Glomerulonephritis

Question 1

Define glomerulonephritis.

Answer 1

Glomerulonephritis (GN) denotes glomerular injury and applies to a group of diseases that are generally, but not always, characterised by inflammatory changes in the glomerular capillaries and the glomerular basement membrane (GBM).

Question 2

Explain the aetiology/risk factors of glomerulonephritis.

Answer 2

Group A beta-haemolytic Streptococcus
Respiratory infections
Gastrointestinal infections
Hepatitis B
Hepatitis C
Infective endocarditis
HIV
Systemic lupus erythematosus (SLE)
Systemic vasculitis
Hodgkin’s lymphoma
Lung cancer
Colorectal cancer
Non-Hodgkin’s lymphoma
Leukaemia
Thymoma
Haemolytic uraemic syndrome
Drugs

Question 3

Summarise the epidemiology of glomerulonephritis.

Answer 3

For every patient with clinically apparent GN, approximately 5 to 10 patients have undiagnosed subclinical disease. In the US and Europe, GN is the third commonest cause of end-stage renal disease (ESRD), after diabetes and hypertension.

Question 4

Recognise the presenting symptoms of glomerulonephritis. Recognise the signs of glomerulonephritis on physical examination.

Answer 4

Haematuria
Oedema
Hypertension
Oliguria
Anorexia
Nausea
Malaise
Weight loss
Fever
Skin rash
Arthralgia
Haemoptysis
Abdominal pain
Sore throat

Question 5

Identify appropriate investigations for glomerulonephritis and interpret the results.

Answer 5

Urinalysis
Comprehensive metabolic profile
Glomerular filtration rate (GFR)
Full blood count
Lipid profile
Spot urine albumin:creatinine ratio (ACR)
Ultrasound of kidneys