Glomerulopathies

Question 1

ultrafiltrate

Answer 1

not urine yet but it’s the fluid that is generated in these structures

Question 2

blood flow through kidney

Answer 2

• Very high blood flow through the kidney

* Vasculature is very rich and could be important for pathophys

Question 3

glomerulpathy

Answer 3

pathology related to the glomerulus (Preferred term to use b/c more open than glomerulonephritis)

Question 4

Glomerulonephritis

Answer 4

inflammatory response

Question 5

types of glomerulopathies

Answer 5

• Primary= disease which affects glomerulus first
• Secondary= other systemic diseases that affect glomerulus
○ Ex. SLE= autoimmune
○ Ex. Diabetes= affects primary glomeruli but can also affect other structures

Question 6

what is one of the most common causes of chronic kidney disease?

Answer 6

chronic glomerulonephritis

Question 7

types of primary glomerulopathies

Answer 7

• Acute= lasts few weeks
○ Not really serious consequences
○ Could be caused from infection
• Chronic= always leads to end stage renal disease (ESRD)
○ ESRD= chronic renal failure/ significant insufficiency in kidney function
○ Acute have high potential to progress to chronic
• Crescentic (rapidly progressive)= clinical course is quite fast; may lead to acute kidney failure
• Membranous glomerulopathy= basement memb is affected
•minimal-change disease
•focal-segmental glomerulosclerosis
•IgA nephropathy

Question 8

systemic diseases with glomerular involvement

Answer 8

systemic lupus erythematosus (SLE) and DM

amyloidosis

Question 9

Bowman’s space

Answer 9

surrounded by capillaries

When the filtrate is produced, it accumulates in the bowman space

Question 10

Bowman’s capsule

Answer 10

covered by epithelial cells called parietal layer

Question 11

filtrate coming into the glomerulus

Answer 11

when filtrate comes in, it has to pass through endothelium, basement membrane, and visceral layer of epithelial cells

Question 12

hematouria

Answer 12

presence of RBCs in the urine

Question 13

where does ultra-filtration occur at?

Answer 13

Space b/w podocytes

Question 14

Which mechanism is most commonly in the pathogenesis of glomerulonephritis?

Answer 14

ANTIBODY-MEDIATED INJURY

Question 15

antibody-mediated injury

Answer 15

• Antibody together with target (immune complex) can deposit in glomerular structures and cause probs
• Circulating immune complexes= formed somewhere else and get deposited in the kidney
• Cytotoxic antibodies= go and kill certain cells but not common

Question 16

activation of compliment in the kidney

Answer 16

can lead to cell lysis b/c of TCC (terminal complement complex)

Question 17

what is the best way to diagnose antibody-mediated injury?

Answer 17

kidney biopsy
○ Use antibodies to detect immune complexes
○ Important b/c sometimes treatment for glomerular nephritis is very harsh

Question 18

effacement

Answer 18

podocytes are becoming flat

Barriers are becoming very leaky and have cells going into the urine

Question 19

C5a

Answer 19

very potent inflammatory mediators → causes inflammation and recruits other immune cells to site of injury

Question 20

C5b-9

Answer 20

part of complement

bunch of proteins together

Question 21

symptoms of nephritic syndrome

Answer 21

HEMATURIA
azotemia (increases in blood nitrogen)
oliguria ( decreased amt of urine produced in 24 hours)
variable proteinuria (but mild), edema, HTN

Question 22

what is the normal amt of urine prod in 24 hours?

Answer 22

○ Normal= 1.5 L/day

○ Oliguria= <400 mL/day

Question 23

symptoms of nephrotic syndrome

Answer 23

PROTEINURIA >3,5 g/day
hypoalbuminemia
hyperlipidemia, lipiduria, edema

Question 24

symptoms of rapidly progressive glomerulonephritis

Answer 24

acute nephritis (like nephritic syndrome), proteinuria, acute renal failure

Question 25

symptoms of chronic renal failure

Answer 25

asotemia progressing to uremia

Question 26

what is the most common primary glomerular disease that causes nephritic syndrome?

Answer 26

acute proliferative (poststreptococcal-postinfectious) glomerulonephritis

Question 27

what is the most common systemic disease that causes nephritic syndrome?

Answer 27

SLE

Question 28

what are the two most common causes of nephritic syndrome?

Answer 28

primary glomerular diseases and systemic diseases

Question 29

minimal-change disease

Answer 29

most common in children