Glomerulopathies Flashcards
ultrafiltrate
not urine yet but it’s the fluid that is generated in these structures
blood flow through kidney
- Very high blood flow through the kidney
* Vasculature is very rich and could be important for pathophys
glomerulpathy
pathology related to the glomerulus (Preferred term to use b/c more open than glomerulonephritis)
Glomerulonephritis
inflammatory response
types of glomerulopathies
• 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
what is one of the most common causes of chronic kidney disease?
chronic glomerulonephritis
types of primary glomerulopathies
• 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
systemic diseases with glomerular involvement
systemic lupus erythematosus (SLE) and DM
amyloidosis
Bowman’s space
surrounded by capillaries
When the filtrate is produced, it accumulates in the bowman space
Bowman’s capsule
covered by epithelial cells called parietal layer
filtrate coming into the glomerulus
when filtrate comes in, it has to pass through endothelium, basement membrane, and visceral layer of epithelial cells
hematouria
presence of RBCs in the urine
where does ultra-filtration occur at?
Space b/w podocytes
Which mechanism is most commonly in the pathogenesis of glomerulonephritis?
ANTIBODY-MEDIATED INJURY
antibody-mediated injury
- 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
activation of compliment in the kidney
can lead to cell lysis b/c of TCC (terminal complement complex)
what is the best way to diagnose antibody-mediated injury?
kidney biopsy
○ Use antibodies to detect immune complexes
○ Important b/c sometimes treatment for glomerular nephritis is very harsh
effacement
podocytes are becoming flat
Barriers are becoming very leaky and have cells going into the urine
C5a
very potent inflammatory mediators → causes inflammation and recruits other immune cells to site of injury
C5b-9
part of complement
bunch of proteins together
symptoms of nephritic syndrome
HEMATURIA
azotemia (increases in blood nitrogen)
oliguria ( decreased amt of urine produced in 24 hours)
variable proteinuria (but mild), edema, HTN
what is the normal amt of urine prod in 24 hours?
○ Normal= 1.5 L/day
○ Oliguria= <400 mL/day
symptoms of nephrotic syndrome
PROTEINURIA >3,5 g/day
hypoalbuminemia
hyperlipidemia, lipiduria, edema
symptoms of rapidly progressive glomerulonephritis
acute nephritis (like nephritic syndrome), proteinuria, acute renal failure
symptoms of chronic renal failure
asotemia progressing to uremia
what is the most common primary glomerular disease that causes nephritic syndrome?
acute proliferative (poststreptococcal-postinfectious) glomerulonephritis
what is the most common systemic disease that causes nephritic syndrome?
SLE
what are the two most common causes of nephritic syndrome?
primary glomerular diseases and systemic diseases
minimal-change disease
most common in children
