Glomerulonephritis - 2024 PDF

glomerulonephritis by Group 2: Omda, Fai, Shweden, Ali, Waad, Razan, Fatima, Osama, Asmaa, Shima  Objectives Introduction Pathophysiology Clinical Presentation Investigations Prognosis Treatment Introduction  Nephron The main organ of the Urinary...

glomerulonephritis by Group 2: Omda, Fai, Shweden, Ali, Waad, Razan, Fatima, Osama, Asmaa, Shima  Objectives Introduction Pathophysiology Clinical Presentation Investigations Prognosis Treatment Introduction  Nephron The main organ of the Urinary System is the Kidney The functional unit of the kidney is nephron There are about 1,000,000 nephrons in each human kidney  Nephron Each nephron has two components: Vascular component: Renal tubule: Renal Corpuscle: 1. Proximal convoluted 1. Glomerulus tubule (PCT) 2. Bowman’s capsule 2. Loop of Henle 3. Distal convoluted tubule (DCT) 4. Collecting ducts (CD)  Nephron The Nephron Execute the Kideny function Through 4 Processes: Reapsorbtion Filitiation Excretion Secretion  Nephron Filtration: Transport of water and solutes through the filtration membrane from the blood into the Bowman’s Capsule due to pressure gradient. The Substances go through the following layers: 1. Fenestrated Endothelium layer of the capillaries 2. Glomelures Basement Membrane (-ve) 3. Epithelial cells of Bowman’s capsule (podocytes)  Nephron Mesangial Cells: Mesangial cells are specialized cells located within the glomerulus of the kidney. Their main function is: 1. Phagocytic Activity 2. Structural Support 3. Regulation of Glomerular Filtration What is the glomerulonephritis?  Glomerulonephritis a subset of renal diseases characterized by immune- mediated damage to the basement membrane, the mesangium, or the capillary endothelium, resulting in hematuria, proteinuria, and azotemia which affect the Filtration. Usually inflammatory but it can not ( DM)  Glomerulonephritis It can be divided based on the following: Time of onset to: 1. Acute: A sudden onset of glomerular inflammation (post-streptococcal glomerulonephritis) 2. Chronic: A long-term condition where the glomeruli are progressively damaged over years (Berger's Disease)  Glomerulonephritis Aetiology 1. Primary: Glomerular diseases that originate primarily within the kidneys without a systemic disease (Membranous Nephropathy) 2. Secondary: Glomerular diseases that occur as a part of systemic diseases affecting multiple organs (Diabetic Nephropathy) Pathophysiology in General, How does this disease happened?  Pathophysiology Triggering Event: Infection or Autoimmune Response: An infection (e.g., streptococcal infection) or an autoimmune disorder (e.g., lupus) triggers the production of antibodies. Immune Complex Formation: Circulating Immune Complexes: Antibodies bind to antigens forming immune complexes in the bloodstream.  Pathophysiology Deposition in Glomeruli: Immune Complex Deposition: Immune complexes deposit in the glomerular basement membrane or mesangium. Direct Antibody Attack: Antibodies attack specific components of the glomerular basement membrane (e.g., anti-GBM disease)  Pathophysiology Activation of Immune Response: Complement Activation: The complement system is activated, leading to the production of inflammatory mediators. Glomerular Inflammation and Injury: Inflammation: Inflammatory cells release enzymes and free radicals, causing damage to the glomerular endothelial and epithelial cells.  Pathophysiology Alteration of Glomerular Structure: Podocyte Damage: Damage to podocytes (cells lining the glomeruli) disrupts the filtration barrier, leading to proteinuria. Mesangial Proliferation: Mesangial cells proliferate and expand, leading to further glomerular damage. Clincal Presentation  Clincal Presentation hematuria: may be visible or only under the microscope. It’s due to the inflammation of glomeruli which allows RBCs to leak into urine Proteinuria: present of protein in urin  Clincal Presentation hypertension: due to reduced kidney function and fluid retention edema: in hand, feet, face, abdomen due to loss of protein in urine which will lead to low oncotic pressure  Clincal Presentation oliguria: low urine output azotemia: high nitrogenous waste in blood such as urea flank pain: pain in lower back or side due to inflammation of the kidney Investigation  Investigation urinalysis: examines the urin for present of blood or protein or othe abnormalities urin protein-to-creatinine ratio: measure the amount of protein relative to creatinine in urin to assess proteinuria what is creatinine? It’s wast product produced by muscles and if it’s high that is mean there is something in kidney  Investigation serum creatinine and blood urea nitrogen: to assess kidney function by measuring the level of wast product in blood - ⁠what is urea? It’s wast product formed by breakdownof proteins and if it’s high that means there is something with the kidney  Investigation cbc: to reveal anemia and other abnormalities ultrasound: identify structural abnormalities or obstructions renal biopsy: to know specific type of glomerulonephritis Prognosis  Prognosis Glomerulonephritis affects the ability of nephrons to filter the bloodstream efficiently. The breakdown in filtering results in: Accumulation of wastes or toxins in the bloodstream. Poor regulation of essential minerals and nutrients. Loss of red blood cells. Loss of blood proteins.  Prognosis Possible complications of glomerulonephritis include: Acute kidney failure. Chronic kidney disease. High blood pressure. Nephrotic syndrome. Treatment  Treatment Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is and the underlying cause of the condition. Some cases of glomerulonephritis get better on their own. If the illness continues, you may have kidney failure. This has no cure. Treatments focus on slowing the progression of the disease and preventing complications. Treatment may include:  Treatment Blood pressure medicines such as ACE (angiotensin-converting enzyme) inhibitors that protect blood flow into the kidneys Corticosteroids to decrease inflammation that leads to scar tissue Diuretics (water pills) to remove excess fluid in the body through more urine production Diet changes including eating less protein, sodium, and potassium  Treatment Dialysis to remove wastes and fluid from the blood after the kidneys have stopped working Kidney transplant to replace your diseased kidney with a healthy kidney from a donor Any Questions? Thank you