Glomerulonephritis Flashcards
What 3 layers compose the filtration barrier at the glomerulus?
Endothelial lining (fenestrated) Basal lamina Podocytes
What is the glomerulus?
A ball of looped capillaries
Through which vessels does blood enter the glomerulus?
Afferent arteriole
Through which vessels does blood exit the glomerulus?
Efferent arteriole
What type of molecules are not filtered out the blood?
Proteins (equal or bigger than albumin)
RBC
What cells are responsible for supporting the glomerulus?
Mesangial cells
Where does filtrate go after leaving the glomerulus?
Bowman’s space
What is the pathology of glomerulonephritis?
Disease of glomerulus, can be inflammatory or non-inflammatory
What are the 4 most common presentations of glomerulonephritis?
Haematuria
Heavy proteinuria (nephrotic syndrome)
Slowly increasing proteinuria
Acute renal failure (AKI)
What are the main causes of haematuria?
UTI
Urinary tract stone
Urinary tract tumour
Glomerulonephritis
What types of haematuria can occur?
Macroscopic - discoloured urine
Microscopic (2)
What tests would you do in someone presenting with discoloured urine?
Dipstick test
MSSU - urine culture
Ultrasound scan
Renal biopsy
What pathological findings will be observed in biopsy associated with IgA glomerulonephritis?
IgA (immnoglobulin)
C3 complement
What is the cause of IgA glomerulonephritis?
Unknown - antibody excess
What disease progress is observed in IgA glomerulonephritis?
Accumulation of IgA at the glomerulus, clogging the filter membrane
What happens to the mesangial cells in IgA glomerulonephritis?
Proliferation & matrix expansion
What is observed in the urine in IgA glomerulonephritis?
Blood cells
What is the prognosis for IgA glomerulonephritis?
Usually self-limiting
Small % develop chronic renal failure
If high levels of albumin are present in urine what would this suggest?
Leaky glomeruli filtration barrier
If there is heavy protein loss, (>2g/day) what is this suggestive of?
Nephrotic syndrome
What investigations would you carry out if suspected nephrotic syndrome?
Renal biopsy
In membranous glomerulonephritis, what deposits are found between the pdocytes & BL?
IgG
In membranous glomerulonephritis, what does IgG activate? What action does it have?
C3 complement & results in holes being punched in glomerular membrane
What is the underlying cause of IgG (membranous glomerulonephritis)?
Unknown
If there is a massive loss of plasma protein, would sign will be observed peripherally?
Oedema
In a diabetic nephropathy, what causes leakage of albumin out of glomerulus?
Glycated molecules deposit in BL & mesangium resulting in thickened BL & mesangial matrix
In diabetic nephropathy, what is another name for nodules of mesangial matrix?
Kimmelsteil-Wilson lesion
What hastens poor prognosis in diabetic nephropathy?
Poor glycemic control
What tests would you do to test GFR?
Serum creatinine
What would rapidly rising creatinine be indicative of?
Acute kidney failure
What does US allow you to visualise in renal tract?
Presence/absence of obstruction
When the glomerulus is crushed by a crescent of macrophages, what is this called?
Crescenteric glomerulonephritis
What causes crescentic gloermulonephritis?
Wegners granulomatosis
What is another name for Wegners granulomatosis?
Granulomatosis with polyangiitis
What is Granulomatosis with polyangiitis?
A form of vasculitis which affects the vessels of kidneys, nose & lungs
What tests could you perform to test for Wegners granulomatosis?
serum ANCA test (anti-neutrophil cytoplasmic antibodies)
What are ANCA antibodies directed against?
Enzymes in primary granules of neutrophils
What can be used to treat Wegeners?
Cyclophosphamide
What are the 4 different types of glomerulonephritis?
IgA glomerulonephritis
Membranous glomerulonephritis
Diabetic nephropathy
Crescentic glomerulonephritis
