Glomerulonephritis Flashcards
GN definition
Inflammation of glomeruli in the kidneys
What is nephritic syndrome?
It refers to a group of symptoms that occur in nephritis (inflammation of the kidneys)
What are the features in nephritic syndrome?
Haematuria (blood in the urine), which can be microscopic (not visible) or macroscopic (visible)
Oliguria (significantly reduced urine output)
Proteinuria (protein in the urine), but less than 3g per 24 hours (higher protein suggests nephrotic syndrome)
Fluid retention
What is nephrotic syndrome?
Nephrotic syndrome refers to a group of symptoms that happen when the basement membrane of glomeruli becomes highly permeable, resulting in protein being filtered through
What are the features in nephrotic syndrome?
Massive proteinuria (more than 3g per 24 hours) - might see frothy urine
Low serum albumin (less than 25g per litre)
Peripheral oedema
Hypercholesterolaemia
Why is there hypercholesterolaemia in nephrotic presentations?
Low albumin as well as general protein loss induces liver production of albumin as well as other proteins like lipoproteins (eg LDL, VLDL)
Massive proteinuria means a lot of enzymes like lipoprotein lipase are excreted, so there is an impaired clearance rate
Why is there peripheral oedema in nephrotic syndrome?
Loss of protein leads to reduced oncotic pressure, resulting in fluid shift from vascular compartment into interstitial fluid.
Hypovolaemia stimulates both the renin-angiotensin-aldosterone system and ADH production, which retains sodium and water in the body, further exacerbating oedema.
What conditions does nephrotic syndrome predispose patients to?
It predisposes patients to thrombosis, hypertension and high cholesterol
In HTN, the trigger of RAAS not only induces Na+/H2O retention, but also don’t forget angiotensin II is a potent vasoconstrictor. Hypercholesterolaemia might also contribute to vasculature stiffening
