Nephropathy

Question 1

What’s the difference in onset of IgA nephropathy and post-strep GN?

Answer 1

IgA neph - within 1-2 days after URTI (and more blood)

PSGN - 1-2weeks after URTI (more protein)

Question 2

What are the different features of nephrotic and nephritic syndrome?

Answer 2

Nephrotic -
++++protein (>3.5g/24 hours), frothy urine, hypoalbuminaemia, oedema (reduced intravascular oncotic pressure), hyperlipidemia (liver increases production of albumin and also lipids).

Nephritic -
++ protein, haematuria +++ (red cell casts), hypertension, low urine volume <300ml/day.

Question 3

Most common nephrotic syndromes?

Answer 3

Primary
Minimal change disease (children)
Focal segmental glomerulosclerosis (young adults)
Membraneous nephropathy.

Secondary
MN - hep b, SLE, diabetes, sarcoidosis, malignancy
FSGN - hiv, obesity, diabetes, hypertension
MCD - drugs, malignancy

Question 4

How can renal vein thrombosis present?

Answer 4

Loin pain, haematuria, palpable kidney, sudden deteriourisation of kidney function. (Can be caused by nephrotic syndrome and it’s hypercoagulant state)

Ix: Doppler Uss, MRI or renal angio