S8.1 Glomerular Pathology Flashcards
What can go wrong with the glomerulus?
It can block causing renal failure
It can leak causing proteinuria
What is nephrotic syndrome and its key features?
Glomerulus leaky to large amounts of protein (>3.5g in 24h)
Get proteinuria, hypoalbuminaemia and oedema
eGFR is normal
Why do you get oedema in nephrotic syndrome?
As the low albumin decreases the oncotic pressure so water moves out
What is nephritic syndrome and its key features?
Blockage of the glomerulus
Get acute renal failure, haematuria and hypertension
Which 4 sites can glomerular injury occur at?
Mesangial
Subendothelial - nephritic syndrome
GBM
Subepithelial/podocytes - nephrotic syndrome
What are the 3 primary causes of nephrotic syndrome?
Minimal change glomerulonephritis
Focal segmental glomerulosclerosis
Membranous glomerulonephritis
Describe the main features of minimal change glomerulonephritis
Occurs in childhood
Heavy proteinuria
No progression to renal failure
Describe the main features of focal segmental glomerulosclerosis
Patch scarring in adults
Collagen laid down
Progresses to renal failure
Describe the main features of membranous glomerulonephritis
Immune complex deposits in kidney underneath podocytes causing injury so proteins leak
What are the 2 secondary causes of nephrotic syndrome?
Amyloidosis
Diabetes mellitus
What are the causes of nephritic syndrome?
IgA nephropathy
Hereditary causes (thin GBM + Alports)
Goodpastures syndrome
Vasculitis
Describe IgA nephropathy
Activates IgA which gets deposited in the glomerulus causing mesangial damage
Describe the hereditary causes of nephritic syndrome
Thin GBM nephropathy (abnormally thin GBM) Alports syndrome (abnormally split GBM)
Describe goodpastures syndrome
Rapidly progresses to acute severe glomerulonephritis, associated with pulmonary haemorrhage in smokers.
Describe vasculitis
Associated with ANCA which attacks endothelial cells causing segmental necrosis and crescents
