Chronic hom Flashcards
Description
Chronic Glomerulonephritis (CGN) is a progressive kidney disorder characterized by long-term inflammation and scarring of the glomeruli, the filtering units of the kidneys.
· This condition ultimately leads to chronic kidney disease (CKD) and end-stage renal disease (ESRD)
Physiology
Physiology
o Immune Mechanisms: Immune complex deposition and complement activation cause inflammation and glomerular damage.
o Non-Immune Mechanisms: Hypertension and metabolic stress (e.g., diabetes) lead to glomerular and tubular injury
· Functional Changes
o Glomerular Damage: Leads to proteinuria, hematuria, and reduced glomerular filtration rate (GFR).
o Tubular Dysfunction: Impairs urine concentration and electrolyte balance.
Causes
Proteinuria and Oedema: Due to GBM damage and hypoalbuminemia.
o Hypertension: From sodium retention and RAAS activation.
o Azotaemia: Accumulation of waste products from declining GFR.
Symptoms
There is hyalinization of glomeruli, tubular atrophy and interstitial fibrosis
· Presentation
o Presents as chronic renal failure
o 30-50 of patients who require haemodialysis have chronic CrGN
o 20% of cases have no history of renal disease
o Usually first noted in young and middle-aged adult
Diagnosis
Laboratory Tests
o Urinalysis: Detects proteinuria, hematuria, and cellular casts.
o Blood Tests:
§ Renal Function: Elevated blood urea nitrogen (BUN) and creatinine.
§ Electrolytes: Hyperkalaemia, metabolic acidosis.
Prognosis
Poor without treatment, progression to uraemia and death
o Progression extremely variable (10 years)
o Renal dialysis and transplantation allow long-term survival
Treatment
Sodium restriction to reduce hypertension and oedema.
§ Protein intake adjustment to reduce kidney workload.
o Blood Pressure Control:
§ Target: ≤130/80 mmHg.
Cure: No complete cure for chronic forms; treatments aim to manage and slow progression.
o Vaccines: No specific vaccines for CGN; prevent triggers like infections (e.g., immunization against streptococcal infections)bn
