Lipiduria
= lipid in urine
- diagnostic of glomerular disease
- usually in nephrotic disease b/c of the hyperlipidemia associated w/ the hypoalbuminemia
ASO
= strep antibodies
- when high can be a sign of post-streptococyl glomerulonephritis = acute nephritic syndrome
- proliferation of cells in glomeruli
- like to recover (good prognosis)
Hallmark of glomerular disease in urinalysis
RBC casts. Presence of protein and blood in urine Bc the glomerulus is damaged
Mesangial immunocomplex deposits
IgA glomerulopathy
Proliferation of parietal epithelial cells
-Proliferation of the parietal epithelium of Bowman’s capsule (simple squamous) causes crescents that encroach upon and destroythe glomerulus
Proliferative glomerulonephritis
> 100 nuclei in affected glomeruli
Membranous glomerulopathy
Thick GBM, no proliferative change
Membranoproliferative glomerulophritis
Thick FBM, hypercellular glomeruli
Granular immunofluorescence
Immunocomplex type of glomerulonephritis
- granular irregular deposits in the capillaries
ex: post strep GN
Dysmorphic RBCs in urine
= RBC w/ irregularly shaped membranes
-Nephritic
Key UA finding for nephritic syndrome
RBC casts
What is the BUN: Creatinine ratio in Nephritic syndrome?
> 15
-tubular fxn is intact
Glomerular disease associated w/ Hep C
MPGN = membranoproliferative glomerulonephritis
2 most likely causes of crescentic GN
ANCA or anti-GBM (both nephritic)
Differential for nephrotic syndrome
MCD, FSGS, MGN
Child w/ nephrotic syndrome is treated with what?
-treated w/ corticosteroids immediately (assuming MCD), then if they don’t improve do biopsy to look for other cause
Spikes and holes
MGN on silver stain
- seeing immune complexes deposited subepithelially = holes
- spikes = GBM
Anti-PLA2R antibodies
Primary MGN
Causes of secondary MGN
- lupus
- malignancy
Differential for intrinsic renal failure
ATN, interstitial nephritis
Acute interstitial nephritis
- normal glomerulus
- interstitium expanded by lymphocytes
- eosinophilia
