chapter 20 part 2

Glomerulonephritis

• Definition: Glomerulonephritis is a kidney condition characterized by inflammation of the glomeruli, the tiny filters in the kidneys that remove excess fluid, electrolytes, and waste from the bloodstream.

Causes and Types

• Bacterial Infection: One of the common bacterial causes is Streptococcus, particularly the beta-hemolytic strain, which is very aggressive and can lead to serious complications.

• Immune Response: When this bacteria invades the body, it triggers an immune response. This involves antibodies recognizing and attaching to the bacteria, forming an antigen-antibody complex.

• Kidney Impacts: If the bacteria-antibody complexes accumulate, they can get trapped in the kidney’s filtration system, particularly affecting the Bowman’s capsule, leading to impaired filtration and inflammation.

Acute vs Chronic Glomerulonephritis

Acute Glomerulonephritis

• Symptoms: This stage can develop rapidly, within weeks, leading to significant kidney damage if not treated. Symptoms may include hematuria (blood in urine), edema (swelling), and decreased urine output.

• Causes: Often triggered by infections (like streptococcal infections) or significant dehydration.

• Potential Outcome: Can lead to acute kidney failure within a short period if the underlying cause is not addressed.

Chronic Glomerulonephritis

• Symptoms: This form develops slowly over many years, often without noticeable symptoms until significant kidney damage has occurred.

• Underlying Conditions: It may be associated with longstanding conditions such as hypertension or diabetes, leading to gradual loss of kidney function.

• Management: While chronic glomerulonephritis may not be reversible, its progression can often be slowed down through medication and lifestyle changes.

Kidney Function and Urine Formation

• Primary Processes:

  • Filtration: Initial step where blood is filtered through the kidneys.

  • Reabsorption: Essential nutrients and water are reabsorbed back into the bloodstream.

  • Secretion: Waste products are secreted into the urine.

Factors Affecting Kidney Function

• Hydration: Adequate water intake is essential for kidney health. Dehydration can impair kidney function rapidly.

• Blood Pressure: Managing hypertension is crucial to prevent chronic kidney damage.

Urine Concentration and Regulation

• Hormonal Control: Hormones like ADH (Antidiuretic Hormone) play a crucial role in regulating water reabsorption in the kidneys, influencing urine concentration.

• Urine Characteristics: Urine should typically contain minimal sugar (0% for non-diabetics). The presence of sugar often indicates poor glucose management (diabetes).

Symptoms and Diagnosis

• Symptoms of Glomerulonephritis: Hematuria, proteinuria (protein in urine), edema of the ankles and face, fatigue, and possibly hypertension.

• Diagnostic Tests: Blood tests (to check waste levels), urine tests (to look for abnormalities), and imaging studies (like ultrasounds) may be used to evaluate kidney health.

Treatment

• Immediate Care: Focused on treating the underlying cause, such as antibiotic therapy for infections.

• Long-term Management: May involve immunosuppressive drugs, dietary modifications, and careful monitoring of kidney function.

• Transplant Options: In cases of severe, irreversible damage, kidney transplantation may be considered as a potential treatment.