Glomerulanephritis

Question 1

Epidemiology

Answer 1

chronic - 1/3 leading cause of end stage renal disease

Question 2

Aetiology

Answer 2

primary, originating in the kidneys,
or secondary, caused by a vast array of disorders - SLE, polyarteritis nodosa

-postinfectious glomerulonephritis.
as a complication of a throat or skin infection with streptococcus or other bacteria/parasites, in children between the ages of 2 and 10 after recovery from the infection.

• Genetic
• Immune - lupus, vasculitis

Question 3

Pathogenesis

Answer 3

acute or chronic infammation of the glommerulus of the kidney.

Leads to increased cell proliferation and thickening membranes.

Resulting in a failure of the filtration/osmotic control of the blood.

Minimal change.
Diffuse: affecting all glomeruli.
Focal: affecting only some of the glomeruli.
Segmental: only affecting parts of an affected glomerulus

Question 4

Natural history

Answer 4

end stage kidney disease

Question 5

Clinical Manefestations

Answer 5

characterized by body tissue swelling (edema), high blood pressure, and the presence of red blood cells in the urine

Question 6

Symptoms

Answer 6

About half of the people with acute glomerulonephritis have no symptoms.

If symptoms do occur, the first to appear are tissue swelling (edema) due to fluid retention, low urine volume, and production of urine that is dark because it contains blood.

Edema may first appear as puffiness of the face and eyelids but later is prominent in the legs.

Blood pressure increases as kidney function becomes impaired. Some people become drowsy or confused.

In older people, nonspecific symptoms, such as nausea and a general feeling of illness (malaise), are more common.

Question 7

Signs

Answer 7

Asymptomatic haematuria and/or proteinuria.

Nephrotic syndrome: heavy proteinuria, hypoalbuminaemia and fluid retention.

Nephritic syndrome: haematuria (sometimes macroscopic), proteinuria, a fall in glomerular filtration rate (GFR), salt and water retention and hypertension.

Chronic glomerulonephritis involves a much slower deterioration in renal function, usually over several years, accompanied by haematuria, proteinuria and hypertension.

Question 8

Complications

Answer 8

1% of children and 10% of adults who have acute glomerulonephritis, it evolves into rapidly progressive glomerulonephritis, in which most of the glomeruli are destroyed, resulting in kidney failure.

When rapidly progressive glomerulonephritis develops, weakness, fatigue, and fever are the most frequent early symptoms. Loss of appetite, nausea, vomiting, abdominal pain, and joint pain are also common.

About 50% of people have a flu-like illness in the month before kidney failure develops. These people have edema and usually produce very little urine. High blood pressure is uncommon and rarely severe when it does occur.

Hypertension may accelerate the decline in renal function so tight blood pressure control is an essential part of the management of all forms of glomerulonephritis.

Nephrotic syndrome: for example, thrombotic episodes, pneumococcal infection.

Question 9

Prognosis

Answer 9

This depends on the type of glomerulonephritis but treatments for glomerulonephritis remain nonspecific, often leading to side-effects and only partly successful.

Chronic kidney disease
1% Children
10% Adults