• Clinical science

Glomerular diseases (Glomerulonephritis)

Abstract

Renal glomeruli excrete urinary substances and excess water as an ultrafiltrate into the urine by selectively filtering the blood. Any damage to the glomeruli disrupts the filtration process and results in the appearance of blood components (proteins and red blood cells) in the urine. Glomerular damage is commonly caused by immune-mediated processes, which often lead to glomerulonephritis. Non-inflammatory causes, such as metabolic disease (e.g., diabetes, amyloidosis), can also result in significant damage to the glomeruli. The pathophysiology of glomerular diseases is complex; most patients present with either nephritic syndrome (low-level proteinuria, microhematuria, oliguria, and hypertension) or nephrotic syndrome (high-level proteinuria and generalized edema). All glomerular diseases can progress to acute or chronic renal failure. Thus, quick diagnosis and immediate initiation of immunosuppressive therapy are required to prevent irreversible kidney damage.

Definition

  • Terminology of glomerular diseases
    • Diffuse: all glomeruli are affected
    • Focal: only a number of glomeruli are affected
    • Global: the entire glomerulus is affected
    • Segmental: only part of the glomerulus is affected
    • Proliferative: an increased number of cells in the glomerulus
    • Sclerosing: scarring of the glomerulus
    • Necrotizing: cell death within the glomerulis
    • Crescentic: accumulation of cells such as macrophages, fibroblasts, and epithelial cells in Bowman's space

References:[1]

Pathophysiology

Overview glomerular diseases

Nephrotic vs. nephritic syndrome

Nephritic Syndrome

Nephrotic Syndrome

Presentation
Causes

All glomerular diseases can lead to acute and chronic kidney failure!


References:[2][2][3]

  • 1. Goljan EF. Rapid Review Pathology. Philadelphia, PA: Elsevier Saunders; 2013.
  • 2. Goldman L, Schafer AI. Goldman-Cecil Medicine, 25th Edition. Philadelphia, PA: Elsevier; 2016.
  • 3. Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J. Harrisons's Principles of Internal Medicine, 18th Edition, 2011. McGraw-Hill Medical; 2011.
  • Herold G. Internal Medicine. Cologne, Germany: Herold G; 2014.
last updated 12/10/2018
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