3. Is a renal disease characterized
by inflammation of the glomeruli, or small
blood vessels in the kidneys
Affects both Kidneys symmetrically
Accounts for 1/3 of patients requiring
dialysis or transplantation
4. Cardinal symptoms:
Proteinuria
Haematuria
Urinary Casts
Also presents with
◦ ARF or CRF
◦ Nephrotic or Nephritic syndrome
◦ Proteinuria & HTN
5. Primary
2ry association with:
• Wegener granulomatosis and other vasculitides
• SLE
• Certain infections (e.g Streptococcus pyogenes)
• DM
• Drugs
6. Investigations:
◦ Bloods including – ANCA, Anti-GBM, ANF, C3/4 etc
◦ Renal USS
◦ Blood cultures
◦ Biopsy (providing kidney is not to small)
Diagnosis of underlying cause is crucial for
determining prognosis and therapy
7. This is characterised by lack of
hypercellularity in the glomeruli.
Usually cause Nephrotic syndrome.
◦ Minimal change
Causes 80% of nephrotic syndrome in children, but
only 20% in adult
Rx- Supportive care for oedema & steroids
8. ◦ Focal Segmental Glomerulosclerosis (FSGS)
o Primary or Secondary to:
Reflux nephropathy, Alport syndrome, HIV or heroin use.
o Presents as a nephrotic syndrome with varying degrees
of impaired renal function
o Steroids are tried but not shown to be affective
o 50% of patients with FSGS have progressive renal
failure
9. ◦ Membranous glomerulonephritis (MGN)
o Common type of GN in adults,
o Frequently produces a mixed nephrotic and nephritic picture
o Usually idiopathic but can be secondary to:
Cancer, infection (malaria, hepatitis), drugs, CTD (SLE)
o Prognosis is rule of 1/3
• 1/3 remit – 1/3 remain with MGN – 1/3 progress to end-
stage renal failure (ESRF)
o Treatment with corticosteroids
10. Characterised by increased number of cells in
the glomerulus (hypercellular)
Present as a Nephritic syndrome and can
lead to ESRF
11. ◦ IgA nephropathy (Berger's disease)
most common type of glomerulonephritis in adults
It usually presents as macroscopic haematuria
Often affects young males within 24-48hrs after an
upper respiratory tract or gastrointestinal infection
ACE inhibitors are the mainstay of treatment.
Prognosis is variable, 20% progress to ESRF
12. ◦ Post-infectious GN
Can occur after any infection; most common Strep
Pyogenes
Treatment is supportive
Generally resolves in 2–4 weeks.
13. ◦ Rapidly progressive GN
Can be due to any type of GN
Poor prognosis progression to renal failure in weeks
Medical emergency and early intervention crucial
Treat with aggressive immunosuppression, blood
pressure treatment and control of lipids.
14. Patient present with:
• chronic renal failure
• Small shrunken kidneys
• Chronic glomerulosclerosis and fibrotic changes
Pathological process usually burnt out and
does not respond to therapy
15. Accounts for 1/3 of patients requiring dialysis
or transplantation
Multiple presentations
Non Proliferative usually nephrotic
Proliferative usually nephritic
Rapidly progressive GN is a medical emergency
Alport syndrome
A genetic condition characterized by the progressive loss of kidney function and hearing. The prevalence of Alport syndrome is approximately 1 in 50,000 newborns
Alport syndrome can also affect the eyes. As this condition progresses, the kidneys become less able to function properly and kidney failure results.
Hearing loss is a common feature of Alport syndrome, but the abnormalities in the eyes seldom lead to loss of vision.
