Session 7- Glomerularnephritis Flashcards
what is glomerularnephritis
inflammation of the glomeruli
- capillary endothelim
- glomerular basement membrane
- mesangial cells
- podocytes
nephrotic syndrome
a triad of
- proteinuria
- hypoalbuminaemia
- oedema
usually accompinied by high cholesterol
causes of nephrotic syndrome
primary renal disease
- minimal change disease
- membranous glomerulonephrititis
- focal segmenal glomerulosclerosis
secondary renal disease
-diabetes
diabetic nephropathy
narrowing of efferent arteriole
- leading cause of end stage renal disease
- excess glucose in blood binds to proteins
- hyaline arterosclerosis
- mesangial cells secreye matrix
- thickening of BM
treatment of diabetic nephropathy
hypertension, good glycemic control, ACE inhibitors, angiotensin receptor blockers
minimal changes diease
most common cause of nephrotic sundrome under 6
no significany changes are seen under light microscopic
membranouse glomerularnephritis
subepithelial deposition of immune complexes
thickening of BM
40% of adult nephrotic syndrome
focal segmental glomerulosclerosis cause
primary: idiopathic
Secondary: sickle cell disease. HIV, heroin abuse, kidney hyperperfusion
patholofy of FSGS
Proteins build up in glomerulus- hyalinosis leading to sclerosis
podocytes damaged
how do we treat FSGS
steroids
nephritic syndrome
haematuria
reduction in GFR
hypertension
inflammation of basmemen membrane
- loss of immune cells
- BM enlarges and thickens
- gaps get larger so RBCs can get through
nephrotic syndrome
podocyte damge leading to proteinuria
- increased albumin in urine
- decreased albumin in blood
- decreased oncotic pressue
- fluid stay in interstitium
OEDEMA
IGA nephropathy - bergers disease
hypertension and IgA levels raised. Deposited in mesangium. Sclerosis of damged segment
treatment of bergers disease
control BP
antihypertensives
steroids
rapidly progressive glomerulonephrotis
severe glomerular injury- leakage of fibrin, macrophages and epithelial cells proliferate
crescent shape masses form
reduced glomerular blood supply
treatment of rapidly progressive glomerulonephrotis
high dose steroida
immunosuppresants
Goodpastures syndrome
antibodies to type IV collagen in glomerular BM develop causing inflammation
results in rapidly progressive glomerulonephritis, lung haemorrage and renal failure
treatment of goodpasture’s
plasma exchange to remove antibodies
corticosteriods
post streptococcal glomerulonephrotis
presents 1-3 weeks following grop A beta-haemolytic streptococcal infection of tonsils, pharynx and skin
treatment of post-streptococcal glomeruloneohritis
antibiotics
