Nephrotic Syndrome
- Massive Proteinuria > 3.5g per Day
- Edema
- Increased risk of infection
- Thromboembolism
- Hyperlipidemia
- Fatty casts
Minimal Change Disease
- Nephrotic
- Most Common in Children
- May be Triggered by Recent Infection or Immune Stimulus
- On Electron Microscopy (EM) See Foot Process (Podocyte) Effacement
- On Light Microscopy (LM) See Normal Glomeruli
- Loss of Negative Charge
- Selective Loss of Albumin
- Responds to Corticosteroids
Focal Segmental Glomerulosclerosis
- Most Common Cause of Nephrotic Syndrome in Hispanic People and African Americans
- Associated with Sickle Cell Disease and HIV
- Associated Interferon Therapy and Heroin Abuse
- LM Segmental Sclerosis and Hyalinosis
- EM Focal Damage of Visceral Epithelial Cells
- IF Negative
- Microscopic Hematuria
- Nonselective Proteinuria
- Poor Prognosis
Glomerulonephritis Assessment
- Group A Beta-Hemolytic Streptococcal Infection
- Hypertension
- Hematuria
- Proteinuria
- Oliguria
- Generalized Edema
- Increased BUN and CR
- Flank Pain
Acute Glomerulonephritis Interventions
- Rest
- Restrict Salt and Fluid Intake
- Restrict Protein
- Antihypertensives
- Diuretics
- Antibiotics
Berger's Disease (IgA Nephropathy)
- Nephritic
- IgA Nephropathy
- Immune Complex Deposit in Mesangium
- Increased Synthesis of IgA
- Most Common Cause of Nephritic Syndrome
- Overlapping Features with Henoch–Schönlein Purpura
- Presents with Pharyngitis, URI or Acute Gastroenteritis
Post Streptococcal Glomerulonephritis
- Nephritic
- Children
- Edema
- Cola Colored Urine
- Follows Group A Streptococcal pharyngitis or Skin Infection
- Neutrophils
- Immunofluorescence (IF) Granular
- Lumpy Bumpy Appearance on Immunofluorescence (IF)
- Subepithelial Immune Complex Humps
Membranoproliferative Glomerulonephritis
- Nephritic-Nephrotic Syndrome
- Type I
- Subendothelial Immune Complexes
- Hepatitis C Virus
- Granular IF
- Tram Tracks Caused by Splitting of the GBM
- Ingrowth of Mesangium
- Type II
- Dense Deposit Disease
- C3 Nephritic Factor
Membranous Glomerulonephritis
- Nephrotic
- LM Thickening of Capillary and Glomerular Basement Membrane (GBM)
- EM Spike and Dome Appearance with Subepithelial Deposits
- IF Granular
- Phospholipase A2 Receptor Autoantibodies
- NSAIDS
- Gold
- Solid Tumors
- Hepatitis B Virus (HBV)
- Lupus
Rapidly Progressive Glomerulonephritis
- Nephritic Syndrome
- Crescent Shape
- Crescents Consist of Fibrin and C3b
- With Parietal Cells, Monocytes, and Macrophages
- Linear Immunofluorescence
- Negative Immunofluorescence
- Granular Immunofluorescence
- Goodpasture Syndrome
- Granulomatosis with Polyangiitis (Formerly Wegener's)
- Microscopic Polyangiitis
- Poor Prognosis
Anti-glomerular Basement Membrane Antibodies
- Glomerulonephritis
- Goodpasture's Disease
- Linear immunofluorescence
- Hemoptysis
- Hematuria
Microscopic Polyangiitis
- Necrotizing Small Vessel Vasculitis
- Lungs, Kidneys, and Skin Commonly Affected
- Palpable Purpura
- Rapidly Progressive Cresentic Glomerulonephritis
- Lesions are Same Age
- Non-granulomatous
- Minimal Nasopharyngeal Involvement
- P-ANCA
- Corticosteroids
- Cyclophosphamide
Granulomatosis with Polyangiitis (GPA) Characteristics
- Small Vessel Vasculitis
- Necrotizing
- Lungs and Upper Airway
- Crescentic Glomerulonephritis
- c-ANCA
- X-ray
- Multiple Nodules in Lungs
- Cyclophosphamide
- Corticosteroids
- Rituximab
Granulomatosis with Polyangiitis (GPA) Symptoms
- Saddle Nose
- Perforation of Nasal Septum
- Chronic Sinusitis
- Otitis Media
- Mastoiditis
- Cough
- Dyspnea
- Hemoptysis
- Rapidly Progressive Glomerulonephritis
- Hematuria
- RBC Casts