Student

Pathogenesis of Glomerular Diseases PBL Resource Session
Prof.J.Jose,M.D.

Diseases of kidney-classification
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Classified into those that affect the following 4 compartments: each one has distinct manifestations
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Glomeruli Tubules, Interstitium Blood vessels
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Disease of one compartment will eventually affect the entire structure.

Clinical manifestations of renal diseases
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1.Nephritic syndrome ("nephritis")  Indicates acute inflammation of glomeruli  hematuria (including red cell casts)  mild to moderate proteinuria  oliguria, hypertension and mild edema 2.Nephrotic syndrome  Indicates excessive permeability of the filtration membrane to plasma proteins.

Clinical manifestations of renal diseases (contd..)
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heavy proteinuria (adult more than 3.5 gm/day) hypoalbuminemia (less than 3.0 gm/dL) severe generalized edema Hyperlipidemia and lipiduria

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3.Asymptomatic proteinuria or haematuria or both 4.Acute renal failure 5.Chronic renal failure 6.Renal tubular defects-polyuria,electrolyte disorders 7.Urinary tract infection 8.Nephrolithiasis 9.Urinary tract obstruction and renal tumors

Glomerular diseases-classification
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1.Primary glomerulopathies
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Acute diffuse proliferative glomerulonephritis- post streptococcal, Rapidly Progressive GlomeruloNephritis (RPGN), lipoid nephrosis, membranous GN,MPGN, chronic glomerulo nephritis ( classified by histologic changes as aetiology is unknown in many glomerulopathies)

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2.Systemic diseases with glomerular involvement
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SLE, DM, Amyloidosis, Henoch- Schonlein purpura, infective endocarditis Vasculitis Alport syndrome

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3.Hereditary disorders
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Review of Glomerular structure and function

Glomerular filter consisting from bottom to top,of fenestrated endothelium, BM and foot processes of epithelial cells. Note filtration slits and diaphragm

Structure of type IV collagen triple-helical molecule in the BM