肾小球疾病概述(英文版)ppt课件.pptxVIP

Outline of Glomerular Disease 1 Pathogen v Primary v Secondary v Hereditary 2 Clinical Classifications of Primary Glomerular Diseases u Acute glomerulonephritis u Rapidly progressive glomerulonephritis u Chronic glomerulonephritis u Latent glomerulonephritis u Nephrotic syndrome 3 Acute glomerulonephritis v Following infections by nephritogenic strains of Group A ß hemolytic streptococci v proliferation of glomerular cells infiltration by WBC’s, electron dense deposits – “humps” v About1- 3 weeks after a sore throat or skin infection. Haematuria, proteinuria, oliguria , Edema. C3 Complement (C3) ↓: usually still to 8 weeks v 95% with complete recovery. 4 Rapidly Progressive GN (RPGN) v RPGN is characterized by rapidly progressive deterioration in renal function associated with oliguria. v Decline in GFR occurs over weeks. v Many crescents are seen on biopsy. 5 Chronic glomerulonephritis v Patients usually have hypertension, hematuria, proteinuria and broad casts. v Small kidneys on ultrasound. v Generally no specific diagnosis can be established by renal biopsy 6 Latent glomerulonephritis v Hematuria or proteinuria: only v No : edema, hypertension, or renal dysfuction 7 Nephrotic syndrome v Massive proteinuria :Excretion of 3.5 g or more of protein in the urine per day (≥3.5g/d) The protein excretion is due to glomerular injury v Hypoalbuminemia≤ 30g/L; v Edema v Hyperlipidemia, and lipiduria 8 Pathologic classifications of Glomerular Diseases v minor glomerular abnormalitie v Focal segmental lesion (focal glomerulonephritis) v Diffuse glomerulonephritis v Unclassified glomerulonephritis 9 Ø Membranous glomerulonephritis, Membranous nephropathy Ø proliferative glomerulonephritis Ø 1.mesangial proliferative glomerulonephritis Ø 2.Endcapillary proliferative glomerulonephritis Ø 3.mesangiocapillary- proliferative glomerulonephritis Ø 4.Crescentic and necrotizing glomerulonephritis Ø Sclerosing glomerulonephritis Diffu