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Glomerulonephritis

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Overview

Overview Glomerulonephritis is inflammation of the glomerulus.  Glomerulonephritis is classified by clinical syndrome/presentation (e.g. nephritic or nephrotic syndrome), histological appearance , or by aetiology. We will divide glomerulonephritis broadly into  two broad types: Nephritic glomerulonephritis and nephrotic glormerulonephritis.

Classification

Two Types of Glomerular disease:

DIFFERENCE BETWEEN NEPHROTIC AND NEPHRITIS SYNDROME 
 Nephrotic SyndromeNephritic Syndrome
OnsetSlowAcute
Swelling++++++
Blood PressureNormalIncreased
Proteinuria++++++
Haematuria+/-+++
Red cell castsNot presentPresent
GFRNormalNormal/low
Serum albuminLowNormal/low
Serum lipidsHighNormal
Most commonc causeDiabetic NephropathyIgA nephropathy

Approach

  • History
  • Examination
  • Investigations
    • EUC
    • Urinalysis
    • Urine culture
    • Immunological
    • X-ray
    • CT
    • MRI
    • Renal biopsy

Renal biopsy looks at the histology of glomerular disease

  • Light microscopy – Useful for morphology, chronicity, and diagnosis.
  • Immunofluorescence – Usually by immunofluorescence but also immunoperoxidase staining. Localizes immune reactants
  • Electron lightmicroscopy – Examining cell and basement membrane structure and for characterizing glomerular deposits.
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