Glomerular Disease Flashcards
what is the glomerulus?
- network of capillaries
- filters blood through
what are the 2 process of glomerulus that works toward making urine?
- ultrafiltration
- active reabsorption (need SELECTIVE permeability)
what are the 4 categories of glomerular disease?
- Acute nephritic syndromes
- Nephrotic syndromes
- asymptomatic protienuria & hematuria
- acute & chronic glomerulonephritis
Acute nephritic syndromes
-decrease in glomerular permeability(decrease in glomerular filtration rate)
(decrease filtration, retain more, keep fluids in with nitrogenous wastes, retaining nitrogenous wastes)
-fluid & nitrogen waste retention which then leads to edema and hypertension
Nephrotic syndromes
- increase in glomerular permeability
- leads to fluid loss and electrolyte loss (leading to hypotension & hypovolemia
- which will then lead to an increase in proteinuria(increase permeability protiens, large pore sizes, proteins go through & loose) and Hypoalbumenia (loss of albumin, which is a protein)
- also hyperlipidemia & lipiduria
why does hyperlipidemia & lipiduria occur with nephrotic syndromes?
secondary to proteinuria, secondary problem in liver, loosing proteins in urine, liver responds by synthesizing more proteins, as part of that synthesis more lipids produced, especially (triglycerides & LDLs)
when hyperlipidemia & lipiduria occurs with nephrotic syndromes what are the lipids that are usually produced?
-triglycerides & LDL(low density lipids)
asymptomatic proteinuria & hematuria
- asymptomatic because does not significantly affect renal function (DOES NOT AFFECT GFR)
- no impairment of kidney function
- level of proteinuria much lower than what is in nephrotic syndrome
acute & chronic gomerulonephritis
- there are several forms of glomerulonephritis
- glomerular inflammation
- several types
what is the type of golmerulonephritis we HAVE to KNOW and remember for this stupid exam?
acute post infectious (proliferative) glomerulonephritis
what is Acute post infectious (proliferative) glomerulonephritis?
- common form of glomerulonephritis
- usually in children (has a 95% recovery rate)
- is a type 3 hypersensitivity reaction
- Immune complex traps in glomerulus and glomerular function impeded
what is Acute post infectious (proliferative) glomerulonephritis usually preceded by?
Pharyngeal or Dermal infection (7-12 days after)
commonly from B hemolytic streptococcus (hemolytic is hemolysis so break down of erythrocytes during infection)
what are the manifestations of Acute post infectious (proliferative) glomerulonephritis?
- oliguria (decreased urine output), proteinuria, hematuria
- azotemia
- fluid retention: causing hypertension & edema
treatment of acute post infectious (proliferative) glomerulonephritis?
usually self limiting (recover in weeks)
symptomatic treatment
how does this type 3 hypersensitivity play out in acute post infectious (proliferative) glomerulonephritis?
immunocomplex forms from infection (antigen) this immunocomplex is to small for enzymes to detect so avoids destruction. In both cases immunocomplex pressists & exisits in circulation until finds a vesesl small enough to attach to like a capillary for example the capillaries in the kidney . The immunocomplex arrives & deposits in glomerulus, impeded perfusion obstructing pores, macrophages will try to remove, when removing causing damage causing larger holes in membrane.