Shunt Nephritis

Shunt nephritis occurs when a shunt becomes infected with bacteria, most commonly
Staphylococcus epidermidis. Bacteria from this infected shunt seed the bloodstream, leading to
blood infection (bacteremia). In response to long-standing infection (months to years), the body
mounts an immune response that results in deposition of immune complexes in the kidney,
leading to nephritis.
In these infections, IgC and IgM antigen- antibody immune complexes are formed and
deposited in the renal glomeruli. The complement system is activated with subsequent depletion
of circulating complement factors C3 and C4. Thickening of the glomerular basement membrane,
accompanied by mesangial cell proliferation, leads to nephrotic syndrome.

Rule In
Proteinuria
Hematuria
Febrile episodes
Hepatosplenomegaly

Rule Out
History of VA shunt placement as treatment for
hydrocephalus
No hypertension
No azotemia
No anemia