GLOMERULAR

DISORDERS
CATALUÑA, Hanz Nikko G
BMLS 3E
Glomerular Disorders

• Immunologic
• Nonimmunologic
 • IgA Nephropathy
GLOMERULO- • Chronic Glomerulonephritis
NEPHRITIS • Acute Poststreptococcal
Inflammation of Glomerulonephritis
Glomerulus and • Rapidly Progressive
associated with the Glomerulonephritis
findings of blood, • Goodpasture Syndrome
protein, and casts • Wegener Granulomatosis
in the urine. • Henoch – Schonlein Purpura
• Membranous
Glomerulonephritis
Immunoglobulin A Nephropathy
Primary Urinalysis Result:
• Berger Disease
• Most commonMacroscopic hematuria
cause of glomerulonephritis
Microhematuria
• Immune complexes containing IgA are deposited on
Proteinuria
the glomerular membrane
RBC
• Patients have casts serum levels of IgA
increased
 Primary Urinalysis
Acute Poststreptococcal Result:
Glomerulonephritis
• Sudden onsetMacroscopic hematuria
of symptoms consistent with damage to
the glomerularMicrohematuria
membrane
• Fever
Proteinuria
• Edema
• Oliguria RBC casts
• Hematuria Hyaline and granular casts
• Proteinuria WBC
• Caused by group A Beta-hemolytic Streptococcus
 Primary Urinalysis
Goodpasture SyndromeResult:
• AutoimmuneMacroscopic hematuria
Disease that attacks the basement
membraneMicrohematuria
of the alveoli and glomeruli
• Morphologic
Proteinuria
changes to the glomeruli resembling
those in RPG
RBC casts
• Production of Antiglomerular Basement Membrane
Antibody
 Primary Urinalysis Result:
Wegener Granulomatosis
• Small VesselHematuria
Vasculitis
Proteinuria
• Causes a granuloma-producing inflammation of the
small bloodRBC casts
vessels (kidney and respiratory system)
• Antineutrophilic Cytoplasmic Antibody (ANCA)
• ANCA + Neutrophil = Vasculitis with granuloma formation
Henoch-Schonlein Purpura
Primary Urinalysis Result:
• Small vessels vasculitis
Hematuria
• Occurs primarily in children after upper repiratory
infection Proteinuria
• AppearanceRBC castsRed patches on the skin
of raised,
(purpura)
• Blood in the sputum and stools
Rapidly Progressive Glomerulonephritis
• Crescentic glomerulonephritis
• Development of Crescents in the glomerulus can happen in
several ways
• Idiopathic
• Type 1 – Anti-GBM Antibodies
• Type 2 – Immune Complexes
• Type 3 – Pauci – immune
• Damage by macrophages to the capillary walls releases
cells and plasma into the urine.
Rapidly Progressive Glomerulonephritis
• Expansion of epithelial cells into a thick, crescent-
moon shape is caused by the presence of:
• Monocytes and Macrophages
• Plasma Protein
• Fibrin
• Parietal Epithelial Cells – which proliferates
• This crescent may undergo sclerosis, where it is replaced by
connective tissue
Chronic Glomerulonephritis
• Long-term inflammation of the glomeruli (microscopic
structures in the kidney that filter blood and produce urine).
• End Stage Renal Disease
• Is the last stage of Chronic Kidney Disease
• Your kidneys are no longer able to work as they should to meet
your body's needs
• You need dialysis or kidney transplant
• Symptoms: Fatigue, Anemia, Hypertension, Edema and
Oliguria
Nephrotic Syndrome
• Marked by massive
proteinemia (>3.5 g/day)
• Low levels of serum
albumin
• High levels of serum
lipids
• Edema
 Primary Glomerulonephritis
Membranous Urinalysis Result:

Microhematuria
• Predominant characteristics
• Thickening of the glomerular basement membrane
Proteinuria
• Hallmarks of Membranous Glomerulonephritis
Fatty Casts
• Proteinuria (>3.5 g/day)
Fat Droplets
• Hypoalbuminemia
• Edema Oval Fat Bodies
• Lipiduria
Minimal Change Disease
• Lipid nephrosis
• Little cellular change in the glomerulus
• Symptoms
• Edema
• Heavy Proteinuria
Focal Segmental Glomerulosclerosis
• Affects only certain numbers and areas of glomeruli, and
others remain normal
• Associated with:
• Heroin abuse
• AIDS