glomerularmephritis Flashcards
(30 cards)
what are clinical consequences of glomerular nephritis?
depending on where the inflammation is… - protein in urine - blood in urine - abc in urine - casts failure of the filtration membrane-> leads to AKI which may lead to further scarring and CKD
presentation of nephrotic syndrome
Preserved renal function Proteinuria > 3g/day, Spot UPCR or ACR >300mg/mmol or > 180mg/mmol decreased serum albumin – normal 40 Decreased total protein normal 65
presentation of nephritic syndrome
Impaired renal function (rapid or chronic) Proteinuria, haematuria, leucosuria
what are general presentations of GN?
Presentation Symptoms Systemic, flu like symptoms Rash Arthralgia Swelling
what examinations would you do for suspected GN?
Examination Skin CVS, Oedema Chest abdomen Urine Analysis
Draw a table to cmpare the urine dip nephrotic vs nephritic syndrome
which blood tests would you preform when suspecting GN?
serum albumin
protein
renal function
autoimmune screen
what checks are done for a renal biopsy?
- ligh microscopy
immuno-histology
electron microscopy
what are the nephrotic diseases
- minimal change disease
- mebranous nephropathy
- focal segmental sclerosis
what are associations of minimal change disease?
–NSAIDS
–Lithium/Gold
–Allergy
–Hodgkins
NORMALLY HAPENS IN CHILDREN
what are treatments for minimal change disease?
–steroids, Calcineurin Inhibitors (tacrolimus)
•50% relapse
what is the typical presentation of minimal change disease?
–Frothy urine, oedema
–Low albumin
–Preserved function
what changes do you see when you take a minimal change disease biopsy?
LM- normal
Immune assay- normal
electron microscopy- effacemnt of podocyte foot processes
what are autoimmune causes of membranous nephropathy?
•Lupus,
sjorgrens,
Rh Arthritis,
ank spond,
post transplant
what are infections that can cause membranous nephropathy?
•Hep B, Hep C
what are drugs that cause membranous nephropaty?
•Mercury,
Captopril,
Gold,
penicillamine
which nephrotic disease is associatedd with paraneoplasms?
membranous nephropathy
what are the biospy changes seen in membranous nehrotic syndrome?
LM- capilliary and glomerular basement membrane thickening due to immune complex deposition
also can see irregulr expansions from glomerular basement when stained with glomerular methenamine
immunofluresence- granular complexes made of igG and C3
EM- flattening of podocytes and spike dome pattern
what is the treatment for membranous?
–Underlying cause
–Steroids, CNIs, BP
which type of nephritic disease results in deposition of IGA in the glomeruli?
mesangial proliferative GN
Ig A deposition can be a result of the following;
–Malaria
–Typhoid
–IgA nephropathy
what can mesangial proliferative GN present as?
•Presentation variable
–Haematuria
–AKI, CKD, hypertensive crisis
what is the disease is associated with IgA nephropathy?
IGA normally forms in resp and GI infections so the nephropathy is accompanied by resp or GI infection
what are the causes of diffuse proliferative glomerulonephritis?
endocarditis
post strep GN
