Modern approaches to the chronic glomerulonephritis classification

Chronic (CGN) glomerulonephritis (GN) is a heterogeneous group of immune-mediated kidney diseases requiring a clear classification system to optimize diagnosis and therapy. This article reviews the evolution of CGN classification, from clinical and morphological criteria to modern immunopathogenetic frameworks. The importance of categorizing CGN into five major groups (immune complex GN, antineutrophil cytoplasmic antibody (ANCA)-associated GN, anti-glomerular basement membrane disease, monoclonal immunoglobulin-associated GN, and C3-glomerulopathy) based on pathogenesis, activity, and degree of chronicity is emphasized. Advantages of immunophenotyping-based classification, integrating analysis of biopsy samples, serological markers, and genetic data, are presented. Emerging approaches enable personalized treatment, including immunosuppression, clone-oriented therapies, and targeted cytokine/complement blockade. The necessity of integrating molecular-immunological data into clinical practice to enhance diagnostic accuracy and therapeutic efficacy is highlighted. Modern CGN classification systems pave the way for targeted drug use and improved patient outcomes.