Glomerular diseases Flashcards
azotemia
increased serum blood urea nitrogen and crreatinine due to reduced glomerular filtration rate
causes are pre renal, renal, post renal
causes of acute renal failure
vascular obstruction rapidly progressive glomerulonephritis acute tubular necrosis acute tubulointerstitial nephritis pyelonephritis DIC urinary obstruction
what is nephrotic syndrome
proteinuria is greater than 3.5g characterised by : hyperlipidemia lipiduria severe edema
pathophysiology of nephrotic syndrome
increased permeability to plasma proteins cause massive proteinuria, hyoalbunemia and generalized edema
hyperlipidemia due to increased lipoprotein synthesis and decreased catabolism
lipiduria due to leakage of lipoproteins with albumin
syndromes of nephritic syndrome
visible hematuria hypertension variable protein uria azotemia oliguria edema
microscopic manifestations of kidney disease
- hypercellularity
cellular proliferation of white blood cells, crescents - basement membrane thickening
- hyalinization and sclerosis of glomeruli
pathogenesis of glomerular injury
usually immune mediated via antibody deposition
minimal change disease causes
causes - respiratory infections, immunizations, nsaids, acute interstitial nephritis, hodgkin lymphoma
causes of diabetic nephropathy
glomerular disease
arteriolar sclerosis
pyelonephritis
papillary necrosis
uremia
Azotemia plus clinical signs/symptoms (gastroenteritis, peripheral neuropathy, fibrinous pericarditis)
chronic renal failure
Stages of chronic renal failure:
(1) diminished renal reserve (GFR 50% normal) with normal BUN/Cr,
(2) renal insufficiency (azotemia, anemia, hypertension, polyuria, nocturia,
(3) renal failure: GFR < 20% normal, kidneys cannot regulate volume or solutes and patients develop edema, metabolic acidosis and hypocalcemia,
(4) end stage renal disease: GFR <5% normal, represents the end stage of various renal diseases
diseases associated with nephrotic syndrome
Minimal change disease
Focal segmental glomerulonephritis
Membraneous glomerulonephritis
Systemic disease (SLE, diabetes, amyloidosis)
diseases associated with nephritic syndrome
Acute diffuse proliferative glomerulonephritis (post-streptococcal or not)
Rapidly progressive (crescentic) glomerulonephritis,
Membranoproliferative glomerulonephritis
secondary diseases
Systemic lupus erythematosus (SLE), diabetes, amyloidosis, polyarteritis nodosa, Goodpasture syndrome, Wegener granulomatosis, Henoch-Schonlein purpura, bacterial endocarditis
clinical presentation of minimal change disease
nephrotic syndrome
severe edema and proteinuria
