. 2. The GL seen in primary glomerulopathies may be divided into 3 subgroups: minimal, focal (segmental and focal glomerulonephritis and focal glomerular sclerosis) or diffuse (membranous nephropathy and the various types of proliferative glomerulonephritis). The clinical presentation and course are studied for each of these varieties. 3. The GL seen in specific diseases (acute post-infectious glomerulonephritis, septicemia, systemic diseases, Goodpasture's syndrome, essential cryoglobulinemic glomerulonephritis, etc.) are in many ways similar to most of the lesions seen in primary glomerular diseases, but may have a different prognosis. 4. The GL seen in hereditary nephropathies (Alport's syndrome, nail patella syndrome, infantile mesangial sclerosis, partial lipodystrophy, amyloidosis of FMF, storage diseases, etc.) show, in most cases, specific morphological features. It is important for the clinican to know the natural history of these clinicopathologic entities in order to take appropriate decisions regarding possible treatment. Moreover, the fact that some of these glomerular lesions may recur on the grafted kidney is one more reason for identification of the underlying disease.