Flashcards in Glomerulonephritis Deck (32):
What is GN?
Immune medated disease of the kidneys affecting the glomeruli
What are the 3 aspects of the pathogenesis of GN?
Humoral - antibody mediated
Inflammatory cells, mediators and complement
Damage to endothelial or mesangial cells leads to what kind of lesion in GN?
Proliferative lesions and blood in urine - nephritic syndrome
Damage to podocytes leads to what kind of lesion in GN?
Non-proliferative lesion and protein in urine - nephrotic syndrome
How does GN present?
Nephrotic syndrome - proteinuria
Nephritic syndrome - haematuria
What level of proteinuria classified as the nephrotic syndrome?
RBCs in the urine from the glomerulus are described as what shaped?
What 3 investigations are required for biopsy sample in GN?
How does cresentic GN form?
Cells burst into Bowman's sapce ad forma cresta round the glomerulus which compresses it and it becomes ischaemic and dies.
What are the main aims of treatment for GN?
Reduce degree of proteinuria
Induce remission of nephrotic syndrome
Preserve long term renal function
In general what treatment can be given for GN?
Calcineurin inhibitors - Cyclosporin/Tacrolimus
Mycophenolate Mofetil (MMF)
What is the target BP for GN?
<120/75 if proteinuria
How is minimal change GN diagnosed?
EM: foot process fusion
Normal biopsy, LM and IF
What is the treatment for minimal change GN?
If steroid-resistant/ dependent then biopsy and cyclophosphamide/CSA
Does minimal change GN cause progressive renal failure?
Is minimal change GN proliferative or non-proliferative lesions?
What is the most common cause of nephrotic syndrome in adults and children?
Children - Minimal change GN
Adults - Focal Segmental Glomerulosclerosis
What are the secondary causes of focal segmental glomerulosclerosis?
Describe focal segmental glomerulosclerosis as seen on biopsy?
Minimal Ig deposition on LM
Complement deposition on IF
What is the treatment for focal segmental glomerulosclerosis?
What is the second most common cause of nephrotic syndrome in adults?
What can cause secondary membranous nephropathy?
Infections - HepB, parasites
CTDs - SLE
Malignancies - carcinomas, lymphomas
Drugs - gold, penicillamine
Describe membranous nephropathy as seen on biopsy?
Subepithelial immune complex deposition in the basement membrane
Does the BM become thicker in membranous nephropathy?
What is IgA nephropathy?
Abnormality of IgA which gets stuck in the kidneys and causes damage - prolifertive lesion
Which can IgA nephropathy cause, AKI or CKD?
IgA nephropathy on biopsy looks like what?
Mesangial cell prolifertion and expansion on light microscopy with IgA deposits in mesangium on IF
What treatment is given for IgA nephropathy?
What is rapidly progressive GN?
rapid deterioration in renal function over days/ weeks
a treatable cause of cute renal failure
What is RPGN associated with?
Systemic disease - pANCA > nANCA
Glomerular cresents on biopsy
Is RPGN a proliferative lesion?