Glomerular syndromes

Nephritis syndrome = Nephritic Syndrome (Acute Glomerulonephritis) + Rapidly Progressive Glomerulonephritis (RPGN)

1. Nephritic Syndrome (Acute Glomerulonephritis):

Nephritis VS Nephritic syndrome

• Clinical Syndrome: Characterized by hematuria, hypertension, variable degrees of proteinuria, and reduced glomerular filtration rate (GFR), leading to oliguria and renal failure.

• Pathophysiologic Defect: Inflammation of the glomeruli, often due to immune processes that damage the capillary walls, resulting in blood and protein entering the urine.

Acute post-streptococcal glomerulonephritis (APSGN) LOW C3, ASO titer

APSGN Antibiotics

IgA but kidney IgA Nephropathy (Berger's Disease)

IgA but systemic Henoch-Schönlein Purpura (HSP)

Membranoproliferative Glomerulonephritis (MPGN)

Lupus Nephritis

2. Nephrotic Syndrome:

• Clinical Syndrome: Marked by heavy proteinuria (>3.5 grams per day), hypoalbuminemia, severe edema, and hyperlipidemia.

• Pathophysiologic Defect: Permanently increased permeability of the glomerular basement membrane to plasma proteins, leading to their loss in the urine.

Minimal Change Disease (MCD)

Membranoproliferative Glomerulonephritis (MPGN)

Focal Segmental Glomerulosclerosis (FSGS)

Membranous Nephropathy

Diabetic Glomerulosclerosis (Diabetic Nephropathy)

3. Rapidly Progressive Glomerulonephritis (RPGN):

• Clinical Syndrome: Presents with features of acute nephritic syndrome but with a rapid decline in renal function over days to weeks.

• Pathophysiologic Defect: Severe inflammation, often with crescent formation in glomeruli, indicating rapid and progressive glomerular injury.

Anti-Glomerular Basement Membrane Disease (Goodpasture's Syndrome)

ANCA-Associated Vasculitis

Immune Complex-Mediated Glomerulonephritis

Cryoglobulinemic Glomerulonephritis

Pauci-Immune RPGN

4. Asymptomatic Hematuria/Proteinuria:

• Clinical Syndrome: Presence of either blood (hematuria) or protein (proteinuria) in the urine without other symptoms.

• Pathophysiologic Defect: Mild injury to the glomeruli, not enough to cause overt nephritic or nephrotic syndrome.

Hereditary Nephritis (e.g., Alport Syndrome)

Cystic Kidney Diseases (e.g., Polycystic Kidney Disease)

IgA Nephropathy

Thin Basement Membrane Nephropathy (TBMN)

5. Chronic Glomerulonephritis:

• Clinical Syndrome: A long-standing glomerular disease that can be a sequel to acute nephritic syndrome or result from a slowly progressive glomerulopathy.

• Pathophysiologic Defect: Irreversible damage to the glomeruli over months to years, often leading to chronic kidney disease (CKD).

Hypertensive Nephrosclerosis

Chronic Post-Infectious Glomerulonephritis

Diabetic Glomerulosclerosis (Diabetic Nephropathy)

Membranous Nephropathy