Here, Dr Gubler describes the pathogenesis of disorders that affect components of the glomerular basement membrane, including type III and type IV collagen, laminin and fibronectin. Dr Gubler harnesses her considerable clinical experience to recommend diagnostic and management strategies for Alport syndrome, Pierson syndrome, nail–patella syndrome, benign familial hematuria/thin basement membrane nephropathy, and glomerulopathies caused by errant deposition of fibronectin and type III collagen.