302 Inflammatory (intrinsic) kidney disease Flashcards
Name some common nephritic glomerulonephritis subtypes
Nephritic (Haemoproteinuria -/+ high BP)
IgA nephropathy
Post-infectious GN
Membranoproliferative GN (MPGN)
Lupus Nephritis (Assoc with SLE)
Cryoglobulinaemia
Name some common nephrotic glomerulonephritis subtypes
Nephrotic (Proteinuria >3g/day)
Minimal change nephropathy
Membranous Glomerulopathy
Diabetic nephropathy
Focal Segmental Glomerulosclerosis (FSGS)
What is the difference between nephritic and nephrotic?
Nephritic: a clinical syndrome that presents as haematuria, elevated blood pressure, decreased urine output, and oedema.
-Caused by inflammation to the glomerulus
Nephrotic: a kidney disorder that causes your body to pass too much protein in your urine
-Usually caused by damage to the glomeruli
What is IgA nephropathy?
When IgA builds up in the kidney and causes local inflammation that, over time, can hamper your kidneys’ ability to filter waste from your blood
What is Henoch-Schonlein purpura?
AKA IgA vasculitis
A disorder that causes capillaries in your skin, joints, intestines and kidneys to become inflamed and bleed
Symptoms: Rash, Arthralgia, Abdominal pain +/- bloody diarrhoea, Renal disease
What is SLE?
AKA systemic lupus erythematosus
Autoimmune condition can be associated with ANA positivity
50% have renal involvement
Affects:
Arthritis/arthralgia
Fatigue
Sun sensitive skin rash
Heart/lungs/GI/haem/TED/neuropsychiatric/eyes/spleen/bones
What are the physiological consequences of glomerulonephritis?
Oedema
Hypertension
Worsening renal function
What are the 3 main causes of oedema?
Heart failure
Cirrhotic liver disease
Nephrotic renal disease
What is the triad for nephrotic disease?
Oedema
Hypoalbuminaemia
Proteinuria >3g/24 hrs (UPCR >300 mg/mmol)
What are the primary causes of nephrotic disease?
Minimal Change nephropathy
Membranous nephropathy
Focal segmental glomerulosclerosis
What are the secondary causes of nephrotic disease?
Diabetic nephropathy
Renal amyloidosis
Multiple myeloma
SLE with renal involvement
What is minimal change disease?
A disorder where there is damage to your glomeruli that can’t be seen under a regular microscope
Treatment: High dose steroids
What is FSGS (focal segmental glomerular sclerosis)?
When scar tissue develops on the glomeruli
50% have haematuria as well
Secondary to obesity/HIV/heroin/reduced nephron mass
Treatment: High-dose steroids / Tacrolimus (in primary diseases)
What is Membranous nephropathy?
A kidney disorder that leads to changes and inflammation of the glomeruli
PLA2R antibody (present in primary membranous). Secondary cause highly associated with malignancy
One of the lupus nephritis presentation
Treatment: high dose steroids and
cyclophosphamide alternating months for 6 months
What is amyloidosis?
Abnormal production and deposition of amyloid fibrils in organs
AA related to chronic infection
AL related to plasma cell dyscrasia
(also age-related and inherited forms)
