Glomerulonephritis + Histology Of Glomerulus Flashcards
Differentiate between DCT and PCT on histology
DCT is hollow
PCT has brush border (fuzzy)
What is glomerulonephritis?
Inflammation of glomeruli
What can be damaged in glomerulonephritis?
Capillary endothelium
Glomerular basement membrane
Mesangial cells
Podocytes
What charge do podocytes have?
What does this do?
Negative charge
Repels albumin
Types of glomerularnephritis
Nephritic syndrome
Nephrotic syndrome
Outline nephritic syndrome
NeprItic - Inflmmation
- inflammation disrupts glomerular basement membrane
Triad of:
- haematuria (coke coloured urine)
- reduction in GFR
- hypertension
Outline nephrotic syndrome
NeprOtic - Oedema
- podocytes (foot processes) damage > glomerular charge barrier disruption > proteins can pass through
Triad of:
- proteinuria
- hypoalbuminaemia
- oedema
usually accompanied by hypercholesteroaemia
Causes of nephrotic syndrome
- diabetes (most common cause)
- minimal change disease (children)
- membranous glomerulonephritis (adults)
- focal segmental glomerulosclerosis
What is the leading cause of end stage renal disease?
Diabetic nephropathy
Treatment of membranous glomerulonephritis
Immunosuppressants
Treatment of underlying cause
What is minimal change disease?
- Foot processes of podocytes bind together
- Albumin + other proteins can pass through glomerulus > nephrotic syndrome (proteinuria, oedema + hypoalbuminaemia)
What is membranous glomerulonephritis?
Auto immune deposits within the basement membrane > thickening of basement membrane
(Cause of nephrotic syndrome)
What is focal segmental glomerulosclerosis?
- ‘focal’: in some glomeruli (not all)
- podocytes are damage
- proteins build up in glomerulus
- this leads to sclerosis
(Cause of nephrotic syndrome)
Treatment of focal segmental glomerulosclerosis
Steroids
Management of nephrotic syndrome
Manage individuals symptoms
- diuretics, salt/fluid resection - oedema
- ACE inhibitor
- statin - hypercholestolaemia
- LMWH - due to hypercoagulable state
Causes of nephritic syndrome
- IgA nephropathy
- Rapidly progressive glomerulonephritis
- Post streptococcal glomerulonephritis
- Goodpasture’s syndrome (anti GMB)
Outline IgA nephropathy
- Hypertension
- raised IgA levels > deposited in mesangium
- this leads to sclerosis of damaged section
- causes recurrent haematuria
(Causes nephritic syndrome) - can occur after a URTI
Treatment of IgA nephropathy
Control BP
Antihypertensives
Steroids
Outline rapidly progressive glomerulonephritis
- severe glomerular injury > leakage of fibrin, macrophages + epithelial cells proliferate
- crescent shape mass forms > decreased blood supply
- loss of renal function
(Causes nephritic syndrome)
Treatment of rapidly progressive glomerulonephritis
High dose steroids
Immunosuppressants
Plasma exchange
Outline Goodpasture’s syndrome/anti-GBM disease
- antibodies to type IV collagen in glomerular basement membrane develop > inflamamtion
- leads to rapidly progressive glomerulonephritis, acute renal failure + lung haemorrhage (causes haemoptysis)
(Causes nephritic syndrome)
Treatment of Goodpasture’s syndrome
Plasma exchanges (to remove antibodies)
Corticosteroids (to reduce inflammation)
Outline post-streptococcal glomerulonephritis
- presents 1-3 weeks following streptococcal infection e.g. tonsillitis> spreads to kidneys
(Causes nephritic syndrome)
Treatment of post streptococcal glomerulonephritis
Antibiotics to treat remaining infection
