Renal features of Wegener's granulomatosis

The renal manifestations of Wegener's granulomatosis include:

• glomerulonephritis
• haematuria
• proteinuria
• azotaemia

Renal involvement occurs in about 77% of cases - in contrast to polyarteritis nodosa, hypertension is an unusual feature of Wegener's granulomatosis.

Notes:

• patients may present with life-threatening renal failure due to rapidly progressive glomerulonephritis requiring urgent dialysis and immunosuppression
• at the other end of the spectrum are patients with proteinuria or haematuria with no impairment of renal function
• any renal involvement is associated with a significantly worse outcome

Reference:

• 1) ARC Autumn 2012. Topical Reviews - ANCA-associated vasculitis; 1:1-12.