Glomerulopathies Flashcards
Focal Nephritic
Inflammatory lesions in s, Casts, Proteinuria
IgA Nephropathy
Diffuse Nephritic
Affects most of glomeruli
UA similar to focal, edema, HTN
Post-strep glomerulonephritis
Glomerulonephritis (GN) Patho
Most forms are immunologic. autoimmune
Etiology generally unknown except for strep
Humor and cellular response results in inflammation
GN S/S
HTN Edema Tea colored urine Fatigue Oliguria Azotemia
Post Strep Glomerulonephritis
60% of cases in kids 2-12
More male than female
Usually occurs 7-10 days post strep throat
Abx do not prevent glomerular dz
Post strep GN presentation
Sudden onset gross hematuria (100%) Edema HTN Back pain Oliguria Renal insufficiency Azotemia
Post strep GN course
Generally rapid resolution
Diuresis within 1 week
Hematuria resolves within 3-6 months
Post strep GN Tx
Decrease sodium intake
Fluid restriction
Control HTN
Dialysis for severe dz
Henoch-Schoenlein Purpura (HSP)
Most common cause of vasculitis in kids
usually occurs btw ages of 3-15
HSP Tetrad
Palpable purpura w/o thrombocytopenia
Arthralgias/Arthritis
Abd pain
Renal dz
HSP renal dz
More likely to occur in older children and adults
Identical to IgA nephropathy
Nephrotic presentation
Methylpred can be used.
IgA Nephropathy (Berger’s Dz)
Most common lesion to cause primary GN
COmmon in asians and caucasians
More males
Most diagnosis made btw 15-35 yo
IgA Nephropathy presentation
Gross hematuria Proteinuria Flank pain Nephritic syndrome Autoimmune
IgA GN Biposy
Prominent IgA deposits in mesangium
C3 and IgG also deposited
IgA GN Tx
HTN control (ACE, ARB) Corticosteroids, immunosupressive for severe dz
Rapidly Progressive Glomerulonephritis (RPGN)
Features of glomerular dz in urine
Progressive loss of renal fxn over short period
Crescent GN
RPGN Tx
Pulse Methylpred
Then daily pred
Oral or IV cyclophosphamide
Goodpastures Dz
Anti GBM
Pulmonary hemorrhage and RPGN with circulating antibodies against basement membrane antigens.
Hemoptsys, infiltrates, dyspnea, renal failure
One in a million (holy rare batman)
Membranoproliferative Glomerulonephritis (MPGN)
10% of all nephrotic syndrome in adults
ages 8-30 primarily
MPGN histologic changes
Thickening of glomerular basement membrane
Proliferation of mesangial cells
Influx of monocytes
MPGN Tx
Treat underlying infxn if cause Tx for idiopathic is BP control (ACE) High dose corticosteroids Plasmapheresis Immunisuppressive agents
Interstitial Nephritis
Accounts for 10-15% of cases of intrinsic renal failure.
Interstiital inflammatory response with edema and tubular cell damage
Interstitial Nephritis Causes
Generally drugs
Abx
Infectious diseases (strep)
Immunologic entities (SLE, sarcoid)
Interstitial Nephritis Causes
Fever Rash Arthralgias Red cells in urine White cell casts oliguria, azotemia
