Glomerular Diseases Flashcards
normal glomerulus what is NOT filtered out?
RBCs
proteins
in tubules, what are NOT reabsorbed?
creatinine
urea
capillary lining of endothelium in glomerulus is special how?
large fenestrated endothelium
podocytes
what so special about the basement membrane in glomerulus?
negatively charge Type IV collagen
3 types of cells in glomerulus are?
endothelial: lining
mesangial: contractile: stalk
epithelium: podocytes
what is dropsy?
severe proteinuria and you get crazy full body swelling
which protein is lost in proteinuria? how much?
albumin 3-4 g/day
why do swell in proteinuria?
not enough proteins in vessels to generate oncotic pressure of fluid back into vessels so all fluid just leaks out into tissues
3 reasons why proteins stay in glomerulus?
- negative charged BM
- Physical structure of Type IV collagen
- proteins in slit membranes (Nephrin)
Finnish subpopulation have a defect in Nephrin which causes what?
protein leakage from birth in urine
What is Alport syndrome?
mutated collagen IV subtype in BM = proteinuria
4 common reasons for proteinuria?
DMII
glomerulonephritis
amyloid deposition
Nephrin deficiency
Acute renal ‘failure’ refers specifically to what?
decrease GFR = reduced creatinine clearance
increased serum urea and creatinine
renal causes of acute renal failure? 4 main?
acute tubular necrosis
acute glomerulonephritis
acute interstitial nephritis
other. eg. vascular disease
Glomerulonephritis one or group of conditions? most often due to what?
group of conditions
immune mediated: immune complex deposition
Is there Glomerulonephritis without immune complexes?
yes. rare: pauci-immune
Acute Glomerulonephritis acute or chronic?
Can be both
Acute Glomerulonephritis cause?
post-streptococcal GN
Chronic Glomerulonephritis cause?
IgA nephropathy
what do you get if you get severe necrosis from acute Glomerulonephritis ?
crescents
What’s most common form of Glomerulonephritis in Australia?
IgA nephropathy
in Glomerulonephritis , how do glomeruli react?
BM new layers: spikes/protrusions
cell proliferation
inflammatory cell arrival
How many glomeruli are affected in diffuse or global?
ALL OF THEM!
Lots of what in Acute post-infectious Glomerulonephritis ?
neutrophils
IgG clumps on BM
what else can cause acute Glomerulonephritis besides post strep immune complexes?
antibiotic reaction
4 tools for diagnosis of Glomerulonephritis?
clinical findings
light microscopy
immunostains
electron microscopy
Glomerulonephritis in systemic lupus erythematosis histologically?
immune complex deposition in glomeruli
IgA nephropathy have immune complexes where?
mesangium
immune complexes deposit where in membranous nephropathy?
outer aspect of basement membrane
What is a Crescent in the glomerulus made of?
exuded fibrin, monocytes and podocytes
are crescents specific for one form of GN?
Nope, any response to severe injury
Injury to Gl progression
Necrotizing lesions
sclerosing lesions
sclerotic ball without capillaries
Does Glomerulonephritis resolve completely?
Some acute
Which Glomerulonephritis progress to chronic?
Lupus, HIV due to continued stimulus
Does IgA nephropathy have good prognosis?
Used to be yes. Now, not so much due to immune complex deposition
Is Diabetec nephropathy due to autoimmune?
Nope: hyperglycemia
what is THE most common cause of end stage renal failure?
Diabetec nephropathy
What renal features of early and late Diabetec nephropathy?
early: protein leakage/nephrotic syndrome
late: chronic renal failure
HUS/TTP, sever hypertension, scleroderma causes what?
acute endothelial injury
