Glomerulonephritis Flashcards
What is glomerulonephritis?
A number of conditions which:
- are caused by pathology in the glomerulus
- present with proteinuria, haematuria or both
- are diagnosed on renal biopsy
- cause CKD
- can progress to renal failure
What is nephritic syndrome?
Inflammation of the glomerulus
What are the features of nephritic syndrome?
Haematuria
Dysmorphic RBCs
RBC casts
Hypertension
Renal impairment
What is nephrotic syndrome?
Podocyte damage
What are the features of nephrotic syndrome?
Massive proteinuria >3g/24hours or creatinine levels of 350mg/mmol
Peripheral oedema
Hypoalbuminemia <35g/L
Hypercholesterolaemia
What is glomerulonephritis?
Inflammation of the glomerulus
How is glomerulonephritis diagnosed?
Kidney biopsy
What are the non-proliferative types of glomerulonephritis?
Minimal change disease
FSGS (Focal segmental glomerulosclerosis)
Which syndrome is associated with non-proliferative glomerulonephritis?
Nephrotic syndrome
What is minimal change disease?
Most common cause of nephrotic syndrome in children
Idiopathic
Remission with steroids (prednisolone)
What is FSGS?
Focal and segmental sclerosis
Most common cause of nephrotic syndrome in adults
What are the proliferative types of glomerulonephritis?
IgA nephropathy (mesangioproliferatiive)
IgG nephropathy (membranoproliferative)
Diffuse proliferative
Crescentic
Which syndrome is associated with proliferative glomerulonephritis?
Nephritic syndrome
What is IgA nephropathy?
Berger’s diseases
Most common cause of primary glomerulonephritis
IgA deposits and glomerular mesangial proliferation
Nephrotic and Nephritic syndromes
What is the treatment of IgA nephropathy?
Corticosteroids
What is membranous glomerulonephritis?
Most common type of glomerulonephritis overall
IgG and complement deposits on the basement membrane
Nephrotic and Nephritic syndromes
What is the treatment of membranous (IgG) glomerulonephritis?
Cyclophosphamide and steroids for 6 months
What is diffuse proliferative glomerulonephritis?
Post infectious e.g. group A strep
Strep. antigen deposits in the glomerulus leading to immune complex formation and inflammation
Develop a nephritic syndrome
What is the treatment of post streptococcal GN?
Supportive
Antibiotics
Usually full recovery
What is crescentic GN?
Principal histologic finding is the presence of extensive glomerular crescents
- ANCA associated
- anti GBM
- IgA vasculitis
- SLE
Nephritic syndrome
What is ANCA associated GN?
aka Wegener’s granulomatosis
- anti neutrophil cytoplasmic antibodies
Type of vasculitis
Acute renal failure, haemoptysis, wheeze, sinusitis, saddle shaped nose
What is anti GBM GN?
aka Goodpasture syndrome
- glomerular basement membrane antibodies
Acute kidney failure and haemoptysis
What is the treatment of Goodpasture syndrome?
Corticosteroids
Cyclophosphamide
Plasmapheresis