Concept Map of Proliferative Glomerulonephritis: a novel classification?

          

A recent article in AJKD 2014 discusses a novel way to look at Proliferative GN. Dr Sethi proposes a new classification that can better be of aid to the pathologist and the clinician. The general term of proliferative GN can be used for mesangial proliferative which can be IgA predominant or could be a full house pattern with lupus nephritis. It can be membrano-proliferative which then leads to a host of different causes. Finally, it really doesn’t give us a clue of the underlying disease.  Based on the article, Sethi proposes a IF based approach.  In general, Proliferative GN is light microscopy finding.  The concept map below summarizes the new approach to proliferative GN.  Electron microscopy helps confirm the diagnosis but may not be that essential given the above classification( especially in low income nations where this cannot be possible). Click on image to see enlarged view( based on Sethi Classification of Prolif GN based on AJKD article above)