Glomerulonephritis Flashcards
(36 cards)
what are the most common causes of glomerular diseases
diabetic nephropathy, glomerulonephritis, amyloid/ light chain nephropathy, transplant glomerulopathy
what are the 2 ways that GN resents
chronic GN- commonest and Acute GN- treatable cause of acute renal failure
what is glomerulonephritis
AN immune mediated disease of kidneys feeding glomeruli
how does GN come about?
Humoral (antibody-mediated), cell mediated T cells, inflammatory cells, mediators na compliments
what are the foot processes held together by?
protein bridging
is the cell surface negative or positively chargeD?
negatively
what type of lesion occurs on endothelial surface?
proliferative
what type of lesion occurs on the endothelial podocytes
non proliferative
how does GN present?
haematuria- asymptomatic or symptomatic (painless haematuria)
Proteinuria- microalbuminuria (30-300mg/ day), nephrotic syndrome >3g/ day
how do we pick up proteinuria and haematuria
urinalysis
why do we use light microscopy
to assess red blood cells- dysmprhic, red cell casts- lots of cells stuck in tubule
what is nephritic syndrome
acute renal failure, hypertension, oedema, oliguria, active urinary sediment- RBCs and granular casts
what presents with nephrotic syndrome
proteinuria, hypoalbuminaemia
is nephrotic syndrom a proliferative or non proliferative porcess
non- proliferative
what are complications of nephrotic syndrome?
infection, renal vein thrombosis, pulmonary emboli, volume depletion- overuse of diuretics, bit D deficiency and subclinical hypothyroidism
What is the aetiology of most causes of GN
idiopathic
what are secondary causes of GN
infections drugs, systemic diseases- good pastures, lupus, HSP
How do we assess GN via investigations
renal biopsy
light microscopy- immunofluorescence
how do you treat GN
Anti-hypertensives (130/80) ACEi/ ARBs - reduce proteinuria Diuretics- reduce oedema Statins- hyperlipidaemia Warfarin/ LMWH
how dos ou treat GN immunosuppressively
Corticosteroids, Azathioprine, Mycophenalite Mofetil
Plasmophoresis- high antibody volume, high ra[id resolution of vasculitis
Antibodies- IV immunoglobulin
how do we treat patients wth nephrotic syndrome
fluid restriction, reduce salt, diuretics- reduce water, ACEi, Anticoagulation
what is the commonest cause of nephrotic syndrome in children
minimal change nephropathy
how do you treat minimal change disease
steroids- cyclophosphamide
what is the commonest cause of nephrotic syndrome in adults
Focal segmental glomerulosclerosis
