Nephrotic, Nephritic and Glomerulonephritis Flashcards
What are the three hallmark features of nephrotic syndrome?
Proteinuria, hypoalbuminemia, and oedema.
What is the significance of proteinuria in nephrotic syndrome?
It indicates excessive protein loss in urine, contributing to hypoalbuminemia.
What percentage of nephrotic syndrome cases are caused by minimal change disease?
10%–25%.
How do glomeruli appear under a light microscope in minimal change disease?
They appear normal.
What changes are seen under an electron microscope in minimal change disease? 3
Diffuse effacement (flattening) of podocyte foot processes, widening of filtration slits, and microvillous transformation.
What is the suspected mechanism behind minimal change disease?
A T-cell-derived factor affecting podocytes (exact mechanism is idiopathic).
Is minimal change disease usually responsive to steroid therapy?
Yes, most patients respond well to steroids.
What might happen if steroid therapy is stopped in minimal change disease?
Symptoms may relapse.
Do most patients with minimal change disease progress to chronic renal failure?
No, most do not.
What condition is associated with progression to chronic renal failure in some patients with minimal change disease?
Focal segmental glomerulosclerosis (FSGS).
Can patients with minimal change disease become steroid dependent?
Yes, some may become steroid dependent.
Name two other types of glomerulonephritis besides minimal change disease.
IgA nephropathy and Goodpasture’s Syndrome.
What is the typical cause of post-streptococcal glomerulonephritis?
A previous infection with Group A β-hemolytic Streptococcus (usually pharyngitis or impetigo)
What is the latent period between infection and PSGN onset?
1–3 weeks.
What are common signs of PSGN? 3
Cola-colored urine, periorbital edema, hypertension.
What is seen on light microscopy in PSGN?
Hypercellular glomeruli with neutrophils and monocytes.
What is the prognosis of PSGN in children?
Usually excellent – most recover fully.
What is the hallmark finding in IgA nephropathy?
IgA deposition in the mesangium.
When do symptoms typically occur in IgA nephropathy?
Within days of a mucosal infection (e.g., respiratory or GI).
What is the classic presentation of IgA nephropathy?
Episodic hematuria, often following an upper respiratory tract infection.
What causes Goodpasture’s syndrome?
Autoantibodies against the glomerular and alveolar basement membranes (anti-GBM antibodies).
What organs are primarily affected in Goodpasture’s syndrome?
Kidneys and lungs
What are common symptoms of Goodpasture’s syndrome?
Hematuria and hemoptysis.
What is the treatment for Goodpasture’s syndrome?
Plasmapheresis and immunosuppressive therapy (e.g., steroids, cyclophosphamide).
What is Alport syndrome?
A hereditary disorder caused by mutations in type IV collagen, affecting the basement membrane.
What are clinical features of Alport syndrome? 4
Hematuria, progressive renal failure, hearing loss, and ocular abnormalities.
What is the inheritance pattern of most cases of Alport syndrome?
X-linked dominant.
What are the key features of nephritic syndrome? 5
Hematuria (blood in urine), proteinuria (mild to moderate), hypertension, oliguria, and edema.
What is the main difference between nephritic and nephrotic syndrome?
Nephritic syndrome is inflammation-based with hematuria and reduced GFR, while nephrotic syndrome is due to podocyte damage with heavy proteinuria and hypoalbuminemia.
What causes the red-colored urine in nephritic syndrome?
Presence of red blood cells and red blood cell casts due to glomerular inflammation.
Why does nephritic syndrome cause hypertension?
Due to reduced GFR and fluid retention.
how to diagnose AKI?
Significant rise in serum creatinine
* 26 µmol/l in 48 hours OR
* 1.5 x baseline in 7 days
Sustained decrease in urine output
* < 0.5 ml/kg/hour for at least 6 hours
stages of CKD?
- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2 Mild CKD (GFR = 60-89 mL/min)
- Stage 3A Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B Moderate CKD (GFR = 30-44 mL/min)
- Stage 4 Severe CKD (GFR = 15-29 mL/min)
- Stage 5 End Stage CKD (GFR <15 mL/min)
