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RENAL > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What are the different types of glomerular disease?

A
  • Diabetic Nephropathy
  • Glomerulonephritis (GN)
  • Amyloid/ Light Chain Nephropathy
  • Transplant Glomerulopathy
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2
Q

Define glomerulonephritis

A

Immune-mediated disease of the kidneys affecting the glomeruli

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3
Q

What can occur secondary to glomerulonephritis

A

secondary tubulointerstitial damage

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4
Q

What are the 3 ways in which the immune system can cause glomerulonephritis?

A
  • Antibody (Humoral)
  • T cell
  • Inflammatory mediators and complement
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5
Q

Damage to endothelial or mesangial cells causes what to appear in the urine?

A

red cells

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6
Q

Protein appears in the urine if what cells are damaged?

A

Podocytes

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7
Q

Injury to the podocytes causes what cellular changes?

A

Atrophy

Loss of charge specific barrier

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8
Q

Damage to the mesangium causes what cellular changes?

A

Proliferate and release Ang2
=> Chemokine release.
=> Attract inflammatory cells

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9
Q

Damage to the endothelial cells in the glomerulus causes what effect?

A

Vasculitis

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10
Q

What investigations are used for diagnosis of GN?

A

Urinalysis (blood/protein)
Urine microscopy - abnormal RBCs/ granular casts/ lipids
Urine Protein: Creatinine Ratio
24hr urine to quantify protein

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11
Q

What indicates a nephritic syndrome?

A
  • Acute Renal Failure
  • Oliguria
  • Oedema/ Fluid retention
  • Hypertension
  • abnormal RBC’s, WBC’s, red cell casts
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12
Q

What indicates a nephrotic syndrome?

A
  • Proteinuria >3 g/day
  • Hypoalbuminaemia (<30)
  • Oedema
  • Hypercholesterolaemia
  • Sometimes normal renal function
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13
Q

What are the main complications of nephrotic syndrome

A
  • Infection (due to loss of Ab in urine)
  • Renal vein thrombosis
  • Pulmonary emboli
  • Volume depletion
  • Vit D deficiency
  • Subclinical hypothyroidism
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14
Q

What systemic diseases can cause secondary GN?

A

ANCA - associated vasculitis
Lupus
Goodpastures
HSP

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15
Q

How is a renal biopsy analysed?

A

Light Microscopy
Immunofluorescence
EM

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16
Q

What is the difference between Focal and Diffuse GN?

A

Focal < 50% glomeruli affected

Diffuse > 50% glomeruli affected

17
Q

What is the difference between Global and Segmental GN?

A 
Global = all of glomerulus affected
Segmental = part of glomerulus affected
18
Q

What does the presence of crescents indicate?

A

epithelial cell extracapillary proliferation

19
Q

What non-immunosuppressive agents are used to treat GN?

A
  • Anti-hypertensives
  • ACE inhibitors/ ARBs
  • Diuretics
  • Statins
20
Q

What immunosuppressive agents can be used to treat GN?

A
  • Corticosteroids
  • Azathioprine
  • Alkylating agents
  • Calcineurin inhibitors
  • Mycophenolate Mofetil
  • Therapeutic plasma exchange
  • IV Immunoglobulin
21
Q

What general treatments are advised in nephrotic syndrome?

A
  • Fluid/salt restriction
  • Diuretics
  • ACE Inhibitors/ ARBs
    ? Anticoagulation
  • IV Albumin
22
Q

What levels indicate partial or complete remission of proteinuria?

A

complete remission <300 mg/day

partial remission <3000mg/day

23
Q

What is minimal change syndrome?

A

Commonest cause of nephrotic syndrome in children

24
Q

Most of minimal change nephropathy is cleared with oral steroids. TRUE/FALSE?

A

TRUE

94 % complete remission with oral steroids

25
Q

Minimal change nephropathy can cause progressive renal failure. TRUE/FALSE?

A

FALSE

Does NOT cause progressive renal failure

26
Q

What is the most common cause of nephrotic syndrome in adults?

A

Focal Segmental Glomerulosclerosis (FSGS)

27
Q

What percentage of patients with FSGS progress to end stage renal failure?

A

50% progress to ESRF after 10 years

28
Q

What are the secondary causes of membranous nephropathy ?

A
  • infections (Hep B/ parasites)
  • connective tissue diseases (e.g. Lupus)
  • malignancies (Carcinomas/ Lymphoma)
  • drugs (gold/penicillamine)
29
Q

How is rapidly progressive glomerulonephritis treated?

A

prompt Tx
strong immunosuppression
+ supportive care including dialysis if needed

RENAL (24 decks)

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