Nephrology > Glomerular Diseases > Flashcards

Glomerular Diseases Flashcards

(16 cards)

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1
Q

the normal glomerulus is partitioned into

A
  • Mesangium
  • endothelium
  • basement membrane
  • epithelium
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2
Q

Diagnostic clues of glomerular disease?

A
  • proteinuria
  • active urine sediment
  • rbc, dysmorphic RBC, RBC casts
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3
Q
  • 80-150mg/ 24 hrs is normal
  • nephrotic range proteinuria (> 3.5g/day)
  • subnephrotic proteinuria (between 150mg and 3.5g/day)
A

proteinuria

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4
Q

what is albuminuria? What are the normal values

A

Presence of albumin in urine

  • normal < 30mg/gm
  • moderately increased 30-300 mg/gm
  • severely increased > 300mg/gm
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5
Q

what is hematuria? what is glomerular hematuria?

A

> 3 RBCs per high power field

Glomerular hematuria = dysmorphic RBCs and casts

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6
Q

what is active sediment?

A

RBC casts or dysmorphic RBCs= an inflammatory process

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7
Q

what should you do if you suspect kidney failure and glomerular disease?

A
  • if there is evidence of renal failure AND glomerular hematuria- STOP
  • often biopsy is indicated
  • you likely have an aggressive, inflammatory process that needs to be treated emergently
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8
Q

classification of glomerular disease?

A

Primary

  • when major problems starts in the glomerulus

Secondary

  • when involvement is part of systemic disease
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9
Q

nephritic syndrome looks like?

A
  • hematuria (+/-RBC casts)
  • HTN
  • non-nephrotic range proteinuria
  • edema
  • azotemia, oliguria, signs of uremia

more emergent needs kidney biopsy for diagnosis

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10
Q

Nephrotic syndrome looks like?

A
  • Massive proteinuria (> 3.5g/day)
  • edema
  • hypoalbuminemia
  • hyperlipidemia
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11
Q

causes of nephritic syndrome?

A
  • lupus nephritis
  • IgA nephropathy
  • ANCA vasculitis
  • post infectious GN
  • thin basement
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12
Q

causes of nephrotic syndrome?

A
  • membranous nephropathy
  • focal segmental glomerulosclerosis
  • minimal change disease
  • Diabetic nephropathy
  • amyloidosis
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13
Q
  • Nephritic syndrome + renal impairment
A

Can be RPGN (rapidly progressive glomerular nephritis)

  • RPGN: nephritic syndrome + doubling of serum Cr or 50% decrease in GFR over < 3 months
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14
Q

when should a kidney biopsy be completed?

A
  • no hard and fast rule
  • cause cannot be determined w/o it
  • differential has different treatments
  • worsening creatinine
  • proteinuria > 1gm despite treatment
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15
Q

therapy for glomerular disease

A
  • managment of the proteinuria
  • immunomodulatory therapies
  • managment of systemic diseases that cause secondary glomerular injury
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16
Q

ways to decrease proteinuria?

Study These Flashcards
A
  • Inhibition of the renin-angiotensin system (either ACEi or ARB)
  • SGLT2i in both diabetics and nondiabetics
  • good BP control
  • good DM control
  • quitting smoking
  • low sodium diet (< 2000 mg of Na/day)
  • weight loss (if obese)
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