Glomerulonephritis Flashcards
What is glomerulonephritis?
Disease of glomerulus
Can be inflammatory or non inflammatory and primary (only glomerulus) or secondary (systemic)
What are four common presentations of glomerulonephritis?
Haematuria (blood in urine)
Heavy proteinuria (nephrotic syndrome)
Slowly increasing proteinuria
Acute renal failure
What are four causes of haematuria?
Urinary tract infection
Urinary tract stone
Urinary tract tumour
Glomerulonephritis
What should always be checked before a renal biopsy?
Clotting
What happens in IgA glomerulonephritis?
IgA is deposited in the glomerulus and this causes mesangial and its surrounding matrix proliferation. Can be detected on immunofluorescence and electron microscopy. This allows RBC to leak through into urine. Usually self limiting but can lead to chronic renal failure.
What happens in membranous glomerulonephritis?
IgG is deposited in the glomerulus which causes the complement system to put holes in the glomerulus so that albumin can leak into the urine so get nephrotic syndrome. Usually progresses to chronic renal failure. Can have underlying malignancy or antigen is phospholipase A2 receptor.
What happens in diabetic nephropathy?
Glycated molecules means Matrix deposition in basal lamina underlying endothelium and in mesangial matrix which leads to thickened but leaky basement membranes + mesangial matrix compresses capillaries (no immune complexes)
What happens in Crescentic glomerulonephritis?
Granulomatosis with polyangiitis (Wegeners) means A form of vasculitis (inflammation in vessels) which affects vessels in kidneys, nose and lungs.
Cellular proliferation and influx of macrophages (crescent) around glomerular tuft, within Bowman’s space
What test can be done to look for Wegeners?
Serum test shows presence of anti-neutrophil cytoplasmic antibodies (ANCA)
Not deposited in kidney
Antibodies directed against proteinase 3 and myeloperoxidase, 2 enzymes in primary granules of neutrophils
Can treat with Cyclophosphamide to prevent fatality
