Chronic Glomerulonephritis
Chronic Glomerulonephritis
Chronic Glomerulonephritis
What is glomerulonephritis?
Glomerulonephritis (GN) is inflammation of the glomeruli(pic),
o which are structures in your kidneys that are made up of tiny blood vessels.
o These knots of vessels help filter your blood(bullet) and remove excess fluids.
o If your glomeruli are damaged, your kidneys cannot get rid of waste & will stop working
properly, and you can go into kidney failure.
Types
GN can be both acute, or sudden, and chronic, or long-term. (topics)
o Acute You may get it after an infection in your throat or on your skin.
o May recover without treatment, but should look out for early symptoms and seek
treatment.
Chronic Glomerulonephritis!!! (ribbons and animations and because post-intro)
o The chronic form may develop silently (without symptoms) over several years.
o often leads to complete kidney failure.
Pathology & Etiology
Early signs and symptoms
o Blood or protein in the urine (hematuria, proteinuria)
o High blood pressure
o Swelling of your ankles or face (edema)
o Frequent nighttime urination
o Very bubbly or foamy urine
Symptoms of kidney failure include:
o Lack of appetite
o Nausea and vomiting
o Tiredness
o Difficulty sleeping
o Dry and itchy skin
o Nighttime muscle cramps
Acute GN
Acute GN can be an overreacting response to an infection such as strep throat or an abscessed tooth.
This can go away without treatment.
Chronic GN
The chronic form of GN can develop over several years with no or very few symptoms. This can cause
irreversible damage to your kidneys and ultimately lead to complete kidney failure.
Chronic GN doesnt always have a clear cause. A genetic disease can sometimes cause chronic GN.
Hereditary nephritis occurs in young men with poor vision and poor hearing. Other possible causes
include:
As well, having the acute form of GN may make you more likely to develop chronic GN later on.
Kidney failure
Your GN may be so advanced that you develop kidney failure. Some of the symptoms of this include:
fatigue
lack of appetite
nausea and vomiting
insomnia
dry, itchy skin
muscle cramps at night
In chronic glomerulonephritis, scarring of the glomeruli impedes the filtering process, trapping waste
products in the blood while allowing red blood cells or proteins to escape into the urine, eventually
producing the characteristic signs of high blood pressure and swelling in the legs and ankles.
The disorder may first come to ones attention because of high blood pressure. In others, fluid retention
and/or foamy urine may be the first signs. Long-term inflammation and scarring (sclerosis) of the
kidneys may lead to kidney failure in severe cases. Damage may progress without symptoms for months
or years; by the time symptoms appear, the course of the disorder may be irreversible.
If you have the chronic type of glomerulonephritis, it is very important to control your blood pressure
since this may slow down kidney damage. Your doctor may tell you to eat less protein. A dietitian
trained to work with kidney patients (a renal dietitian) can be very helpful in planning your diet.
There is no specific treatment for the chronic form of the illness. You doctor may tell you to:
Eat less protein, salt and potassium
Control your blood pressure
Take diuretics (water pills) to treat puffiness and swelling
Take calcium supplements
GN can lead to nephrotic syndrome, which causes you to lose large amounts of protein in your urine.
This leads to a lot of fluid and salt retention in your body. You can develop high blood pressure, high
cholesterol, and swelling throughout your body. Corticosteroids treat this condition. Eventually,
nephrotic syndrome will lead to end-stage renal disease if it doesnt come under control.
The following conditions can also occur due to GN:
acute kidney failure
chronic kidney disease
electrolyte imbalances, such as high levels of sodium or potassium
chronic urinary tract infections
congestive heart failure due to retained fluid or fluid overload
pulmonary edema due to retained fluid or fluid overload
high blood pressure
malignant hypertension, which is rapidly increasing high blood pressure
increased risk of infections
Wiki Stuff
The nephrotic syndrome is characterised by the finding of edema in a person with increased
protein in the urine and decreased protein in the blood, with increased fat in the blood.
Inflammation that affects the cells surrounding the glomerulus, podocytes, increases the
permeability to proteins, resulting in an increase in excreted proteins. When the amount of
proteins excreted in the urine exceeds the liver's ability to compensate, fewer proteins are
detected in the blood - in particular albumin, which makes up the majority of circulating
proteins. With decreased proteins in the blood, there is a decrease in the oncotic pressure of
the blood. This results in edema, as the oncotic pressure in tissue remains the same. It should be
noted here that although decreased intravascular oncotic (i.e. osmotic) pressure partially
explains the patient's edema, more recent studies have shown that extensive sodium retention
in the distal nephron (collecting duct) is the predominant cause of water retention and edema in
the nephrotic syndrome.[3] This is worsened by the secretion of the hormone aldosterone by
the adrenal gland, which is secreted in response to the decrease in circulating blood and causes
sodium and water retention. Hyperlipidemia is thought to be a result of the increased activity of
the liver.[4]:549
Still need:
Tests
Collection requirements (additives, handling, patient prep)
Microscopy results (images)