Primary idiopathic glomerulonephritis: modern algorithm for diagnosis and treatment.

In most countries glomerulonephritis is the second most common cause of the end-stage renal disease, after diabetic nephropathy in renal replacement therapy programs. Occurence of primary glomerular diseases in young and middle aged patients, in whom they restrain their lives and professional careers, results in their particular position among causes of replacement therapy. A highly important component of the therapeutic approach to nephrotic patients is appropriate symptomatic treatment. Proteinuria reduction is crucial in the prevention of progressive kidney function decline in the course of glomerulonephritis. A long-term therapy of glomerulonephritis should be conducted both by the general internal medicine specialist and the nephrologist. The treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can be performed by the internist, but the immunosuppressive programs should be initiated and supervised by the nephrologist.