Focal Segmental Glomerulonephritis

Question 1

What are the 2 types of FSGM?

Answer 1

Primary

Secondary

Question 2

Primary causes?

Answer 2

Idiopathic

Question 3

Secondary causes?

Answer 3

IgA nephropathy reflux

Sickle cell disease

Heroin use

HIV

Question 4

What is the pathology of focal segmental glomerulonephritis?

Answer 4

Scar tissue forming in the glomeruli

Podocytes damaged -

• Plasma protein and lipid enters bowmans space
• Build up and hyalinose

Question 5

What syndrome does focal segmental cause?

Answer 5

NEPHROTIC SYNDROME

Question 6

What is nephrotic syndrome?

Answer 6

> 3.5g/day of proteinuria

Hypoalbinaemia

Hyperlipidaemia

Question 7

What does hypoalbuminaemia cause?

Answer 7

Oedema

Question 8

What does hyperlipideamia cause in nephrotic syndrome?

Answer 8

Lipiduria

Question 9

Investigations?

Answer 9

Renal biopsy

Bloods

Question 10

What tests should be done with the renal biopsy?

Answer 10

Histology

Electronmicroscopy

Immunofluorescence is not relavent in focal segmental

Question 11

Findings on histology?

Answer 11

Hyalinosis

Sclerosis

Question 12

Findings on electronmicroscopy?

Answer 12

Loss of podocyte foot processes

Question 13

Bloodwork investigations?

Answer 13

Creatinine raised
Albumin lowered
Hb

Question 14

Treatment?

Answer 14

Loop diuretic
LMW heparin

Prednisolone

Question 15

If the prednisolone works what should happen to the other treatments?

Answer 15

Stop them immediately

Question 16

What other management should be done?

Answer 16

Salt and fluid restriction

Daily weight

Question 17

Complication?

Answer 17

ESRF