Chapter 7: 1.3 - Glomerular Disorder Flashcards
Glumerolonephritis- a sterile inflammatory process associated with findings of:
blood protein casts -azotemia -edema -hypertension
- characterized by sudden onset of symptoms.
- starts with bacterial infection (Streptococcus pyogenes)
- immunologic, autoimune
Acute postretococcal glomerulonephritis
- more serious form of glomerular disease
- poorer prognosis
- initiated by deposition of immune complexes (immune systemic disorder ex: SLE, history of cancer)
- more common in adults aged 40-60
Rapidly Progressive (Crescentic) Glomerulonephritis
-caused by:
-cytotoxic antibody:
after viral, respiratory infection and alveolar basement membranes
Goodpasture’s syndrome
- this disease affects both kidneys and lungs; it usually involves rapidly progressive kidney failure that develops in days to weeks along with lung disease
- some forms involve just the lung or the kidney, not both.
Goodpasture’s syndrome
- some morphologic changes with RPGN but with hemoptysis and dyspnea
Goodpasture’s syndrome
-can progress to chronic glomerulonephritis and end-stage renal failure (2)
Goodpasture's syndrome IgA Nephropathy (Berger's Disease)
-causes a granuloma-producing inflammation of the small blood vessesls of primarily in the kidney and respiratory system
Wegener’s Granulomatosis
-antineutorphilic cytopasmic autoantibody (ANCA) binds to neutrophils in vascular walls producing damage to small vessels in the lungs and glomerulus
Wegener’s Granulomatosis
-occurs primariy in children following viral respiratory infections
Henoch-Schonelin Purpura
-symptoms include appearnce of red patches on skin, may affect the respiratory and gastroinetsinal tract such as blood in the sputum and stools
Henoch-Schonlein Purpura
-renal involvement is the most serious complication of the disorder
Henoch- Schonlein Purpura
- Caused by deposition of IgA on the glomerular membrane
- results to: increased levels of serum IgA and immune complexes containing IgA
- may be a result of mucosal infection
IgA Nephropathy (Berger’s Disease)
patient may remain asymptomatic for 20 years
IgA Nephropathy (Berger’s Disease)
- Thicking of glomerular membrane after IgG immune complex deposition
- assoc. w/ systemic lupus erythematosus, Sjogren syndrome, secondary syphilis, hepatitis B, Gold and mercury treaments and malignancy
Membranous Glomerulonephritis
-one of the most common causes of nephrotic syndrome
Membranous Glomerulonephritis
-diesea progresses slowly with possible remission but development of nepthrotic syndrome may occur
Membranous Glomerulonephritis
- characterized by cellular proliferation affecting the capillary walls or the glomerular basement
- possibly immune mediated and leukocyte infiltration
Membranoproliverative (Mesangiocapillary) Glomerulonephritis
- display increased cellularity in the subendothelial cells of the mesangium and is often progressive and
- may eventually progress to neptrotic syndrome.
Type I
Membranoproliverative (Mesangiocapillary) Glomerulonephritis
- displays extremely desne deposits in glomerular membrane
- may progress to chronic glomerulonephritis
Type II
Membranoproliverative (Mesangiocapillary) Glomerulonephritis
- marked by decrease in renal function resulting from glomerular damage precipitated by other renal disorders.
- continual or permanent damage to glomerulus
- irreversible loss of renal tissue and chronic renal failure
Chronic Glomerulonephritis
- caused by disruption of the electrical charges of the glomerulus that produce the tightly fitting podocyte barrier
- resulting in massive loss of protein and lipids
Nephrotic Syndrome
Nephrotic Syndrome:
the primary protein depleted from the circulation which appears to stimulate the increased production of ____ by the ____
albumin
lipids, liver
The lower oncotic pressure in the capillaries resulting from the depletion of plasma albumin increases the loss of fluid into the interstitial spaces, which, accompanied by sodium retention, produces ___
edema
Systemic Diseases that can lead to nephrotic syndrome: (5)
- SLE
- Amyloidosis
- DM
- Malignant neoplasms
- Infections
-not assoc. with cellular change in the glomerulus
Minimal Change disease
- occurs primarily in children (2-6)
- more often in males
Minimal Change disease
- disruption of podocytes in certain areas of glomeruli
- assoc. with heroind and analgeic abuse, AIDS
Focal Segmental Glomerulosclerosis
-symptoms may be similar to the nephrotic syndrome and minimal change disease owing to damaged podocytes
Focal Segmetnal Glomerulosclerosis
- affects both children and adults
- males are more affected
- african americans are more affected
Focal Segmental Glomeruloscerlosis
causes about 10-15% of all cases of nephrotic syndrome
Focal Segmental Glomerulosclerosis
- occurs most often in males
- during respiratory infections
- inherited sex-linked or autosomal genetic disorder
Alport Syndrome
-most commmon cause of end-stage renal disease
Diabetic Nephropathy (Kimmelstiel-Wilson Disease)
- damage to the glomerular membrane occurs not only as a result of glomerular membrane thickening but also because of the increased proliferation of mesangial cells and increased deposition of cellular and noncellular material
- accumulation of solid substances around the capillary tufts.
- deposition of glycosylated proteins
- early monitorin of DM patient for microalbuminuria is important to detect onset of diabetic nephropathy
Diabetic Nephropathy
