Makindo Medical Notes

Related Subjects: |Metabolic acidosis |Lactic acidosis |Acute Kidney Injury (AKI) / Acute Renal Failure |Renal/Kidney Physiology |Chronic Kidney Disease (CKD) |Anaemia in Chronic Kidney Disease |Analgesic Nephropathy |Medullary Sponge kidney |IgA Nephropathy (Berger's disease) |HIV associated nephropathy (HIVAN) |Balkan endemic nephropathy (BEN) |Autosomal Dominant Polycystic kidney disease

In the past, many cases of glomerulonephritis occurred 2 to 3 weeks after a Group A Beta-haemolytic streptococcal sore throat, marked by the sudden onset of smoky, brown-colored urine due to haematuria and signs of uraemia. Most of these cases were transient, with patients making a full recovery. The incidence of such cases has decreased with the widespread use of antibiotics. The condition is believed to be immune-mediated.

Nephritic Syndrome

• Haematuria: Characterized by brown or "smoky" coloured urine due to the presence of blood.
• Proteinuria: Protein in the urine, though often less than 4.5 g/day, leading to frothy urine.
• Hypertension: Elevated blood pressure, commonly associated with nephritic syndrome.
• Uraemia: A build-up of waste products in the blood, leading to symptoms such as fatigue, nausea, and confusion.

Causes of Nephritic Syndrome

• Post-infectious Glomerulonephritis: Often follows an infection, particularly Group A Streptococcus, leading to immune-mediated kidney inflammation.
• Crescentic Glomerulonephritis: A rapidly progressing form of glomerulonephritis characterized by crescent-shaped lesions in the glomeruli.
• IgA Nephropathy: Also known as Berger's disease, where IgA immune deposits in the glomeruli cause inflammation.
• Haemolytic Uraemic Syndrome (HUS): A condition often triggered by bacterial toxins (such as E. coli), leading to kidney damage, thrombocytopenia, and haemolysis.
• Alport's Syndrome: A genetic condition affecting collagen production, leading to progressive kidney disease, hearing loss, and eye abnormalities.
• Mesangiocapillary Glomerulonephritis (MCGN): A rare form of GN characterized by thickening of the glomerular capillary walls.
• Mesangioproliferative Glomerulonephritis: Involves mesangial cell proliferation, leading to glomerular dysfunction and inflammation.

Glomerulonephritis Related to Systemic Conditions

• Systemic Lupus Erythematosus (SLE): An autoimmune disorder that often affects the kidneys, leading to lupus nephritis and inflammation of the glomeruli.
• Polyarteritis Nodosa: A type of vasculitis that causes inflammation of small and medium-sized arteries, affecting the kidneys and other organs.
• Granulomatosis with Polyangiitis (formerly Wegener's Granulomatosis): A type of vasculitis that primarily affects the kidneys and respiratory tract, often leading to glomerulonephritis.
• Infective Endocarditis: A bacterial infection of the heart valves that can lead to immune complex deposition in the glomeruli.
• Cryoglobulinaemia: A condition where abnormal proteins precipitate in the blood at cold temperatures, causing vasculitis and kidney damage.
• Henoch-Schönlein Purpura (IgA Vasculitis): A form of vasculitis that primarily affects children, often presenting with purpura, abdominal pain, and glomerulonephritis.