glomerulonephritis

Acute glomerulonephritis ia acute or sudden inflammation of glomeruli with in kidney.

Etiology

1. Bacterial infection; beta-hemolytic streptococcus 

2. Viral infection; mumps, measles, hepatitis C, EPV

3. Good pasture syndrome; autoimmune disorder 

4. Polyarteritis Nodosa; necrotising inflammation of blood vessels 

5. Azotenia

6. Wegener's syndrome

7. Lupus (SLE); systemic lupus erythematosus 

Pathophysiology

Beta-hemolytic infection

Immune response activated

Formation of antigen - antibody complex in glomerulus, deposited bin glomerular filteration membrane

Inflammatory response

1. Increase permeability and passage of protein and RBC's in urine.

2. Proliferation of cells lining in glomerular membrane

Leucocyte infiltration of glomerulus

Glomerular filteration rate decreased

Sodium and water retention occurs

Leading to edema and hypertension 

Clinical features

1. Oligouria

2. Hematuria

3. Tea- colored urine due to hematuria

4. Periorbital edema 

5. Anasarca; generalized Swelling

6. Diplopia

7. Hypertension

8. Anorexia

9. Abdominal pain

10. Fever

11. Fatigue and lethargy

Diagnostic evaluation

1. Blood investigation

2. Blood urea nitrogen (BUN)

3. ESR

4.    Antistreptolysin O (ASLO) ; to check infection caused by group A streptococcus bacteria

5. X-ray/Ultrasound/ CT scan

6. Renal function test

7. Urine culture/ urinalysis 

Management

1. Antihypertensive drug - Hydralazine

2. Diuretics - frusemide 

3. Sodium-potassium and fluid intake restricted

4. Antibiotics

5. Protein diet intake restricted