Glomerulonephritis Flashcards
(42 cards)
Chronic glomerulonephritis is the most common cause of end-stage renal failure (chronic kidney disease). True/False?
False
2nd most common, after diabetic nephropathy
Glomerulonephritis is caused by infection. True/False?
False
Immune-mediated destruction with secondary tubulointerstitial damage
Which aspects of the immune system cause glomerulonephritis?
Antibodies
T-cell mediated
Inflammatory cells, mediators, complement
Which part of the glomerulus is disrupted in glomerulonephritis?
Disruption of glomerular basement membrane and/or podocytes, leading to leakage of protein/blood
The site and type of injury determines the clinical presentation of glomerulonephritis. Damage to endothelial/mesangial cells leads to what?
Proliferative lesion, causing haematuria
The site and type of injury determines the clinical presentation of glomerulonephritis. Damage to podocytes leads to what?
Non-proliferative lesion, causing proteinuria
What might be found on urinalysis in glomerulonephritis?
Proteinuria
Haematuria
What might be found on urine microscopy in glomerulonephritis?
Dysmorphic RBCs
RBC casts
Lipiduria
What ratio is measured over 24 hours to quantify proteinuria?
Urine protein : creatinine ratio
What is the definitive investigation for glomerulonephritis? List other investigations
Kidney biopsy
Urinalysis
Urine microscopy
24hr urine protein: creatinine ratio
Microalbuminuria is low amounts of albumin in the urine and is an early sign of what?
Diabetic nephropathy
How much protein is classed as heavy proteinuria?
1-3 g/day
What is meant by “red cell casts”?
Red cells stuck with other cells in a matrix formed by Tamm-Horsfall protein
List the components that define nephrotic syndrome. What is the site of injury?
Proteinuria over 3 g/day
Hypoalbuminaemia
Oedema (typically periorbital, face)
Hypercholesterolaemia
Podocytes (non-proliferative lesion)
Renal function is usually normal in nephrotic syndrome. True/False?
True
List the components that define nephritic syndrome
What is the site of injury?
Acute renal failure
Oliguria (<400ml urine/day)
Oedema
Haematuria
Endothelial cells (proliferative lesion)
List the main complications of nephrotic syndrome
Pulmonary emboli Infection Renal vein thrombosis Hypovolaemia Vitamin D deficiency Subclinical hypothyroidism
The majority of glomerulonephritis is idiopathic (primary). True/False?
True
List non-idiopathic (secondary) causes of glomerulonephritis
Drugs Malignancy ANCA-vasculitis SLE Goodpasture's syndrome
Once renal biopsy is taken, what histological investigations may be done on the biopsy?
Light microscopy
Immunofluorescence
Electron microscopy
What is meant by focal and diffuse glomerulonephritis?
What is meant by global and segmental glomerulonephritis?
Focal = less than 50% glomeruli affected
Diffuse = more than 50% glomeruli affected
All or parts of glomerulus affected?
What is meant by crescentic glomerulonephritis?
Presence of crescents - epithelial cell extra-capillary proliferation
What are the principal aims of glomerulonephritis treatment? (RRP)
Reduce proteinuria
Reverse nephrotic syndrome
Preserve renal function
What is the target BP for glomerulonephritis with and without proteinuria?
Less than 130/80 if no proteinuria
Less than 120/75 if proteinuria
