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Renal Glomerular Disease

Glomerular Diseases


Presentation

  • In all cases, the number of RTCs was within normal limits or slightly increased, and a variable number of non-G1DEs were present in 161 cases.[ncbi.nlm.nih.gov]
  • Group I was subdivided on the basis of whether extensive mesangiocapillary change was present or not.[ncbi.nlm.nih.gov]
  • May present with the nephrotic syndrome. May present with the nephritic syndrome.[what-when-how.com]
  • Just over 2/3 of patients were dialysis-dependent on presentation.[renalfellow.blogspot.com]
  • MCC primary glomerular disease Presentation - young man who develops macroscopic haematuria 1-2 days after URTI. Can also present with asymptomatic haematuria, proteinuria and renal impairment.[brainscape.com]
Fatigue
  • She also reported having fatigue, dizziness, and decreased appetite. A week before the onset of symptoms, a mild upper respiratory tract infection had developed.[nejm.org]
  • Diagnosis As many people have no symptoms, it may take a routine check-up or tests linked to hypertension or fatigue to reveal glomerulonephritis. Diagnosis can be difficult, as the causes are often unknown.[medicalnewstoday.com]
Weight Gain
  • Retention of salt and water causes weight gain and ankle swelling.[omicsonline.org]
Kidney Failure
  • In many cases, CKD leads to kidney failure. What are kidney failure and end-stage renal disease? Kidney failure is the acute or chronic loss of 85 percent or more kidney function.[niddk.nih.gov]
  • Treatment or management of the early stages of kidney failure depends on the disease causing the damage.[kidneyhealthcare.com]
  • Sometimes you may need medication or temporary treatment with an artificial kidney machine to remove extra fluid, control high blood pressure and treat kidney failure.[kidney.org]
  • In most of these cases it ends in kidney failure. Glomerular disease may lead to total loss of kidney function, either rapidly or, more commonly, in a slowly progressive fashion over many years.[news-medical.net]
Oliguria
  • The pathophysiology of glomerular diseases is complex; most patients present with either nephritic syndrome (low-level proteinuria, microhematuria, oliguria, and hypertension ) or nephrotic syndrome (high-level proteinuria and generalized edema ).[amboss.com]
  • Signs and symptoms The symptoms of glomerular disease include: Edema (swelling) in different parts of the body Reddish, brownish, or pinkish urine Foamy urine Oliguria (reduced urine output) The signs which might be picked up on urine and blood testing[news-medical.net]
  • Oliguria E. Hyperlipidemia Which of the following conditions produce marked proteinuria (Excretion of 3.5 grams daily) ? A. Neprhotic Syndrome B. Systemic lupus erythematosus C. Renal vein thrombosis D. Amyloidosis E.[quizlet.com]
  • Nephrotic syndrome - heavy proteinuria leading to hypoalbuminaemia and oedema Clinical assessment of glomerular disease History: - Recent frank haematuria 1-2 days after URTI - IgA nephropathy - Nephritic syndrome (haematuria, oedema, hypertension, oliguria[brainscape.com]
  • Slight oliguria and rise in BUN Maintenance: oliguria, salt and water overload, rising BUN, hyperkalemia, metabolic acidosis Recovery: increase in urinary output (up to 3L/day), hypokalemia, BUN returns to normal.[pathologystudent.com]

Workup

  • Patients who fail to respond to treatment are referred for early kidney transplant workup and the philosophy of this group is to avoid dialysis if possible.[mayo.edu]
  • Kashani, Biomarkers for Early Detection of Acute Kidney Injury, The Journal of Applied Laboratory Medicine: An AACC Publication, September 2017, jalm.2017.023325; DOI: 10.1373/jalm.2017.023325 (May 1, 2017) Arora, P Chronic Kidney Disease Workup.[labtestsonline.it]
  • […] bisphophonates Malignancy Leukemia, Lymphoma Infection Syphillis, HIV, Hepatitis Allergy Associated with multiple environmental allergies Again though, secondary MCD is very uncommon, and a diagnosis of MCD does not confer any risk of having (or prompt a “workup[unckidneycenter.org]
  • Because MN may also be associated with malignancy or infection, the workup for post-transplant MN should include a careful search for underlying cancer or viral infection.[cjasn.asnjournals.org]

Treatment

  • Different findings on biopsy can suggest various causes and can be helpful in prognosis and determining treatment. Treatment Multiple treatments are available.[med.stanford.edu]
  • Services offered by the Glomerular/Renal Parenchymal Disease Clinic Comprehensive medical evaluation and treatment including: Multidisciplinary approach to diagnosis and treatment of glomerular diseases Evaluation of patients experiencing common conditions[mayoclinic.org]
  • A biopsy will help your healthcare provider plan the best treatment for you. What treatment is available for glomerular disease? Your healthcare provider will need to find what is causing your glomerular disease.[kidney.org]
  • While a trial of treatment may still be indicated, I believe a rapid re-assessment of the patient’s condition and need for continued immunosuppressive therapy is indicated given the high infectious risks with treatment.[renalfellow.blogspot.com]
  • Washington University offers SLE patients a multidisciplinary approach to diagnosis and treatment of SLE.[renal.wustl.edu]

Prognosis

  • Different findings on biopsy are extremely helpful in establishing prognosis and determining treatment.[med.stanford.edu]
  • New-onset post-transplant diabetes may worsen both the patient and graft prognosis.[cjasn.asnjournals.org]
  • […] excellent Isolated Hematuria/Benign recurrent hematuria -Defined as asymptomatic hematuria after other possibilities are excluded -Renal biopsy normal -50% remission after 5 years, good prognosis Crescent formation in the glomeruli are commonly seen[quizlet.com]
  • These forms present with the nephritic syndrome, hypocomplementemia, and have a poor prognosis.[en.wikipedia.org]

Etiology

  • “This study looking at a vast and diverse population across 17 countries and 4 continents provide further insights into the epidemiology of glomerular disease and also underscore the complexity behind the etiology of glomerulonephropathies,” said John[renalandurologynews.com]
  • HIV - variant is associated Obesity Black patients - defect in CD2AP slit pore protein What is the etiology of membranous nephropathy? What does imaging show and how do patients respond to treatment? MCC nephrotic syndrome in older patients.[brainscape.com]
  • They may be classified by clinical severity, by histological changes in the kidney, or by etiology.[medical-dictionary.thefreedictionary.com]
  • Diagnosis Although renal biopsy remains the definitive diagnostic tool in glomerular disease, a thorough clinical evaluation is essential in determining the etiology and nature of these cases.[what-when-how.com]
  • The only exception was the infection caused by a streptococcal organism, but in most cases, the etiology of infections was variable with different characteristics of presentation. The histologic picture at biopsy was also heterogeneous.[cjasn.asnjournals.org]

Epidemiology

  • Sim, MD, who has conducted epidemiologic studies of glomerular diseases but was not involved in the new study. “The findings suggest the interplay and importance of both nature and nurture on glomerular disease.”[renalandurologynews.com]
  • We actively track the epidemiologic patterns in glomerular disease through the Mayo Clinic renal biopsy database.[mayo.edu]
  • […] breast, colon, prostate -Nephrotic syndrome may precede clinical evidence of cancer by up to 1 year Associated with certain drugs or other agents -Gold, penicillamine, hydrocarbons, mercury, formaldehyde, captopril Minimum Change Nephrotic Syndrome epidemiology[quizlet.com]
  • Epidemiology Diseases of the glomerulus are the most common causes of end-stage renal disease worldwide.[what-when-how.com]
  • Research Opportunities The Glomerular Fellow will have the opportunity to participate in all aspects of ongoing research at the Center for Glomerular diseases, including therapeutic trials, epidemiological research, clinical investigations, and basic[columbianephrology.org]
Sex distribution
Age distribution

Pathophysiology

  • Damage to the glomeruli disruption of the glomerular filtration barrier can lead to nephritic or nephrotic syndrome See pathophysiology of nephritic syndrome See pathophysiology of nephrotic syndrome Overview glomerular diseases Nephrotic vs. nephritic[amboss.com]
  • This edition has been thoroughly revised by world-renowned contributors to reflect recent developments in renal pathophysiology.[books.google.com]
  • […] practice patterns across the world that may confound the interpretation of some of these [new study’s] findings,” Dr Sim said, “this study further supports previous work and emphasizes the need to consider the multifactorial mechanisms underlying the pathophysiology[renalandurologynews.com]
  • The pathophysiology of nephritic and nephrotic disorders differs substantially, but their clinical overlap is considerable—eg, several disorders may manifest with the same clinical picture—and the presence of hematuria or proteinuria does not itself predict[merckmanuals.com]
  • Regardless of the clinical presentation, the physician should correlate the clinical syndrome with the underlying pathophysiologic events. Epidemiology Diseases of the glomerulus are the most common causes of end-stage renal disease worldwide.[what-when-how.com]

Prevention

  • The molecular mechanism that normally prevents Fn deposition appears to involve high-affinity binding of UG with Fn to form Fn-UG heteromers that counteract Fn self-aggregation, which is required for abnormal tissue deposition.[ncbi.nlm.nih.gov]
  • Thus, quick diagnosis and immediate initiation of immunosuppressive therapy are required to prevent irreversible kidney damage.[amboss.com]
  • Glomerular diseases are the third leading cause of end stage renal disease; however, if treated early, progression can potentially be prevented.[gwdocs.com]
  • What can I do to prevent glomerular disease? It is important to pay attention to signs and symptoms and let your healthcare provider know as early as possible when you notice them.[kidney.org]
  • Early recognition of the underlying disease process—with referral to a nephrologist—renal biopsy if indicated, and initiation of appropriate therapy are essential in preventing progressive renal injury.[what-when-how.com]

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