Glomerulonephritis aetiologies n that Flashcards
Define nephritic syndrome?
Nephritisis a very generic term that means inflammation of the kidneys.
What are the set criteria for nephritic syndrome?
There are no set criteria (unlike nephrotic syndrome)
What are the symptoms of nephritic syndrome?
1 - Haematuria (micro- or macroscopic)
2 - Proteinuria (progressive)
3 - Oliguria (significant reduction in urine production)
4 - Fluid retention
What are the criteria for nephrotic syndrome?
1 - Peripheral oedema
2 - Proteinuria (>3g/day)
3 - Hypoalbuminaemia
4 - Hypercholesterolaemia/lipidaemia
What is glomerulonephritis?
Glomerulonephritisis an umbrella term applied to conditions that causeinflammation of or around the glomerulus.
What are the two key parts of treating most conditions characterised as glomerulonephritis?
1) . Immunosuppression (E.g Steroids)
2) . Blocking the RAAS system (ACE Inhibitors and ARBs)
How does nephrotic syndrome predispose people to thrombosis, DVT and PE?
Loss of AT-III (anti-thrombin III)
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
What is the most common cause of nephrotic syndrome in adults?
Focal segment glomerulosclerosis
Treatment for minimal change disease?
Steroids - Prednisolone
Aetiology of minimal change disease?
Most are primary/idiopathic
Some are secondary:
- Drugs (NSAIDs, Lithium)
- Paraneoplastic (Haematological malignancy, usually Hodgkin’s Lymphoma)
Aetiology of focal segment glomerulosclerosis?
Primary/idiopathic
or
Secondary:
- HIV
- Heroin
- lithium
- Lymphoma
- Any cause of reduced kidney mass
- Kidney scarring due to another GNSynonym for IgA GLomerulonephritis?
Berger’s Disease
Histological findings of IgA GN?
Histology shows “IgA deposits and glomerular mesangial proliferation”
Most common cause of glomerular pathology and chronic kidney disease in the UK?
Diabetic nephropathy
What is the the most common type of glomerulonephritis?
Membranous glomerulonephritis
Explain the histological findings of membranous glomerulonephritis?
Histology shows “IgG and complement deposits on the basement membrane”
Aetiology of membranous glomerulonephritis?
Primary/Idiopathic ~ 70% Secondary: - Malignancies - Infection (Hep. B/C, Malaria, Strep) - Rheumatoids disease - Drugs (NSAIDs)
Common sights of malignancies in malignant aetiology Secondary Membranous Glomerulonephritis? (5)
- Lung
- Breast
- GI
- Prostate
- Haemitological malignancies
What is post-streptococcal glomerulonephritis also called?
Diffuse proliferative glomerulonephritis
What is post-streptococcal glomerulonephritis?
Occurring 1 - 3 weeks after a streptococcal infection (throat or impetigo)
Develop nephritic syndrome
Usually a full recovery
Synonym for “Goodpasture” syndrome?
Anti-GBM antibodies - (GBM = Glomerular basement membrane
What is Goodpasture syndrome
Rare, auto-antibodies developed into Type IV collagen - this is found only within the glomerular and alveolar basement membrane
A typical presentation of Goodpasture disease?
1 - Haemturia (Nephritic syndrome)
2 - Haemoptysis
Histological findings in Rapidly Progressive GN (RPGN)?
Crescentic glomerulonephritis
How does RPGN present?
• It presents with a very acute illness with sick patients but it responds well to treatment
3 most common aetiologies of RPGN?
1 - Goodpasture syndrome (most common)
2 - Granulomatous with polyangiitis (Wegener’s Disease)
3 - Systemic lupus erythematosus
What are “Kimelsteil-Wilson” lesions?
Nodule of mesangial matrix found in diabetic nephropathy
