Glomerulonephritis Flashcards
What is Glomerulonephritis?
Glomerulonephritis refers to inflammation of the glomeruli in the kidneys. It describes the pathology in various diseases rather than being a disease itself. Treatment targets the underlying cause and may involve supportive care and immunosuppression.
The glomerulus filters fluid from the capillaries into the renal tubule.
What is Nephritic Syndrome?
Nephritic syndrome refers to a group of features that occur with nephritis, characterized by:
* Haematuria (blood in the urine)
* Oliguria (reduced urine output)
* Proteinuria (less than 3g of protein per 24 hours)
* Fluid retention
What is the difference between Nephritic and Nephrotic Syndrome?
Nephritic syndrome involves inflammation of the kidneys with symptoms like:
* Haematuria
* Oliguria
* Mild proteinuria
Nephrotic syndrome occurs when the basement membrane in the glomerulus becomes highly permeable, leading to significant proteinuria (>3g/24hrs), low serum albumin, peripheral oedema, and hypercholesterolaemia.
What are the main features of Nephrotic Syndrome?
Main features of Nephrotic Syndrome include:
* Proteinuria (>3g/24hrs)
* Low serum albumin (<25g/L)
* Peripheral oedema
* Hypercholesterolaemia
It can also lead to frothy urine, thrombosis, hypertension, and high cholesterol.
What is the most common cause of nephrotic syndrome in children?
Minimal change disease, which is typically idiopathic and treated successfully with steroids.
What are the top causes of nephrotic syndrome in adults?
Top causes of nephrotic syndrome in adults include:
* Membranous nephropathy
* Focal segmental glomerulosclerosis
What are other causes of nephrotic syndrome?
Other causes of nephrotic syndrome include:
* Membranoproliferative glomerulonephritis
* Henoch-Schönlein purpura (HSP)
* Diabetes
* Infection (e.g., HIV)
What is the most common cause of primary glomerulonephritis?
IgA nephropathy (or Berger’s disease). It typically affects patients in their 20s with haematuria, and histology shows IgA deposits and mesangial proliferation.
What is Membranous Nephropathy?
Membranous nephropathy involves immune complex deposits in the glomerular basement membrane, causing thickening and proteinuria. Histology shows IgG and complement deposits. It is a key cause of nephrotic syndrome in adults and is often idiopathic but can be secondary to malignancy, lupus, or NSAIDs.
What is Membranoproliferative Glomerulonephritis?
Membranoproliferative glomerulonephritis affects patients under 30 and involves immune complex deposits and mesangial proliferation.
What is Post-Streptococcal Glomerulonephritis?
Post-streptococcal glomerulonephritis affects patients under 30 and presents 1-3 weeks after a streptococcal infection (e.g., tonsillitis or impetigo). Patients typically recover fully.
What is Rapidly Progressive Glomerulonephritis?
Rapidly progressive glomerulonephritis presents with acute, severe illness but usually responds well to treatment. Histology shows glomerular crescents.
What is Goodpasture Syndrome?
Goodpasture syndrome (anti-GBM disease) involves anti-glomerular basement membrane antibodies attacking the glomerulus and pulmonary basement membranes, causing glomerulonephritis and pulmonary haemorrhage. It typically affects patients in their 20s or 60s with acute kidney failure and haemoptysis.
What are systemic diseases that can cause glomerulonephritis?
Systemic diseases that can cause glomerulonephritis include:
* Henoch-Schönlein purpura (HSP)
* Vasculitis (e.g., microscopic polyangiitis, granulomatosis with polyangiitis)
* Lupus nephritis (associated with systemic lupus erythematosus)
How can you differentiate between conditions causing acute kidney injury and haemoptysis?
Differentiation can be made by:
* Anti-GBM antibodies – Goodpasture syndrome
* p-ANCA (or MPO antibodies) – Microscopic polyangiitis
* c-ANCA (or PR3 antibodies) – Granulomatosis with polyangiitis
How is Glomerulonephritis diagnosed and treated?
Diagnosis may require a renal biopsy for histology. Treatment depends on the underlying cause and may involve supportive care (e.g., hypertension management and dialysis) and immunosuppression (e.g., corticosteroids).
