What is glomerulonephritis?
Autoimmune disease of the glomeruli
What is the commonest cause of renal failure after diabetes?
What immune components mediate glomerulonephritis?
Inflammatory cells, cytokines, complement
What are the three layers of the glomerular membrane?
Endothelium of glomerular capillary
Glomerular basement membrane
Glomerulonephritis causes disruption of which structure?
What symptoms are seen?
What signs are produced if glomerulonephritis damages
a) endothelial or mesangial cells
What happens to podocytes when they are damaged by glomerulonephritis?
No inflammation, but allows leakage of protein
What happens to mesangial cells if they are damaged by glomerulonephritis?
Vasoconstriction (by angiotensin II)
What happens to endothelial cells if they are damaged by glomerulonephritis?
Endothelial damage causes (slow / rapid) decline in renal function.
rapid decline in renal function
Does mesangial damage cause rapid decline in renal function?
Haematuria and proteinuria
What urine tests can be done for someone with glomerulonephritis?
Urine microscopy - for cell casts, culture
P/C ratio - to quantify proteinuria
What investigation can you do if you're struggling to classify glomerulonephritis after urine analysis?
Is haematuria painful?
may be in UTI
On urine microscopy, what do red blood cells look like if they've come from the
What type of casts are seen in glomerulonephritis?
Red cell casts
pathognomic of GN, usually endothelial damage
What can acutely or chronically deteriorate due to glomerulonephritis?
What are the presentations of
a) NEPHRITIC SYNDROME
b) NEPHROTIC SYNDROME?
a) Acute renal failure, oliguria, oedema, hypertension, urinary sediment
caused by inflammation
b) Proteinuria, hypoalbuminaemia, oedema, hypercholesterolaemia
due to inability of kidneys to retain albumin
What type of glomerulonephritis causes nephritic syndrome?
because they proliferate and cause inflammation
What type of glomerulonephritis causes nephrotic syndrome?
What is renal function like in
a) nephrotic syndrome
b) nephritic syndrome?
What are people with nephrotic syndrome at increased risk of?
How does the presentation of GN differ from that of interstitial nephritis?
Shouldn't see proteinuria, haematuria on dipstick
As glomerulus isn't involved
What is the cause of primary GN?
Idiopathic autoimmune disease
What are some causes of secondary GN?
Connective tissue diseases
What cells tend to proliferate when damaged in GN?
What is the difference between focal and diffuse GN?
Focal - < 50% affected
Diffuse - > 50% affected
How is glomerulonephritis treated with drugs?
Antihypertensive drugs - ACE inhibitors, ARBs, diuretics (also help with fluid overload)
Immunosuppression - IV steroids, azathioprine, antibody injections, biologic agents
How are people with nephrotic syndrome managed?
ACE inhibitors / ARBs
People with glomerulonephritis usually need ___ after symptomatic relief.