Glomerulonephritis

First Things First (assess & treat for the following)

• Is nephritic syndrome present?
  • Severe acute inflammation injury to glomerulus
  • Decreased renal function
  • Hematuria with RBC casts
  • Proteinuria 1-2 g/24 hr
  • Hypertension
  • Pyuria
  • Fluid retention

• Is rapidly progressive glomerulonephritis (RPGN) present?
  
  • Nephritic syndrome AND
  • Doubling of creatinine in < 3 months AND
  • Glomerular crescents on renal biopsy
  • If untreated, progresses to ESRD in weeks to months
  • This is a medical emergency!
• Is nephrotic syndrome present?
  • Due to increase in glomerular permeability
  • There is SEVERE glomerular injury; not unusual to present w/ decrease in renal function early in disease.
  • >3.5 mg protein/24 hrs
  • Decreased albumin, edema and hypercholesterolemia
• Are there signs & symptoms of acute renal failure requiring dialysis (see Acute Kidney Injury)?