Glomerulonephritis Flashcards
(35 cards)
What is glomerulonephritis?
kidney disease that result from immunologic and inflammatory injury to the glomeruli
What are the features of nephrotic syndrome?
proteinuria, hypoalbuminaemia, oedema, hyperlipidaemia, variable haematuria, normo or hypertensive, variable GFR decline
What are the features of nephritic syndrome?
haematuria, hypertension, rapidly progressive GFR, may have nephrotic range proteinuria
What are the pathogenic types of GN?
immune complex GN, pauci-immune GN, anti GBM GN, monoclonal Ig GN, C3 glomerulopathy
What is immune complex GN?
characterised by granular deposits of polyclonal Ig
What are the main types of immune complex GN?
IgA nephropathy, lupus nephritis, fibrillary GN, infection related GN
What is the most common cause of primary GN?
IgA nephropathy
Which patients typically get IgA nephropathy?
males in teens to 20s
How do most patients with IgA nephropathy present?
with macroscopic haematuria
What are other less common ways that IgA nephropathy can present?
flank pain, fever, microscopic haematuria, mild proteinuria, malignant HTN, AKI
What other diseases is IgA nephropathy associated with?
cirrhosis, coeliac disease, HIV, minimal change disease, membranous GN, GPA
What are the indications for renal biopsy in IgA nephropathy?
persistent protein excretion, elevated serum creatinine, new onset hypertension, significant elevation in BP above previous stable baseline
When does lupus nephritis usually develop?
within 3-36 months of diagnosis of SLE
What regular testing should be done for patients with SLE?
urinalysis, spot PCR, serum creatinine, eGFR, dsDNA, complement levels
Which SLE patients should get a renal biopsy?
most patients who develop evidence of renal involvement (not if protein <0.5g/day)
What are the characteristic histopathological findings on renal biopsy for lupus nephritis?
glomerular deposits that stain predominantly for IgG but have co-deposits of IgA, IgM, C3 and C1q
How do you diagnosis infection related GN?
kidney biopsy, preceding or concurrent infection, low C3
What is the differential diagnosis for infection related GN?
SLE, cryoglulinaemia, C3 glomerulopathy, IgA, ANCA
What are the risk factors for infection related GN?
male, diabetes, immunocompromised, alcoholism, malignancy, malnutrition, synthetic heart valve, IVDU, AIDS, TB
What is pauci immune GN?
characterised by negative or few Ig deposits on IF (can be either ANCA positive or negative)
Which ANCA do patients with GPA usually have?
PR3-ANCA
Which ANCA do patients with MPA usually have?
MPO-ANCA
Which has higher relapse rates GPA or MPA?
GPA
Which histological subtype of pauci immune GN has the best survival?
focal
