GLOMERULAR DISORDERS Flashcards
- Deposition of immune complexes formed in conjunction with group A Streptococcus infection, on the glomerular membranes.
- Rapid onset of hematuria and edema; permanent renal damage seldom occurs.
- Macroscopic hematuria
Dysmorphic RBCs
RBCs Casts
Granular Casts
(+) ASO Titer
↑ BUN
Acute Poststreptococcal Glomerulonephritis (APGN)
- Deposition of immune complexes from
systemic immune disorders on the
glomerular membrane.
SLE (Systemic Lupus Erythematosus) - Rapid onset with glomerular
damage and possible progression
to end stage renal failure.
Production of Crescentic
Formations containing
macrophage, fibroblasts,
polymerized fibrins - Macroscopic hematuria
Proteinuria
RBC Casts
↑ fibrin degradation products,
cryoglobulins, IgA immune
complexes in glomerulus
Rapidly Progressive
Glomerulonephritis
(Crescentic Glomerulonephritis)
- Attachment of a cytotoxic antibody
formed during viral respiratory infections
to glomerular and alveolar basement
membranes.
Deposition of antiglomerulus basement
membrane antibody to glomerular and
alveolar basement membranes. - Hemoptysis and dyspnea
followed by hematuria; Possible
progression to end stage renal
failure. - Macroscopic hematuria
Proteinuria
RBC Casts
Goodposture Syndrome
- Antineutrophilic Cytoplasmic
Autoantibody (ANCA) binds to
neutrophils in vascular walls producing
damage to small vessels in the lungs and glomerulus - Pulmonary symptoms including
hemoptysis developed first
followed by renal involvement
and possible progression to end -stage renal failure. - Macroscopic hematuria
Proteinuria
RBC Casts
Wegener’s Granulomatosis
Occurs primarily in children following viral respiratory infections
Decrease in platelets disrupts vascular
integrity.
Initial appearance of purpura
followed by blood in sputum and
stools and eventual renal
involvement.
Complete recovery is common,
but may progress to renal failure.
Macroscopic hematuria
Proteinuria
RBC Casts
Henoch-Schonlein Purpura
Thickening of the glomerular membrane
following IgG immune complex
deposition associated with systemic
disorders
Slow progression to nephrotic
syndrome or possible remission;
tendency of Thrombosis.
Macroscopic hematuria
Proteinuria
Membranous
Glomerulonephritis
Cellular proliferation affecting the
capillary walls or the glomerular
membrane basement membrane,
possibly immune mediated.
Associated with autoimmune disease,
infection and malignancies
Slow progression to chronic
glomerulonephritis (Type 2) or
nephrotic syndrome (Type I).
Hematuria
Proteinuria
Tram-Track appearance
Membranoproliferative
Glomerulonephritis
(MPGN)
Marked decrease in renal function
resulting from glomerular damage
precipitated from by other renal
disorders.
Noticeable decrease in renal
function progressing renal failure.
Hematuria
Proteinuria
Glucosuria
Cellular and Granular Casts
Waxy and Broad Casts
Chronic Glomerulonephritis
Deposition of IgA on the glomerular
membrane resulting from increased
levels of serum IgA.
Recurrent macroscopic
hematuria following exercise with
slow progression to chronic
glomerulonephritis.
Early stage: Hematuria
Late Stage: See Chronic
Glomerulonephritis
IgA Nephropathy
(Berger’s Disease)
Disruption of electrical charges that produce the tightly fitting podocyte
barrier resulting in massive loss of
proteins and lipids.
Acute onset following systemic shock
Heavy Proteinuria
Microscopic Proteinuria Renal
Tubular Cells (RTE)
Oval fat bodies
Fat droplets
Fatty and Waxy Casts
Blood: Decrease Albumin
Urine: Increase Albumin
Nephrotic Syndrome
Disruption podocytes occurring primarily
in children following allergic reactions
and immunizations.
Frequent complete remission
following corticosteroid
treatment.
Heavy Proteinuria
Transient hematuria
Fat droplets
Minimal Change Disease
(Lipoid Nephrosis, Nil Disease)
Disruption of podocytes in certain areas
of glomeruli associated with heroin and
analgesic abuse and AIDS.
May resemble nephrotic
syndrome or minimal change
disease.
Proteinuria
Hematuria
Focal Segmental
Glomerulosclerosis
(FSGS)
Genetic disorder showing lamellated and
thinning of glomerular basement
membrane.
Slow progression to nephrotic
syndrome and end stage renal
disease.
Same with Nephrotic
Syndrome
Alport Syndrome
Believed to be associated with
deposition of glycosylated proteins
resulting from poorly controlled blood
glucose level.
Most common cause of end stage RENAL
DISEASE
Develops Sclerosis
Modification of diet and strict
control of hypertension
Indicator: Microalbuminuria
(+) Red color in Micral Test
Diabetic Nephropathy
(Kimmelsteil - Wilson Disease)
