Renal System >
“A syndrome consisting of symptoms related to inflammation of the glomeruli“
- Modifiable: n/a
- Recent Infections
- Underlying immune system disorders (such as Systemic Lupus Erythematosus or Vasculitis)
- Certain genetic disorders
- Family history of Kidney disease
- IgA nephropathy (Berger’s disease) – The commonest cause of primary GN and is commonly seen in children 1-2 days post-URTI
- Post-streptococcal GN – seen in children/adolescences but is usually 2-3 weeks post-streptococcal infection (tonsillitis, impetigo)
- Membranoproliferative GN (primary or SLE) – seen in adults
- Goodpasture’s syndrome (autoantibodies against BM) – also affects lungs = haemoptysis due to type IV collagen involvement)
- Inflammatory process affecting the glomeruli → increased capillary permeability → RBC’s leaking into the tubule and therefore appear in urine → reduced GFR → AKI
- The exact cause of inflammation is dependent on the underlying cause and can be either infective or auto-immune with immune complex deposition.
- Abrupt onset of haematuria (cola-coloured urine) with RBC casts in the urine
- Sterile pyuria (cloudy with pus)
- Oliguria (AKI)
- There may also be mild proteinuria (<3.5g/day) but less than nephrotic syndrome
- If left untreated they may present with uraemic symptoms form AKI.
- Urea and Electrolytes – assess Glomerular Filtration Rate for AKI
- Imaging: n/a
- Urinalysis – Any haematuria?
- Renal biopsy – diagnose the underlying cause
- Conservative: n/a
- Control blood pressure – ACE Inhibitors or angiotensin receptor blockers
- Reduce inflammation – use steroids
- Surgical: n/a
- Quickly progress into AKI and have the complications associated with this
- Chronic inflammation can result in CKD and may result in the need for dialysis/renal transplantation
- Prognosis is usually better in children than it is in adults.