What are the 3 parts of the glomerular membrane?
Foot processes of Podocytes
What are mesangial cells?
“tree-like” groups of cells that support capillaries in the glomerulus
Any disease of the glomerulonephritis, doesn’t have to be inflammatory
What are the 4 main presentations of glomerular disease?
- Heavy Proteinuria
- Slowly increasing proteinuria
- Acute renal failure
What could cause haematuria?
- UT Stone
- UT tumour
4 Main causes of glomerulonephritis?
Cases with immunoglobulin deposition:
- IgA Glomerulonephritis
- Membranous Glomerulonephritis
Without immunoglobulin deposition:
- Diabetic Glomerular disease
- Crescentic Glomerulonephritis
Explain the pathology of IgA glomerulonephritis?
IgA gets stuck in the mesangium causing irritation which stimulates matrix and mesangium formation
This can lead to blood in the urine
Prognosis for IgA glomerulonephritis
Mostly self limiting
Some can progress so far they cause chronic renal failure
Explain the pathology of IgG glomerulonephritis?
IgG gets deposited between the basal lamina and podocytes causing thickening
It then activates complement C3 which punches holes in the filter, allowing albumin through –> Nephrotic syndrome
Prognosis for IgG glomerulonephritis?
25% reach chronic renal failure within 10 yrs
How does diabetic glomerular disease occur?
Glycalated molecules deposited in the basal lamina and mesangial matrix leading to a thick leaky basement membrane and compressed capillaries
What is a kimmelsteil-wilson lesion?
A nodule of mesangial matrix formed during Diabetic glomerular disease
Pathology of Crescentic Glomerulonephritis?
A number of conditions cause:
cellular proliferation and influx of macrophages, forming a crescent within the bowman’s space that crushes the glomerulus
What can cause crescentic glomerulonephritis?
- Wegener’s Granulomatosis
- Microscopic polyarteritis
- Antiglomerular basement membrane disease
What is wegener’s granulomatosis?
A form of vasculitis in kidneys, nose and lungs.
How do you test for and treat wegener’s granulomatosis?
Serum ANCA (Anti-neutrophil cytoplasmic antibodies) test.
Treat with cyclophosphamide, untreated mean survival is 6 months
What tests are relevant to glomerular disease?
- urine cultures to rule out infection
- Abdo US to rule out tumours/stones
- Dipstic for haematuria
- Clotting screen
- Renal biopsy