5. INTRODUCTION
It is a term used to refers to several kidney disease (both
kidney) characterized by inflammation either of the
glomeruli or of the small blood vessels in the kidney.
These knots of blood vessels help to filter the blood and
remove excess fluid. If glomeruli are damaged , kidney
will stop working properly and can lead to kidney failure.
It is sometimes called nephritis.
Also known as Bright’s disease.
7. INCIDENCE RATE
Incidence rate of primary glomerulonephritis vary
between 0.2/100000/year and 2.5/100000/year. This
disease can exist subclinically and is therefore only
detected by chance in some patients.
8. TYPES OF GLOMERULONEPHRITIS
There are two types of glomerulonephritis-
1. Acute glomerulonephritis
2. Chronic glomerulonephritis
9. TYPES
Acute glomerulonephritis
begins suddenly
occur after 5-21 days of
streptococcal infection.
It may be problem with the
immune system.
Chronic glomerulonephritis
Develops gradually over
several years.
Occur after acute phase.
Irreversible damage to
kidney that can lead to
complete kidney failure.
Shows few symptoms.
No clear cause.
10. CAUSES
Cause
Streptococcal infection
Abscessed tooth
SLE
Goodpasture syndrome
Amyloidosis
Granulomatosis with
polyangitis
Polyarteritis nodosa
Cause
Hereditary disease
Immune disease
Genetic
History of cancer
Exposure to some
hydrocarbons
12. SYMPTOMS
Symptoms
Puffiness in face
Oliguria
Dysuria
Gross hematuria
High blood pressure
Symptoms
Proteinuria
High blood pressure
Swelling in ankles and face
Foamy urine
Abdominal pain
13. PATHOPHYSIOLOGY
Due to etiological factor like immune, streptococcal
infection
Release of antigen subsatnce into the circulation
In response formation of antiboy occur
Formation of antigen and antibody complex in the
glomerulus
Inflammatory response
Proliferation of epithelial cells lining the glomerulus
Leukocytes infiltration of the glomerulus
14. CONT..
Thickening of the glomerular filtration membrane
Scarring and loss of glomerular filtration membrane
Decrease GFR and glomerular plasma flow
Retention of sodium and water
Edema and hypertension
15. DIAGNOSTIC EVALUATION
History collection
Physical examination
Urineanalysis
Blood test
Biopsy
Intravenous pyelogram
Immunological test
CT scan
USG
Chest X-ray
16. MANAGEMENT: MEDICAL
MANAGEMENT
Pharmacological management
Treatement depend on the cause of disorder , type and
severity of symptoms.
-diuretic-e.g.chlorthalidone, chlorothiazide
-immunosuppresants-e.g.cyclosporine
antiproliferative agent-e.g.azathioprine
-antihypertensive drug
ACE inhibitors-e.g.benazepril, perindopril, enalapril
Angiotensin receptor blocker-e.g.losartan
17. CONT..
Corticosteroids-e.g.decadron, cotolone
Plasmapheresis
Dialysis if condition worsen
Non pharmacological management
Sodium and water restriction.
Potassium, phosphorus, magnesium restriction.
Limit intake of protein in the diet.
Take calcium supplements.
Maintain healthy weight through diet $ excercise.
18. CONT..
Measure liquid intake.
Patient education
Breathing excercise – pursed lip $ diaphragmatic
breathing.
Endurance excercise such as walking, swimming,
bicycling, aerobic dancing, circulatory excercise.
This excercise improves blood circulation, accelerate
kidney to discharge waste and toxins.
To quit smoking.
19. SURGICAL MANAGEMENT
KIDNEY TRANSPLANT-
It is done to treat kidney failure when glomerulonephritis
is difficult to treat with medication and other procedure
and there is immediate need to replace the diseased
kidney.
20. NURSING MANAGEMENT
NURSING DIAGNOSIS-
1. Acute pain related to inflammation of renal cortex as
evidenced by facial expression and patient verbalization.
2. Excess fluid volume related to accumulation of fluid in
the body as evidenced by edema and weight gain.
3. Ineffective breathing pattern related to accumulation of
fluid in the peritoneal cavity as evidenced by respiratory
rate, dyspnea.
22. OUTLOOK
If glomerulonephritis early caught then acute
glomerulonephritis could be temporary and chronic
glomerulonephritis could be slowed.
If glomerulonephritis worsen, causes reduced kidney
function which turn into chronic renal failure and then
into end stage renal disease.
