Gl

omer
ulonephr
it
is:
-
I
ntr
oduct
ion:
-
 I
tisater
m usedtorefer
stosever
alkidneydisease(bothki
dney)char
acteri
zedby
i
nfl
ammat i
oneit
herofthegl
omeruliorofthesmallbloodvessel
sinthekidney
.Butnot
al
lthedi
seasenecessar
il
yhaveaninfl
ammat orycomponent.

 I
toccursduetorepeat
edepi
sodesofacut
enephr
oti
csy
ndr
ome,
nephr
oscl
erosi
sand
hyper
li
pidemi
a.

 Def
ini
ti
on:
-
 Gl
omer
ulonephr
it
isi
saki
dneycondi
ti
ont
hati
nvol
vesdamage/
inf
lammat
iont
othe
gl
omer
uli
.

I
nci
dence:
-
 I
ncidencer at
esofpr i
mar yGNv arybet
ween0.2/100,
000/yearand2.5/
100,000/year.
thi
sdiseasecanexi stsubcl i
nicall
yandisther
efor
eonlydetectedbychanceinsome
pati
ents.Inadditi
on,ref
erralpolici
esfordi
agnosti
cbiopsyvarybet
weencount r
ies.Thi
s
wil
laffecttheinci
dencerat esfound.

 Et
iol
ogy&r
iskf
act
or:
-
 St
rept
ococcal
inf
ect
ionoft
het
hroat(st
rept
hroat
)orski
n(i
mpet
igo)

 Her
edi
tar
ydi
seases

 I
mmunedi
seases,
suchasSLE

 Di
abet
es

 Hi
ghbl
oodpr
essur
e

 Vascul
i
tis(
inf
lammat
ionoft
hebl
oodv
essel
s)

 Vi
ruses(
HIV,
hepat
it
isBv
irus,
andhepat
it
isCv
irus)

 Endocar
dit
is(
inf
ect
ionoft
hev
alv
esoft
hehear
t).

 Ty
pesofgl
omer
ulonephr
it
is:
-

1.Acut
egl
omer
ulonephr
it
is:
-
 Begi
nssuddenl
y.

 I
toccur
saf
ter5-
21day
sofst
rept
ococcal
Inf
ect
ion.

2.Chr
oni
cgl
omer
ulonephr
it
is:
-
 Dev
elopsgr
adual
l
yov
ersev
eral
year
s.I
toccur
saf
tert
heacut
ephase.

 Pat
hophy
siol
ogy
:-
Duet
oanyet
iol
ogi
cal
fact
or.

Rel
easeofAgsubst
ancei
ntot
heci
rcul
ati
on

For
mat
ionofAb

f
ormat
ionofAgandAbcompl
exi
nthegl
omer
ulus

I
nfl
ammat
oryr
esponse.

Pr
oli
fer
ationofepi
thel
i
alcel
l
sli
ningt
hegl
omer
ulusLeukocy
tesi
nfi
l
trat
ionoft
he
gl
omerulus.

Thi
ckeni
ngoft
hegl
omer
ularf
il
tr
ati
onmembr
ane.

scar
ri
ngandl
ossofgl
omer
ularf
il
tr
ati
onmembr
ane.

Decr
easeGFRapdgl
omer
uluspl
asmaf
low.

Ret
ent
ionofsodi
um andwat
er.
 Edemaandhy
per
tensi
on.

 Cl
i
nical
mani
fest
ati
ons:
-
 Fl
ankpai
n.

 Foamyur
ine.

 Col
acol
orordi
l
utedi
cedt
eacol
orur
ine.

 Hemat
uri
a.

 Ol
i
gur
ia,
Dysur
ia.

 Fat
iguet
oanemi
aandki
dneyf
ail
ure.

 Hy
per
tensi
on.

 Fl
uidRet
ent
ion.

 Di
agnost
icev
aluat
ion:
-
 Hi
stor
ycol
l
ect
ion

 Phy
sical
exami
nat
ion

 Ur
inal
ysi
s

 Bi
opsy

 I
VP

 Bl
oodTest

 USG

 Management
:-
 Tr
eat
mentdependont
hecauseoft
hedi
sor
der
,ty
peandsev
eri
tyoft
hesy
mpt
oms.

 Hi
ghB.
P.maybehar
dtocont
rol
.Cont
rol
l
ingt
heB.
P.

 usual
l
ythemosti
mpor
tantpar
toft
het
reat
ment
.

 Di
aly
sisMedi
cat
ion.

 Di
uret
ics.

 I
mmuno-
suppr
essant
s.
 Ant
i-
hyper
tensi
ve.

 Li
fest
ylechanges:
-
 Sodi
um andwat
err
est
ri
cti
on.

 Pot
assi
um,
phosphor
us,
magnesi
um r
est
ri
cti
on.

 Li
miti
ntakeofpr
otei
nint
hedi
et.

 Takecal
cium suppl
ement
s.

 Mai
ntai
naheal
thywei
ghtt
hroughdi
etandexer
cise.

 Phy
siot
her
apyt
reat
ment
.

 Pat
ienteducat
ion:
-
 Ly
mphat
icmessaget
oreducet
heedema.

 Br
eat
hingexer
cise-pur
sedl
i
panddi
aphr
agmat
icbr
eat
hing.

 Enduranceexerci
sesuchaswalki
ng,swimmi
ng,bicycl
ing,
aerobi
cdancing,
circul
ator
y
exer
cise.Thisexer
cisei
mprov
ey ourbl
oodci
rcul
ation,
acceler
ateki
dneytodischarge
wasteandt oxi
ns.

 Compl
i
cat
ion:
-
 Acut
eandchr
oni
crenal
fai
l
ure.

 Nephr
oti
csy
ndr
ome.

 Hy
per
tensi
on.

 El
ect
rol
ytei
mbal
ances.

 Pul
monar
yedema.

 CHFduet
ofl
uidov
erl
oad.