7. Nephrotic And Nephritic Conditions Flashcards
What are the 4 structures in glomerulus that can be damaged in glomerulonephritis?
Capillary endothelium
Glomerular basement membrane
Mesangial cells
Podocytes
What happens in nephritic syndrome?
Inflammation disrupting glomerular basement membrane
Blood cells can pass through into urine
What happnes in nephrotic syndrome?
Podocyte damage leading to glomerular charge-barrier disruption
Can cause oedema
Proteinuria
What is the triad in nephrotic syndrome?
Proteinuria >350mg/mmol
Hypoalbuminaemia
Oedema
Usually accompanied by high cholesterol
What are some other features of nephrotic syndrome?
BP often normal
Creatinine may be normal
What are the causes of nephrotic syndrome?
Primary renal disease - minimal change disease, membranous glomerulonephritis, focal segmental glomerulosclerosis
Secondary renal disease - diabetes, lupus, amyloid
What is the management for oedema in nephrotic syndrome?
Diuretic, need large doses and may need to be IV
Salt and fluid restriction
What is the management for nephrotic syndrome?
Treat oedema
ACE-inhibitor - interrupt RAAS system, to reduce BP and absorption of water
Hypercholesterolaemia- lifestyle advice, statins
Treat underlying condition
What is the triad in nephritic syndrome?
Haematuria
Reduction in GFR
Hypertension
What are the other features of nephritic syndrome?
Often some proteinuria but less than nephrotic syndrome
Disruption of endothelium results in inflammatory response and damage to glomerulus
Onset may be acute or rapidly progressive
Rapidly progressive/crescentic GN - a fulminant form of nephritic syndrome
What are the common causes of nephritic syndrome?
Goodpasture’s syndrome
Readily progressive GN
IgA nephropathy (Berger’s disease)
Post-streptococcal GN
What is the management of nephritic syndrome?
Blood pressure control/reduction of proteinuria - ACE-I, salt restrict
Treatment for oedema - diuretics
Disease specific treatments - immunosuppressants, RPGN
Cardiovascular risk management
Dialysis (short-term)
What does a history of frothy urine suggest?
Heavy proteinuria
What is the most common cause of nephrotic syndrome in children?
Minimal change GN
