7.2 Glomerulonephritis Flashcards
look at histology slides
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why can RBCs leak out
natural filtration barrier damaged
simply, what is nephritic syndrome?
inflammation disrupting glomerular basement membrane
simply, what is nephrotic syndrome?
podocyte damage leading to glomerular barrier disruption
how does proteinuria cause oedema in nephrotic syndrome?
loss of proteins means less albumin in blood, oncotic pressure of capillaries decreases
cant draw water from interstitium to circulation
fluid pools in extremities
triad of nephrotic syndrome
massive proteinuria
hypoalbuminaemia
oedema
(high cholesterol)
how to test for massive proteinuria
urinalysis
process of diabetic nephropathy
excess blood glucose binds proteins, esp at E arteriole
causes hyaline atherosclerosis, thick so cant respond to changes in BP
obstructs blood flow
initially increase GFR
mesangial cells secrete more matrix over time soBM thickens
GFR decrease
treatment of diabetic nephropathy
-glycaemic control
-ACEi/ ARB
-lower bp
light microscope changes in minimal change disease
none (need e- microscope)
why is there protein loss in minimal change disease?
glomerular capillaries have fuse foot processes so don’t form good filtration barrier
treatment of membranous glomerulonephritis
steroids, immunosuppressant, treat underlying cause
primary FSGS cause
idiopathic
secondary FSGS cause
-sickle cell
-HIV
-heroin
-kidney hypo perfusion
how does FSGS cause kidney sclerosis?
protein build up in glomerulars, hyalinosis, sclerosis with scarring and loss of functional filtration
why can FSGS lead to chronic renal failure?
scarring, loss of functional tissue
management of nephrotic syndrome
ACEi
Diuretics + salt/fluid restriction: oedema
treat hypercholesterolaemia
treat underlying condition
triad of nephritic syndrome
haematuria
reduced GFR
hypertension
4 causes of nephritic syndrome
- IgA nephropathy
- rapidly progressive GN
- goodpasture’s
- post-streptococcal GN
treatment of IgA nephropathy
control BP, steroids
what happens in rapidly progressive GN?
severe injury, leakage of: firkin, macrophages
epic cells proliferate
=crescent shape mass
renal function loss in days-weeks
treatment of rapidly progressive GN
high dose steroids, immunosuppressant, plasma exchange
how does post-streptococcal GN occur?
1-3 weeks after group A b-haemoltyic strep infection of tonsils, pharynx or skin that didn’t fully recover
treatment of post-streptococcal GN
stronger, longer ABx
management of nephritic syndrome
ACEi
salt restriction
treat oedema (diuretics)
immunosupprressant
stop smoking, diet
dialysis short term
