Glomerulonephritis Flashcards
Two types of glomerulonephritis?
What’s the distinguishing feature between them?
Nephrotic syndrome: proteinuria
Nephritic syndrome: haematuria
What’s the general pathophysiology of nephrotic syndrome?
Name 3 causes?
Podocyte damage
Minimal change
Focal Segmental Glomerulosclerosis
Membranous nephropathy
What’s the general pathophysiology of nephritic syndrome?
Name 3 causes?
Inflammation disrupting glomerulus basement membrane
IgA nephropathy
Post-strep
Goodpasture’s
Define glomerulonephritis?
Inflammation of glomerulus and nephrons
What is the glomerulus?
The cluster of blood vessels that sits around bowman’s capsule
Renal arteriole -> glomerulus -> renal vein
Features of nephrotic syndrome?
Triad of:
- proteinuria
- hypoalbuminaemia
- oedema
Plus hyperlipidaemia
Features of nephritis syndrome?
Haematuria
Red cell casts
Proteinuria (moderate)
Hypertension
A young man presents with haematuria and hypertension.
He had tonsilitis a few days ago.
What is it?
Nephritic syndrome
IgA nephropathy
A young child presents with haematuria and smoky urine.
What is it?
Nephritic syndrome
Post-strep
1-2 weeks after tonsilitis or skin infection
Pathophysiology of Goodpasture’s syndrome.
Management
Nephritic syndrome
Anti-glomerular basement antibodies
Plasmapherisis Immune supression (prednisolone and cyclophosphamide)
Patient presents with haematuria and haemoptysis.
What is it?
Nephritic syndrome
Goodpasture’s
Anti-glomerular basement membrane antibodies
A child presents with puffy eyes and frothy urine. He just had a URTI.
What is it?
Biopsy?
Management?
Nephrotic syndrome
Minimal change nephropathy
Ix: the usual, but a biopsy would show no changes. Electron microscopy shows fused podocytes
Prednisolone, cyclophosphamide
Pathophysiology of membranous nephropathy?
Is it nephritic or nephrotic?
Biopsy?
Management
Nephrotic
Thickened basement membrane
IgG immune complex deposits in subepithelial area
Prednisolone and cyclophosphamide
Pathophysiology of focal segmental glomerulosclerosis?
Is it nephritic or nephrotic?
Biopsy?
Management?
Nephrotic
Focal scarring due to IgM deposition
IgM deposition
Prednisolone or cyclophosphamide
Aside from managing the specific type of glomerulonephritis, what general measures would you use?
Treat oedema with diuretics
K supplementation
BP management with ACEi or ARB
Lipid lowering therapy (hyperlipidaemia is a complication of nephrotic)
