Renal Flashcards
Nephrotic syndrome symptoms (triad)
1) Proteinuria
2) Hypoalbuminaemia
3) Oedema
Other associations with nephrotic syndrome and why
- Hypercholerterolaemia - - Increased risk of VTE (renal loss of antithrombin3/protein C/protein S)
- Increased risk of infections (loss ofimmunoglobulins in urine)
3 categories of causes of nephrotic syndrome
1) Glomerulonephritis
2) Systemic disease: SLE, amyloiidosis
3) Drugs: gold, penicillimine
3 glomerularnephritis causes of nephrotic syndrome
1) Membranous glomerulonephritis
2) Minimal change glomerulonephritis
3) Focal segmental glomerularsclerosis
Membranous glomerulonephritis causes
1) Infection: hep B, malaria
2) Malignancy
3) Antiphospholipase A2 antibodies
What is the commonest cause of glomerulonephritis in adults?
Membranous glomerulonephritis
What is the commonest cause of glomerulonephritis in children?
Minimal change glomerulonephritis
Biopsy findings in membranous glomerulonephritis
- Spike and dome
- Thckened basement membrane
- Dense electron deposits (IgG, C3)
Membranous glomerulonephritis treatment
ACEi/ARB
Steroids
Cyclophasphamide
What cancer, infection and drugs can cause minimal change glomerulonephritis?
1) Idiopathic
2) Hodkins lymphoma
3) EBV
4) Drugs - NSAIDS
What is the biopsy finding in minimal change glomerulonephritis?
Normal glomerulus
Podocyte fusion
What is the pathophysiology behind minimal change glomerulonephritis
T cell damage to glomerular basement membrane causing anion loss and albumin leaking through membrane causing oedema
Treatment of minimal change glomerulonephritis
Steroids (80% respond)
Cyclophosphamide
Causes of focal segmental glomerulonephritis (3)
1) HIV
2) Heroin
2) Alport syndrome
Symptoms of nephritic syndrome
1) Hypertension
2) Haematuria
3) Proteinuria
Renal causes of nephritic syndrome
1) IgA nephropathy
2) Rapidly progressive (crescentic) glomerulonephritis
Systemic causes of nephritic syndrome
1) SLE
2) Hep C
3) Endocarditis
4) Post streptococcal glomerulonephritis
How long post URTI does post streptococcal glomerulonephritis occur?
1 - 2 weeks
What is the classic presentation of IgA nephropathy?
Young adult with macroscopic haematuria 1 - 2 days after an URTI
Nephritic syndrome
Associations with IgA nephropathy (4)
HSP
Coeliac
Liver cirrhosis
Dermatitis herpatiforms
Biopsy findings in IgA nephropathy
mesangial hypercellularity with IgA and C3
Presentation of rapidly progressive (crescenteric) glomerulonephritis
Nephritic syndrome
Haematuria with red cell casts
HTN
Oliguria
Acute renal failure
Associations with rapidly progressive glomerulonephritis
Goodpastures syndrome
ANCA +ve vasculitis
Glomerulonephritis that causes mixed nephritic and nephrotic syndrome (2)
1) Membranous proliferative glomerulonephritis
2) Diffuse proliferative glomerulonephritis
