American Board of Internal Medicine (ABIM) Certification Practice Exam

Hepatitis B is typically associated with which type of glomerulopathy?

1. Minimal change disease

2. Focal segmental glomerulosclerosis

3. Membranous glomerulopathy

4. Acute interstitial nephritis

The correct answer is: Membranous glomerulopathy

Hepatitis B is primarily associated with membranous glomerulopathy due to the immune-mediated response to the viral antigens present in the systemic circulation. In this condition, the presence of hepatitis B infection can lead to the formation of immune complexes that deposit in the subepithelial space of the glomeruli, resulting in thickening of the glomerular basement membrane. This thickening disrupts normal kidney function, leading to the clinical presentation often seen in membranous nephropathy, such as nephrotic syndrome, characterized by significant proteinuria, hypoalbuminemia, and edema. While other glomerulopathies may occur in the context of various infections or systemic diseases, the specific association between hepatitis B and membranous glomerulopathy is well-established in clinical literature. This connection is especially emphasized in patients with chronic hepatitis B infection, as these individuals are at a higher risk for developing this particular form of kidney disease. Therefore, recognizing this association can aid in the diagnosis and management of renal complications in patients with hepatitis B.