Autoimmune Nephritis Flashcards
- Proteinuria usually indicates what pathology in the kidney
Decreasing GFR
- When is azotemia indicated
When BUN and serum Creatinine levels increase around 20 – 30 % and GFR falls below 70 ml/min.
- When glomerular filtration rate falls below this level, uremia occurs.
Below 60ml/min
- These are under Primary Glomerulonephritis.
Anti – GBM (Goodpasteur’s disease)
IgA Nephritis
Idiopathic Membranous Nephropathy
Membranoproliferative Nephropathy
- T or F. Secondary Glomerulonephritis are those caused by Diabetes Mellitus, Systemic Lupus Erythematosus and Infection
T
- T or F. Glomerular Nephritic Lesions are characterized by an abundance of leukocytes
T
- T or F. The hallmark of nephrotic syndrome is proteinuria (>3g in 24 hr)
T
- Manifestations of Nephrotic Syndrome
Heavy Proteinuria, Edema, Hyperlipidemia, Lipiduria, Hypoalbuminemia, minimal Hematuria
- Manifestations of Nephritic Syndrome
Hematuria, Hypertension, Low Level Proteinuria, Decreased Urine Output
- Most common clinical sign of Renal Disease
Proteinuria
- Most common cause of primary GN
IgA Nephropathy (Berger Disease)
- Major clinical findings in IgA Nephropathy
Macroscopic Hematuria, Nephrotic Syndrome, Acute Renal Failure
*Most commonly presents with bloody urine that occurs 1 – 3 days after the onset of upper respiratory infection
- A patient with IgA Nephropathy but is normotensive, minimal proteinuria and normal GFR should be assessed after how many months
6 -12 months interval
- Treatment for IgA Nephropathy
ACE Inhibitors/ARBs, they are indicated when the patient develops hypertension and proteinuria (>0.5 g/day)
- T or F. Membranous Nephritis would present mostly as nephrotic syndrome
T
- Histopathologic finding of Membranous Nephritis
Coarse Granular Staining of IgG, due to the deposition of immune complex along the urinary side of the glomerular membrane
- Two types of mesangiocapillary glomerulonephritis
Type 1 – deposition of immune complexes (IgG and C3) subendothelial
Type 2 – dense deposit disease (C3) intramembranous
- This type of mesangiocapillary glomerulonephritis appears diffuse and global in Immunofluorescent studies with mesangial rings and intense staining for C3.
Type 2
- This type of mesangiocapillary glomerulonephritis appears fine to coarse granular and strongly positive for IgG and C3. Lobules appear as negative zone
Type 1
- Anticoagulant is indicated if serum albumin is below this level
<2.5 g/dL and additional risks for thrombosis
- Immunosuppressive agents used in nephrotic/nephritic syndrome
Steroids, mycophenolate, cyclophosphamide, azathioprine
- T or F. Kidney Biopsy is indicated in autoimmune nephritides if the patient has rapidly deteriorating kidney function (doubling of Serum Creatinine over 1 -2 months of observation) in the absence of massive proteinuria (> 15g/dl).
T.
Also done in the development of active urine sediment such as in case of anti – GBM antibody, ANCA and Interstitial nephritis.
- T or F. In Membranous Nephritis and Anti – GBM autoantibodies are directed against the components within the kidneys.
T
- In MPGN and IgAN the autoantibodies are directed against components in the immune system (e.g. C3)
T
- Second most common cause of Chronic Renal Failure
Glomerulonephritis
- Most common cause of kidney failure
DM
- Classification of Azotemia
Pre – renal: decreased perfusion to the kidneys
Intra – renal: Primary kidney disease such as acute kidney injury or glomerulonephritis
Post – renal: Ureteral Obstruction
- Most common infection – related glomerulonephritis
Post – streptococcal Glomerulonephritis (PSGN)
- PSGN would present as
Presents with hematuria, pyuria, RBC casts, edema, hypertension, oliguric renal failure, and systemic symptoms of headache, malaise, anorexia, and flank pain
- GoodPasture’s or renopulmonary syndrome presents with this pulmonary symptom
Hemoptysis
- A disease wherein patient develops autoantibodies against glomerular basement antigens.
ANTI – GBM (Goodpasture’s/Renopulmonary Syndrome)
- Histopathologic Finding of Goodpasture’s /Renopulmonary Syndrome
Linear straining of IgG along BM with C3 deposition
- Histopathologic Finding of IgA Nephropathy (Berger Disease)
Deposition of IgA in the mesangium, C3 deposition, sometimes IgG & C4
- T or F. Mesangiocapillary glomerulonephritis would show lobular appearance of glomeruli (Proliferating mesangial cells and increased mesangial matrix) and double contour or tram – track appearance (cause by duplication) of basement membrane
T
