Common Types of Glomerulonephritis(GN)

Question 1

what are the 5 main types of GN

Answer 1

minimal change, FSGS, membranous, membranoproliferative, IgA nephropathy
(all are most commonly idiopathic)

Question 2

what type of cell does minimal change GN affect

Answer 2

podocytes

Question 3

what type of GN is the commonest cause of nephrotic syndrome in children

Answer 3

minimal change

Question 4

what drug puts 94% minimal change GN patients in complete remission, and what is 2nd line

Answer 4

oral steroids

2nd line = cyclophosphamide/CSA

Question 5

what GN type is the commonest cause of nephrotic syndrome in adults

Answer 5

FSGS(focal segmental glomerulosclerosis)

Question 6

describe the renal biopsy seen with minimal change GN

Answer 6

normal on LM and IF, but see foot process fusion on EM

Question 7

describe the progression to renal failure seen in minimal change and FSGS GN

Answer 7

minimal change = do NOT cause progressive renal failure

FSGS = 50% get end-stage renal failure in 10 years

Question 8

describe the renal biopsy seen with FSGS

Answer 8

as name describes, focal segmental glomerulosclerosis

Question 9

describe the FSGS response to steroids

Answer 9

60% patients have remission with prolonged steroid use

Question 10

what GN is the 2nd most common cause of nephrotic syndrome in adults

Answer 10

membranous nephropathy

Question 11

what are some important secondary causes of membranous nephropathy

Answer 11

infections(eg Hep B), connective tissue disease(EG SLE), malignancies, drugs

Question 12

describe the prognosis of membranous nephropathy

Answer 12

30% progress to end-stage renal failure in 10 years

without treatment

Question 13

what is seen in renal biopsy for membranous nephropathy

Answer 13

thickened basement membrane

Question 14

what is the commonest nephropathy in the world

Answer 14

IgA nephropathy

Question 15

how does IgA nephropathy typically present

Answer 15

asymptomatic microhaematuria and CKD

Question 16

what is seen in renal biopsy of IgA nephropathy

Answer 16

mesangial proliferation and expansion on light microscopy with IgA deposits in mesangium on IF

Question 17

describe what Rapidly progressive GN(RPGN) is

Answer 17

treatable cause of AKI, rapid deterioration renal function over days/weeks, assoc. with glomerular crescents

Question 18

what is RPGN typically caused by

Answer 18

ANCA +ve vasculitis

Question 19

what are some of the ANCE -ve causes of RPGN

Answer 19

Goodpasture’s(Anti-GBM), HSP, SLE

Question 20

describe the treatment for RPGN

Answer 20

prompt with strong immunosuppressants (steroids or cytotoxics) and support, including dialysis if needed, and plasmapharesis