Glomerular disorders Flashcards
Nephritic syndrome
- Hematuria,
- proteinuria (<3g/d),
- RBCs & RBC casts
- HTN & volume overload
- Oliguria
- Rapid loss of GFR
Nephrotic syndrome
- Marked proteinuria (> 3g/ day) albumin
- Few cells
- Foamy urine
- hypoalbuminemia,
- massive edema,
- hyperlipidemia,
- fat bodies in urine
Postinfectious Glomerulonephritis- Eti
- Following pharyngitis or impetigo
- Viral, fungal, parasitic or bacterial
Postinfectious Glomerulonephritis- Sx
Nephritic:
- Oliguria
- Hematuria
- < 3g/d proteins
- Edema
Postinfectious Glomerulonephritis- Dx
- Biopsy: Immume complexes in mesangium, deposits or “humps”
- Low serum complement C3
- High ASO
Postinfectious Glomerulonephritis- Tx
- Supportive, salt restriction, diuretics, anti-HTN
Goodpasture syndrome- Eti
Nephritic syndrome:
- Males in 2nd/ 3rd decade
- Some assoc with pulm, tobacco
- Anti glomerular basement memebrane Abs
Goodpasture syndrome- Sx
- Preceeded by URI
- Hemoptysis, dyspnea, resp. failure
- Hematuria/ proteinuria
Goodpasture syndrome- Dx
- Sputum- macrophages
- CXR- pulm infiltrates
- Anti-GBM Abs
- Biopsy- IgG along GBM
- ANCA titers
Goodpasture syndrome- Tx
- Plasma exchange tx
- Corticosteroids
IgA Nephropathy- Eti
Nephritic syndrome:
- Most common glomerular disease in world- Asians!
- M > F, young > old
IgA Nephropathy- Sx
- Gross hematuria associated with mucosal viral infection
- Red or cola colored urine
- Nephritic syndrome sx
IgA Nephropathy- Dx
- Biopsy: Postive IgA
- Normal complement
- Gross hematuria
IgA Nephropathy- Tx
- Low: monitor annually
- Med to high: ACE/ ARB, Immunosupressants
- Kidney transplant
Henoch-Schönlein purpura- Eti
Systemic vasculitis- children
Henoch-Schönlein purpura- Sx
- Purpura on lower extremities
- Knee and ankle pain
- Abd pain, GI bleeding
Henoch-Schönlein purpura- Dx
- Kidney biopsy- cresents & mesangial IgA deposits
Henoch-Schönlein purpura- Tx
Prednisone
Pauci-immune glomerulonephritis- Eti
Nephritic syndrome:
- Due to churg strauss, polyangiitis
- ANCAs
Pauci-immune glomerulonephritis- Sx
- Fever, malaise & wt loss
- Hemat & proteinuria
- Upper & lower resp tract infections
- Purpura
Pauci-immune glomerulonephritis- Dx
- ANCA +
- Renal biopsy
Pauci-immune glomerulonephritis- Tx
- High dose corticosteroids
Minimal change disease- Eti
Nephrotic syndrome:
Children, idiopathic, following URI, hypersensitivity rxn
- Assoc with tumors, drugs (lithium)
Minimal change disease- Sx
- Marked proteinuria (> 3g/ day) albumin
- Few cells
- Foamy urine
- hypoalbuminemia,
- massive edema,
Minimal change disease-Dx
- Biopsy: podocyte foot processes
Minimal change disease-Tx
Prednisone
Focal segmental glomerulosclerosis- Eti
Nephrotic syndrome:
- Common
- Due to primary renal disease
- Secondary to heroin, obesity, urinary reflux, AIDS
Focal segmental glomerulosclerosis- Sx
- Protein uria
- Decreased GFR
- Marked edema
- End stage renal in 6-8 yrs
Focal segmental glomerulosclerosis- Dx
Renal biopsy- fusion of epithelial foot processes
Focal segmental glomerulosclerosis- Tx
- Diuretics
- Prednisone
