Acute and chronic glomerulonephritis - nephritic syndromes
Description
The nephritic syndrome - five features
- Haematuria with dysmorphic RBCs and RBC casts
- Proteinuria (sub-nephrotic, <3.5 g/day)
- Hypertension
- Oliguria
- Oedema (from salt and water retention, not hypoalbuminaemia)
- Lesion is endothelial/inflammatory, on the blood side of the GBM -> leucocyte recruitment -> capillary wall breach
- *RBC casts are the single most specific finding in nephrology* - they are formed only in the tubule, so they prove a glomerular source
The spectrum by tempo
| Course | |
|---|---|
| Acute nephritic | Days-weeks, often self-limiting (PSGN) |
| RPGN | <3 months, crescentic - a renal emergency |
| Chronic GN | Years; incidental proteinuria/haematuria, small kidneys, hypertension |
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