Lecture Notes: Glomerulonephritis

Overview of Glomerulonephritis

• Glomerulonephritis: Inflammation of the glomerulus.
  • Results in hematuria, proteinuria, red blood cell casts.
  • Can lead to hypertension, renal failure.

Causes of Glomerulonephritis

• Acute Glomerulonephritis

  • Characterized by red blood cell casts.
  • Primary Causes:
    • Post-strep glomerulonephritis
      • Not preventable by treating strep throat.
    • Infectious glomerulonephritis (pyelonephritis).
    • IgA nephropathy (Berger's disease).
    • Membranoproliferative glomerulonephritis (MPGN).
  • Secondary Causes:
    • Henoch-Schönlein purpura (HSP)
    • Lupus
    • Polyarteritis nodosa
    • Hemolytic uremic syndrome (HUS)
    • Subacute endocarditis
    • Goodpasture syndrome

• Chronic Glomerulonephritis

  • Does not typically present with casts.
  • Primary Causes:
    • Membranoproliferative glomerulonephritis
    • Membranous nephropathy
    • Focal glomerulosclerosis
    • Mesangial proliferative nephritis
  • Secondary Causes:
    • Same as acute causes: HSP, lupus, polyarteritis nodosa, HUS, subacute endocarditis, Goodpasture syndrome

Diagnosis

• Not always requiring biopsy.
• Situational diagnoses: post-strep glomerulonephritis, hemolytic uremic syndrome, Henoch-Schönlein purpura.
• Complement Levels:
  • Low C3, normal C4 in post-strep glomerulonephritis.
  • Low C3, low C4 in lupus, shunt nephritis, bacterial endocarditis.

Prognosis

• Generally excellent prognosis.
• 98% of children recover fully.
• 2% may develop chronic renal failure or chronic kidney disease.

Summary

• Focused on understanding hematuria and glomerulonephritis.
• Important distinctions in acute versus chronic conditions and primary versus secondary causes.