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Glomerulonephritis Causes

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141. Glomerulonephritis, Membranoproliferative (Diagnosis)

> Membranoproliferative Glomerulonephritis Updated: Jun 23, 2016 Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Membranoproliferative Glomerulonephritis Overview Background Membranoproliferative glomerulonephritis (MPGN) is an uncommon cause of chronic nephritis that occurs primarily in children and young adults. This entity refers to a pattern of glomerular injury based on the following three characteristic histopathologic (...) with all types of membranoproliferative glomerulonephritis (MPGN). Low C3 levels are present in approximately 75% of patients with this condition. Although hypocomplementemia bears no relation to the clinical course or prognosis of MPGN, it plays a role in initiating glomerular inflammation and injury. Hypocomplementemia results from increased catabolism and decreased C3 synthesis. The decreased C3 synthesis is likely caused by the negative feedback by C3 breakdown products. Three nephritic antibodies

2014 eMedicine.com

142. Glomerulonephritis, Acute (Diagnosis)

Noninfectious causes of acute GN may be divided into primary renal diseases, systemic diseases, and miscellaneous conditions or agents. Multisystem systemic diseases that can cause acute GN include the following: Vasculitis (eg, ]) - This causes glomerulonephritis that combines upper and lower granulomatous nephritides). Collagen-vascular diseases (eg, systemic lupus erythematosus [SLE]) – This causes glomerulonephritis through renal deposition of immune complexes). Hypersensitivity vasculitis (...) – This encompasses a heterogeneous group of disorders featuring small vessel and skin disease. – This causes abnormal quantities of cryoglobulin in plasma that result in repeated episodes of widespread purpura and cutaneous ulcerations upon crystallization. - This causes nephritis from a vasculitis involving the renal arteries. – This causes a generalized vasculitis resulting in glomerulonephritis. Goodpasture syndrome – This causes circulating antibodies to type IV collagen and often results in a rapidly

2014 eMedicine.com

143. Glomerulonephritis, Chronic (Diagnosis)

. If disease progression is not halted with therapy, the net results are (CKD), (ESRD), and cardiovascular disease. Chronic glomerulonephritis is the third leading cause of CKD, and accounting for about 10% of all patients on dialysis. The exact cause of CKD in patients with chronic glomerulonephritis may never be known in some patients. Therefore, it has generally been accepted that the diagnosis of CKD can be made without knowledge of the specific cause. [ ] The National Kidney Foundation (NKF) defines (...) distinguish the primary disease. Histology and clues to the etiology are often derived from other systemic diseases (if present). Considerable cause-specific variability is observed in the rate at which acute glomerulonephritis progresses to chronic glomerulonephritis. The prognosis depends on the type of chronic glomerulonephritis (see Etiology). ESRD and death are common outcomes unless renal replacement therapy is instituted. Next: Pathophysiology Reduction in nephron mass from the initial injury

2014 eMedicine.com

144. Glomerulonephritis, Poststreptococcal (Overview)

healthy individuals. [ ] Previous Next: Epidemiology Frequency United States The incidence of clinically detectable glomerulonephritis during an epidemic is up to 10% of children with pharyngitis and 25% of children with impetigo. One study reported a change in the epidemiology of APSGN and found that pharyngitis has replaced impetigo as the predominant cause of APSGN. [ ] International APSGN can occur sporadically or epidemically. The incidence seems to be decreasing in the United States and Europe (...) Glomerulonephritis, Poststreptococcal (Overview) Poststreptococcal Glomerulonephritis: Practice Essentials, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjQwMzM3LW92ZXJ2aWV3

2014 eMedicine.com

145. Glomerulonephritis, Rapidly Progressive (Overview)

to produce a crescentic glomerulonephritis in sheep, and, following this discovery, the role of anti-GBM antibody in was elucidated. Soon afterward, the role of the anti-GBM antibody in rapidly progressive glomerulonephritis associated with Goodpasture disease was established. In the mid 1970s, a group of patients was described who fit the clinical criteria for rapidly progressive glomerulonephritis but in whom no cause could be established. Many of these cases were associated with systemic signs (...) cause; for example, Lingaraj et al describe a "mini-epidemic" of 11 new biopsy-proven cases of anti-GBM rapidly progressive glomerulonephritis seen within a span of 3 months at a single institution in southern India. [ ] Mortality/Morbidity Massive pulmonary hemorrhage is the most common cause of death in patients presenting with ANCA-associated disease. However, once immunosuppressive therapy has begun, infection is more common. Race-, Sex-, and Age-related Demographics White persons are affected

2014 eMedicine.com

146. Glomerulonephritis, Nonstreptococcal Associated With Infection (Overview)

Streptococcus in developed countries. [ ] GN associated with hepatitis C is becoming a far more commonly recognized cause of GN. [ , ] It is estimated that 35–60% of patients with chronic hepatitis C will develop renal manifestations including type I membranoproliferative glomerulonephritis (MPGN), mesangial glomerulonephritis, and focal and segmental glomerulonephritis. [ ] Although specific incidence statistics are not available, in certain developing areas of the world, hepatitis B, HIV disease, malaria (...) , and schistosomiasis are major causes of glomerulopathy. The incidence of GN in malaria is estimated to be around 18%. [ ] GN is present in approximately 15% of patients with schistosomiasis. [ ] In most GNs associated with infection, no racial or sexual predilection exists. However, HIV-associated GN is far more common in males. Although classic postinfectious GN primarily occurs in childhood, it has been documented in all age groups. Glomerulonephritis associated with methicillin-resistant Staphylococcus aureus

2014 eMedicine.com

147. Glomerulonephritis, Diffuse Proliferative (Overview)

membrane thickening caused by subepithelial immune deposits may be observed. Occasional cases of focal mesangial proliferative glomerulonephritis with mesangial deposition of immunoglobulin G (IgG) and complement have been described in polymyositis and dermatomyositis. [ ] In addition to poststreptococcal glomerulonephritis, nephritic syndrome and RPGN can complicate acute immune-complex glomerulonephritis due to other viral, bacterial, fungal, and parasitic infections. Some of these warrant specific (...) or no deposition of immune complexes in the vessel wall (pauci-immune). About 10% of patients presenting with MAP, GPA, and EGPA are ANCA negative. [ ] Post-infectious glomerulonephritis may occur in association with bacterial, viral, fungal, protozoal, and helminthic infection but is most often secondary to streptococcal sore throat or skin infection and occurs 2-4 weeks after infection. Other common infectious causes of DPGN are infective endocarditis, hepatitis B, and hepatitis C. Shunt nephritis

2014 eMedicine.com

148. Glomerulonephritis, Membranoproliferative (Overview)

> Membranoproliferative Glomerulonephritis Updated: Jun 23, 2016 Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Membranoproliferative Glomerulonephritis Overview Background Membranoproliferative glomerulonephritis (MPGN) is an uncommon cause of chronic nephritis that occurs primarily in children and young adults. This entity refers to a pattern of glomerular injury based on the following three characteristic histopathologic (...) with all types of membranoproliferative glomerulonephritis (MPGN). Low C3 levels are present in approximately 75% of patients with this condition. Although hypocomplementemia bears no relation to the clinical course or prognosis of MPGN, it plays a role in initiating glomerular inflammation and injury. Hypocomplementemia results from increased catabolism and decreased C3 synthesis. The decreased C3 synthesis is likely caused by the negative feedback by C3 breakdown products. Three nephritic antibodies

2014 eMedicine.com

149. Glomerulonephritis, Crescentic (Overview)

a crescentic glomerulonephritis in sheep, and, following this discovery, the role of anti-GBM antibody in was elucidated. Soon afterward, the role of the anti-GBM antibody in rapidly progressive glomerulonephritis associated with Goodpasture disease was established. In the mid 1970s, a group of patients was described who fit the clinical criteria for rapidly progressive glomerulonephritis but in whom no cause could be established. Many of these cases were associated with systemic signs of vascular (...) : Epidemiology Frequency United States The exact frequency of ANCA-associated disease is unknown. The incidence of rapidly progressive glomerulonephritis is 7 reported cases per 1 million persons per year. International In the United Kingdom, the frequency is estimated at 2 cases per 100,000 persons. In Sweden, the frequency is estimated at 1 case per 100,000 persons. Despite the overall rarity of the condition, clusters of cases have been reported, suggesting a possible environmental cause; for example

2014 eMedicine.com

150. Glomerulonephritis, Chronic (Overview)

. If disease progression is not halted with therapy, the net results are (CKD), (ESRD), and cardiovascular disease. Chronic glomerulonephritis is the third leading cause of CKD, and accounting for about 10% of all patients on dialysis. The exact cause of CKD in patients with chronic glomerulonephritis may never be known in some patients. Therefore, it has generally been accepted that the diagnosis of CKD can be made without knowledge of the specific cause. [ ] The National Kidney Foundation (NKF) defines (...) distinguish the primary disease. Histology and clues to the etiology are often derived from other systemic diseases (if present). Considerable cause-specific variability is observed in the rate at which acute glomerulonephritis progresses to chronic glomerulonephritis. The prognosis depends on the type of chronic glomerulonephritis (see Etiology). ESRD and death are common outcomes unless renal replacement therapy is instituted. Next: Pathophysiology Reduction in nephron mass from the initial injury

2014 eMedicine.com

151. Glomerulonephritis, Acute (Overview)

Noninfectious causes of acute GN may be divided into primary renal diseases, systemic diseases, and miscellaneous conditions or agents. Multisystem systemic diseases that can cause acute GN include the following: Vasculitis (eg, ]) - This causes glomerulonephritis that combines upper and lower granulomatous nephritides). Collagen-vascular diseases (eg, systemic lupus erythematosus [SLE]) – This causes glomerulonephritis through renal deposition of immune complexes). Hypersensitivity vasculitis (...) – This encompasses a heterogeneous group of disorders featuring small vessel and skin disease. – This causes abnormal quantities of cryoglobulin in plasma that result in repeated episodes of widespread purpura and cutaneous ulcerations upon crystallization. - This causes nephritis from a vasculitis involving the renal arteries. – This causes a generalized vasculitis resulting in glomerulonephritis. Goodpasture syndrome – This causes circulating antibodies to type IV collagen and often results in a rapidly

2014 eMedicine.com

152. Glomerulonephritis, Membranous (Overview)

Glomerulonephritis, Membranous (Overview) Membranous Glomerulonephritis: Practice Essentials, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjM5Nzk5LW92ZXJ2aWV3 processing (...) > Membranous Glomerulonephritis Updated: Oct 23, 2016 Author: Abeera Mansur, MD; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Membranous Glomerulonephritis Overview Practice Essentials Membranous nephropathy (MGN) is one of the more common forms of nephrotic syndrome in the adult population. It can be idiopathic or secondary (30%). The two can be distinguished by clinical, laboratory, and histological features (see and ). [ ] Successful treatment

2014 eMedicine.com

153. Glomerulonephritis, Membranous (Treatment)

== processing > Membranous Glomerulonephritis Treatment & Management Updated: Oct 23, 2016 Author: Abeera Mansur, MD; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Membranous Glomerulonephritis Treatment Medical Care Search for an underlying cause. Successful treatment of the underlying cause may be curative in secondary forms. In hepatitis-associated membranous nephropathy, antivirals may be useful. Symptomatic treatment includes the following: A low-salt diet (...) Glomerulonephritis, Membranous (Treatment) Membranous Glomerulonephritis Treatment & Management: Medical Care, Surgical Care, Diet and Activity Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjM5Nzk5LXRyZWF0bWVudA

2014 eMedicine.com

154. Glomerulonephritis, Membranoproliferative (Treatment)

functionally intact factor H in patients with defined pathologic mutation of the factor H gene. Previous Next: Secondary MPGN Every patient with membranoproliferative glomerulonephritis (MPGN) must be carefully evaluated for a secondary cause of the disease. An excellent history, histopathologic findings, and serologies may help identify the underlying cause. Appropriate treatment of infections such as endocarditis or infected ventriculoatrial shunts may induce remissions. Antiviral therapy is indicated (...) , Lafayette RA. Clinicopathological features of membranoproliferative glomerulonephritis under a new classification. Clin Nephrol . 2015 Dec. 84 (12):323-30. . Neary JJ, Conlon PJ, Croke D, et al. Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1. J Am Soc Nephrol . 2002 Aug. 13(8):2052-7. . Izzedine H, Sene D, Cacoub P, et al. Kidney diseases in HIV/HCV-co-infected patients. AIDS . 2009 Jun 19. 23(10):1219-26. . Hiramatsu R, Hoshino J, Suwabe T, Sumida K

2014 eMedicine.com

155. Glomerulonephritis, Chronic (Treatment)

Glomerulonephritis, Chronic (Treatment) Chronic Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Renal Replacement Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjM5MzkyLXRyZWF0bWVudA== processing > Chronic Glomerulonephritis Treatment & Management Updated: Feb 01, 2017 Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Chronic Glomerulonephritis Treatment Approach Considerations Patients with chronic kidney disease (CKD) who are admitted to the hospital should receive careful monitoring of weight, intake, output, and renal function so that acute kidney injury (AKI) can be diagnosed and treated

2014 eMedicine.com

156. Glomerulonephritis, Membranoproliferative (Follow-up)

functionally intact factor H in patients with defined pathologic mutation of the factor H gene. Previous Next: Secondary MPGN Every patient with membranoproliferative glomerulonephritis (MPGN) must be carefully evaluated for a secondary cause of the disease. An excellent history, histopathologic findings, and serologies may help identify the underlying cause. Appropriate treatment of infections such as endocarditis or infected ventriculoatrial shunts may induce remissions. Antiviral therapy is indicated (...) , Lafayette RA. Clinicopathological features of membranoproliferative glomerulonephritis under a new classification. Clin Nephrol . 2015 Dec. 84 (12):323-30. . Neary JJ, Conlon PJ, Croke D, et al. Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1. J Am Soc Nephrol . 2002 Aug. 13(8):2052-7. . Izzedine H, Sene D, Cacoub P, et al. Kidney diseases in HIV/HCV-co-infected patients. AIDS . 2009 Jun 19. 23(10):1219-26. . Hiramatsu R, Hoshino J, Suwabe T, Sumida K

2014 eMedicine.com

157. Glomerulonephritis, Chronic (Follow-up)

Glomerulonephritis, Chronic (Follow-up) Chronic Glomerulonephritis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Renal Replacement Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjM5MzkyLXRyZWF0bWVudA== processing > Chronic Glomerulonephritis Treatment & Management Updated: Feb 01, 2017 Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN Share Email Print Feedback Close Sections Sections Chronic Glomerulonephritis Treatment Approach Considerations Patients with chronic kidney disease (CKD) who are admitted to the hospital should receive careful monitoring of weight, intake, output, and renal function so that acute kidney injury (AKI) can be diagnosed and treated

2014 eMedicine.com

158. Acute Poststreptococcal Glomerulonephritis (Treatment)

, and the healing process has begun. Thus, influencing the ultimate course of the disease by any specific therapy directed at the cause of the nephritis is not possible. Conversely, morbidity and early mortality are influenced considerably by appropriate medical therapy. Even then, treatment is usually supportive and directed toward the potential complications. Only a small percentage of patients with acute glomerulonephritis require initial hospitalization, and most of those are ready for discharge in 2-4 days (...) Acute Poststreptococcal Glomerulonephritis (Treatment) Acute Poststreptococcal Glomerulonephritis Treatment & Management: Approach Considerations, Consultations, Long-Term Monitoring Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine Pediatrics

159. Acute Poststreptococcal Glomerulonephritis (Follow-up)

, and the healing process has begun. Thus, influencing the ultimate course of the disease by any specific therapy directed at the cause of the nephritis is not possible. Conversely, morbidity and early mortality are influenced considerably by appropriate medical therapy. Even then, treatment is usually supportive and directed toward the potential complications. Only a small percentage of patients with acute glomerulonephritis require initial hospitalization, and most of those are ready for discharge in 2-4 days (...) Acute Poststreptococcal Glomerulonephritis (Follow-up) Acute Poststreptococcal Glomerulonephritis Treatment & Management: Approach Considerations, Consultations, Long-Term Monitoring Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine Pediatrics

160. Acute Poststreptococcal Glomerulonephritis (Overview)

of open access article, "The Role of Nephritis-Associated Plasmin Receptor (NAPlr) in Glomerulonephritis Associated with Streptococcal Infection." Oda T, Yoshizawa N, Yamakami K, et al. Journal of Biomedicine and Biotechnology, 2012; doi: 10.1155/417675. Acute poststreptococcal glomerulonephritis (APSGN) results from an antecedent infection of the skin (impetigo) or throat (pharyngitis) caused by nephritogenic strains of group A beta-hemolytic streptococci. [ , , , ] The concept of nephritogenic (...) % of children with acute sporadic poststreptococcal glomerulonephritis. The prognosis for persons with acute glomerulonephritis secondary to other causes is less certain. Edema usually resolves within 5-10 days, and the blood pressure usually returns to normal after 2-3 weeks, even though persistence of elevated pressures for as many as 6 weeks is compatible with complete resolution. Urinary abnormalities resolve at various times after onset. Proteinuria may disappear within the first 2-3 months or may

2014 eMedicine Pediatrics

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