01/12/2025
GLOMERULONEPHRITIS
DEFINITIONS
It is a renal disorder in which there is inflammation of the glomerular
capillaries resulting into impaired renal function which can be caused by
Group A hemolytic streptococcal and is characterized by proteinuria,
hematuria and peri-orbital edema.
CLASSIFICATION
The classification may be related to time or histological changes
Classification According To The Histological Change
a)Diffuse glomerulonephritis: Characterized by proliferative changes in more than
half the glomeruli.
b)Membranous Glomerulonephritis: Characterized by proteinaceous deposits on
the glomerular capillary basement membrane.
Classification According To Time
This may be acute or chronic glomerulonephritis:
ACUTE GLOMERULONEPHRITIS
DEFINATION
Is a renal condition characterized by sudden inflammatory changes in the
renal glomeruli with haematuria, hypertension and loss of renal function,
mostly preceded by tonsillitis.
Acute Inflammatiom of the basement membrane of the nephrones and it
causes impairement of filtration across the glomerular basement membrane
This is a sudden or rapid inflammation of the glomerulus and nephron
structures of the kidney which may involve the whole kidney. The glomerulo
inflammation is as a result of antigen antibody deposits within the glomeruli.
This is the sudden onset of inflammation of the glomeruli affecting both
kidneys following streptococcal infection of the throat, but rarely skin
infections characterised by haematuria.
This is the sudden onset of inflammation of the glomeruli that results in the
appearance of blood in urine with clumps of RBCs (casts) and variable
amounts of protein in the urine
CAUSES/PREDISPOSING FACTORS
1. Group A beta haemolytic streptococci (same organism that causes Rheumatic Fever)
can cause infection on the throat (strep throat) leading to antigen antibody reaction
2. Acute glomerulonephritis can also be caused by reaction to other infections such as:
• Infection of the skin eg impetigo (an acute inflammation of the skin marked by
pustules and scabs
• Acute viral infections e.g. mumps, varicella zoster, various Epstein Barr virus,
hepatitis B and HIV
CHRONIC GLOMERULONEPHRITIS
It is a slowly progressive disease of the kidneys characterised by inflammation of
the glomerulus resulting in sclerosis, scarring and eventually renal failure.
It may be a sequel of acute glomerulonephritis but often there is no history of this
condition. It remains subclinical and only discovered when albuminuria or hypertension is found during routine medical exams
CAUSES
Primary renal disorders such as membranous proliferation
Focal glomerulonephritis
Rapidly progressing glomerulonephritis
Post streptococcal glomerulonephritis
Systemic disorders such as SLE, good pasture‘s syndrome, haemolytic uraemic
syndrome
PATHOPHYSIOLOGY
There is progressive destruction of the renal glomeruli and gradual loss of renal
function. The prolonged inflammatory process may lead to hardening of the glomeruli
and the kidney may reduce in size. Eventually there will be tubular atrophy, chronic
interstitial inflammation and arteriosclerosis.
SIGNS AND SYMPTOMS
Headache especially in the morning
Dyspnea on exertion
Blurred vision
weakness
Lassitude
Oedema
Weight loss
TREATMENT
There is no specific treatment to reverse the disease process. Treatment of kidney
failure begins when the illness progresses to end stage of the disease, however before
that, treatment is as for acute glomerulonephritis.
Academia-Zambia
