Glomerular pathology in liver cirrhosis is common in autopsies but is
underdiagnosed antemortem. The most common pathologic findings are mes
angial disease with immunoglobulin A deposits, and membranoproliferati
ve glomerulonephritis. The latter is associated, most frequently, with
hepatitis C infection and cryoglobulinemia. We describe a patient wit
h longstanding liver cirrhosis who presented with a nephritic and neph
rotic syndrome. Membranoproliferative glomerulonephritis was diagnosed
on kidney biopsy. There was no clinical, laboratory or histologic evi
dence of hepatitis C infection or cryoglobulinemia. The different aspe
cts of ''cirrhotic glomerulonephritis'' are discussed and the need for
searching for this underdiagnosed condition in patients with chronic
liver disease is emphasized.