Chronic Glomerulonephritis: Understanding the Causes, Symptoms, and Treatment - Prof. Besh, Study notes of Medical Microbiology

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Name : Youssef Hamdi

Subject: Chronic

Glomerulonephritis

Definition

Chronic glomerulonephritis results when tufts

of blood capillaries in the kidney (glomeruli)

that filter waste and control fluid excretion

gradually become unable to function properly.

Glomerulonephritis is a patrial damaged of

kidneys. Chronic glomerulonephritis a slowly

progressive glomerulonephritis generally

leading to irreversible renal failure.

Causes:

• The cause of glomerulonephritis is unknown.
• Known causes include infections: post-streptococcal

glomerulonephritis, bacterial endocarditis, viral

infections, lupus nephritis, Good pasture's syndrome,

and immune diseases: IgA nephropathy, polyarthritis,

Wegener's granulomatosis and

• Conditions that cause scarring of the glomeruli are

HTN, diabetic kidney disease, focal segmental

glomerulosclerosis.

Risk factors of

glumerulonephritis

• Blood or lymphatic system disorders
• Exposure to hydrocarbon solvents
• History of cancer
• Infections such as streptococcal

infections, viruses, heart infections, or

abscesses.

Pathophysiology of

Glomerulonephritis

Reduction in nephrons mass from the initial

injury reduces the GFR. This reduction leads to

hypertrophy and hyper filtration of the

remaining nephrons and to the initiation of

intraglomerular hypertension. These changes

occur to increase the GFR of the remaining

nephrons, thus minimizing the functional

consequences of nephrons loss.

Continue

Pathophysiology..........•........

In early renal disease, a substantial decline in the

GFR may lead to only slight increases in serum

creatinine levels. Azotemia is apparent when the

GFR decreases to less than 60-70 ml/min.

Accumulation of toxic waste products affects all

organ systems. Uremia occurs at a GFR of

approximately 10 ml/min. Some of these toxins have

been identified, but none has been found to be

responsible for all thesymptoms.

Client may have Following

Symptoms:

Cough and shortness of breath

Abdominal pain

Blood in vomit or stools Nose bleed

Excessive urination

General ill feeling, fatigue, and loss of

appetite

Joint or muscle aches

Diagnosis

• History and physical examination
• Urinanalysis: may show RBCs and red casts, an

indicator of possible damage to the glomeruli, WBCs, a

common indicator of infection or inflammation. Increased

protein, which may indicate nephrons damage.

• Blood tests: creatinine and BUN
• Imaging tests: chest x-rays, kidney X-rays, IVU, USG, CT

Scan

• Kidney biopsy: A kidney biopsy is necessary for confirm

a diagnosis of glomerulonephritis.

Complications

• Malignant HTN
• Chronic or repeated UTI
• Congestive heart failure, pulmonary edema
• Chronic kidney disease
• End-stage kidney disease
• Increased susceptibility to other infections
• Nephrotic syndrome

Treatment

• Prescription of antihypertensive medication:

diuretics, angiotensin-converting enzyme

inhibitors, angiotensin Il receptor agonists.

• Other drugs to treat the underlying cause of

glomerulonephritis are:

For streptococcal or other bacterial infections

use antibiotic

• Fluid restriction with prescription of low sodium,

low protein, low potassium.

Prevention

Seek prompt treatment of streptococcal infection

causing a sore throat or impetigo

• To prevent infections, such as HIV and hepatitis that

can lead to some form of

glomerulonephritis follow safe-sex guidelines and

avoid intravenous drug use.

• Control blood sugar if client having diabetes mellitus.
• Control blood pressure if client having hypertension.