glomerulonephritis Flashcards
what is glomerulonephritis
immune-mediated disease of the kidneys affecting the glomeruli
what cells surround the capillaries
podocytes
what can disruption of the capillary wall cause
haematuria and/or proteinuria
what type of lesion does damage to endothelial or mesangial cells lead to
proliferative lesion and red cells in urine
what does damage to podocytes lead to
non-proliferative lesion and protein in urine
what happens when endothelial cells are attacked
vasculitis
diagnosis of GN
- clinical presentation
- blood tests
- examine urine (urinalysis, urine microscopy etc)
- kidney biopsy
presentation of GN
- haematuria
- proteinuria/albuminuria
- AKI/CKD
- hypertension
- nephrotic and nephretic syndrome
what is nephretic syndrome
- acute decline in kidney function
- oliguria
- oedema caused by fluid retention
- hypertension
- active urinary sediment
what is nephrotic syndrome
- proteinuria
- hypoalbuminaemia
- oedema
- hypercholesterolaemia
- usually normal renal function
complications of nephrotic syndrome
- infections
- renal vein thrombosis
- pulmonary emboli
- volume depletion may lead to AKI
two types of GN
primary - autoimmune
secondary - caused by infection or drugs, or part of a systemic disease
what does it mean if GN is crescentic
presence of crescents - extracapillary proliferation of inflammatory cells within Bowman’s space
non-immunosuppressive treatment of GN
- anti-hypertensive
- ACE inhibitors/ARBs
- SGLT2i
- diuretics
- statins
- anticoagulants in nephrotic with hypoalbuminaemia
immunosuppressive treatment of GN
- corticosteroids
- alkylating agents
- calcineurin inhibitors
- anti-proliferatives
- plasmapheresis
- IV immunoglobin
- monoclonal antibodies
