Glomerular Diseases Flashcards
Function of kidney
- barrier: size and charge
- Filters 120-180L/day of plasma water
inflammation of the capillaries
GN (Glomerular Nephritis)
Attract ____ to the tuft and react with antigens/epitopes to produce more cytokines and proteases causing damage
- neutrophils,
- Macs
- T cells
Persistent GN that worsens renal function is always accompanied by
- interstitial nephritis,
- renal fibrosis
- tubular atrophy
Best histo correlate of GN
TIN
- Asymptomatic, +3-5 RBCs/hpf in a spun first voided urine
- Gross - rare except in IgA nephropathy and sickle cell disease
- R/O atomic lesions esp in men; ddx - BPH, IN, papilary necrosis, stones, cysts, vascular
Hematuria
Sustained: more than 1-2 gm/24 hours
- Seen in some inflammatory glomerular disease
- Proteinuria
- pyuria
- 1-2 gm/day proteinuria,
- hematuria with RBC casts,
- pyuria,
- HPN,
- edema,
- decreasedGFR
ACUTE NEPHRITIC
RPGN + lung hemorrhage (GPS, ANCA, LN, cryoglobulinemia)
PULMONARY-RENAL
- heavy proteinuria,
- HPN,
- high chole,
- hypo alb,
- edema/anasarca,
- mxic hematuria
NEPHROTIC SYNDROME
abnormal or injured BM due to autoimmune response + mxic hematuria, mild
to heavy proteinuria + HPN, variable increase in crea
BASEMENT MEMBRANE
vascular injury producing hematuria and moderate proteinuria
GLOMERULAR-VASCULAR
Done in selected patients, clinically stable, adequate blood clotting parameters and willing and able to receive treatment
ULTRASOUND GUIDED BIOPSY
LIGHT MX
- Hand and E:
- PAS:
- Jones methenamine silver stain:
- Congo red:
- Masson’s trichrome:
- Hand and E: cellularity and architecture
- PAS: CHO moieties
- Jones methenamine silver stain: enhance BM structure
- Congo red: amyloid deposits
- Masson’s trichrome: collagen deposits, degree of glomerulosclerosis and interstitial fibrosis
- prototype for acute endocapillary proliferative GN
- Developed countries: elderly M>F; 2-14 y.o.
- Skin and throat infections with M type streptococci
+ Skin 2-6 weeks after impetigo
+ Pharyngitis 1-3 weeks after infection
POST STREP GN