STEPUP Renal and Genitourinary System: Glomerular Disease (Glomerulonephropathies)

Question 1

What are two types of glomerular disease? How else can you classify glomerular disease?

Answer 1

1) Primary (intrinsic renal pathology)
2) Secondary (to a systemic disease)
3) Two important categories of glomerular pathology are diseases that present with nephrotic syndrome and those that present with nephritic syndrome. Many conditions have features of both

Question 2

Is there a range in the rate of glomerular disease progression?

Answer 2

Yes, there is a wide range in the rate of disease progression, varying from days to weeks in the acute glomerular diseases, to years in the chronic disorders

Question 3

What is rapid progressive GN?

Answer 3

It is a clinical syndrome that includes any type of GN in which rapid deterioration of renal function occurs over weeks to months, leading to renal failure and ESRD

Question 4

What are causes of glomerular disease?

Answer 4

1) GN is usually caused by immune-mediated mechanisms

2) Other mechanisms include metabolic and hemodynamic disturbances

Question 5

What are some possible presentations of glomerular disease?

Answer 5

1) Isolated proteinuria
2) Isolated hematuria
3) Nephritic syndrome - hematuria, HTN, azotemia
4) Nephrotic syndrome - proteinuria, edema, hypoalbuminemia, hyperlipidemia

Question 6

What are glomerular disorders characterized by? What happens to GFR as the disease advances and what does this lead to?

Answer 6

1) Impairment of selective filtration of blood, resulting in excretion of larger substances such as plasma proteins and blood cells
2) As disease advances, GFR decreases proportionately, leading to renal failure and the possible need for dialysis and/or transplantation

Question 7

What are the classic features of glomerular disease?

Answer 7

1) Proteinuria, hematuria, or both

2) Nephrotic range proteinuria is pathognomonic for glomerular disease