Week 10 - Glomerular pathology Flashcards
What urine abnormality is dominant in nephritic syndrome?
-Haematuria
What urine abnormality is dominant in nephrotic syndrome?
-Proteinuria
Which group of glomerular pathology leads to hypoalbuminaemia?
-Nephrotic syndrome
Why do you get oedema in nephrotic syndrome?
- Loss of albumin in the urine results in a decreased oncotic pressure in the capillaries
- ECF which is pushed into the interstitium by hydrostatic pressure at the proximal capillary is not drawn back and oedema occurs
Why does hyperlipidaemia occur in nephrotic syndrome?
- Due to hypoalbuminaemia
- Liver tries to compensate by increasing protien production however there is a side effect of increasing lipid production
Which part of the glomerulus is affected in nephritic syndrome?
-Problems with epithelia
Which part of the glomerulus is affected in nephrotic syndrome?
-Podocyte damage
What are the 3 common primary causes of nephrotic syndrome?
- Minimal change glomerulonephritis
- Focal Segmental Glomerulosclerosis
- Membranous glomerulonephritis
What is the most common secondary cause of nephrotic syndrome?
-Diabetes mellitus
When does minimal change glomerulonephritis present?
- In childhood/adolescence
- Incidence decreases with age
What is the primary urine abnormality in minimal change glomerulonephritis?
-Proteinuria
Does minimal change glomerulonephritis progress to renal failure?
-Not usually
What is the cause of minimal change glomerulonephritis?
-Destruction of podocytes via an unknown mechanism
What are the differences between minimal change glomerulonephritis and focal segmental glomeruloslcerosis?
- FGS occurs in adults
- FGS is less responsive to setroids
- FGS progresses to renal failure due to scarring
What is the cause of membranous glomerulonephritis?
-Immune complex formation which become caught in the filter and cause a thickened glomerular basement membrane
What is thought to be the cause of immune complex formation in membranous glomerulonephritis?
-Phospholipase on podocytes causing an autoimmune response by IgG
What is the rule of 3rds in membranous glomerulonephritis?
- 3rd patients remit
- 3rd patients ill but stable
- 3rd patients enter renal failure
What is thought to be a secondary cause of membranous glomerulonephritis?
-Lymphoma
How does diabetes mellitus lead to nephrotic syndrome?
-Microvascular damage leads to progressive proteinuria and progressive renal failure with mesangial sclerosis
What is the most common cause of glomerulonephritis?
-IgA nephropathy
Name 2 hereditary diseases which cause nephritic syndrome
- Alport
- Thin glomerular basement membrane disease
When does IgA nephropathy present?
-At any age
How does IgA nephropathy present?
-Usually with macro/microscopic haematuria
What is IgA nephropathy associated with mucosal infections?
-During infection there is an increased production of IgA which increases blockage in the glomerulus
