Pathophysiology
What part of the kidney is affected the most in acute glomerulonephritis?
What is the glomerulus?
The glomerulus is a cluster of blood vessels located in the nephron. They are responsible for filtering waste from the blood (Cleveland Clinic, 2024).
What is a common urinary symptom of acute glomerulonephritis that involves red-colored urine?
What is hematuria?
The damaged glomeruli have increased membrane permeability, which can allow red blood cells to be transferred from the bloodstream into urine, (Mayo Clinic, 2024).
Acute glomerulonephritis can lead to damage in what organ system besides the urinary system?
What is the cardiovascular system?
Fluid overload and hypertension strain the heart. Patients who are diagnosed with acute glomerulonephritis often show signs of heart failure due to the increased workload (Capriotti, 2024).
What should you inspect in the patient’s face for signs of fluid retention?
What is periorbital edema?
An early sign of fluid retention is periorbital edema, or puffiness around the eyes, especially in younger people. (Cleveland Clinic, 2024).
What type of medication is commonly prescribed to manage high blood pressure in acute glomerulonephritis?
What are antihypertensives; ACE inhibitors or calcium channel blockers?
Antihypertensives dilate the blood vessels to lower the blood pressure (National Kidney Foundation, 2024)
What is the most common cause of acute glomerulonephritis?
What is post-streptococcal infection?
Strep throat can cause acute glomerulonephritis, also known as post-streptococcal glomerulonephritis, by triggering an immune response where the body produces antibodies against the strep bacteria that mistakenly deposit in the glomeruli (Mount Sinai, 2023)
This common symptom of glomerulonephritis is often due to kidney dysfunction and can be seen as swelling in the face, hands, feet, and abdomen.
What is edema?
Kidneys are responsible for filtration of the blood which allows the body to maintain the correct electrolyte balances so that all body systems can function properly. When the kidneys are unable to filter properly this can cause an increase in the solutes in the blood such as sodium. This excess sodium draws water out of cells and into the extracellular space causing edema,(Capriotti, 2024).
What condition, resulting from reduced filtration, can affect the respiratory system?
What is pulmonary edema?
As fluid builds up because the kidneys are no longer correctly filtering out excess fluid, that fluid can accumulate in lung tissue, which can cause difficulty breathing, is characterized by shortness of breath, (Mayo Clinic, 2024).
What should you auscultate for in the lungs to detect fluid overload?
What is crackles?
Crackles indicate fluid accumulation due to pulmonary edema from kidney dysfunction (Capriotti, 2024)
What dietary restriction is often recommended to reduce fluid retention?
What is a low-sodium diet?
The lower amount of sodium will control blood pressure and minimize swelling (National Kidney Foundation, 2024).
How does acute glomerulonephritis affect the permeability of the glomerular membrane?
What is increased permeability that leads to proteinuria and hematuria?
Healthy glomeruli have a highly selective membrane. Once the glomeruli are damaged, the tight junctions are disrupted, allowing larger molecules to leak into the urine (Mayo Clinic, 2024).
Name a symptom caused by reduced kidney function and fluid overload in acute glomerulonephritis.
What is oliguria?
Oliguria is defined as low urine output which is characterized by urine output of less than 400 mL/ day or 20 mL/ hour. It is considered one of the earliest signs of kidney or renal impairment (Haider, 2023).
Acute glomerulonephritis can lead to joint pain due to systemic inflammation, affecting this body system.
What is the musculoskeletal system?
Muscle aches or pains are due to high levels of protein in the body and tissue swelling caused by edema (Capriotti, 2024).
To assess for fluid accumulation in a patient with glomerulonephritis, you should monitor this in the lower extremities.
What is pitting edema?
One of the main indicators of fluid retention is pitting edema in the lower limbs. This may get worse with extended standing or sitting and might be felt in the ankles, legs, or feet. To evaluate fluid accumulation it's critical to measure the level and nature of edema (National Kidney Foundation, 2024).
What treatment is necessary if acute glomerulonephritis progresses to kidney failure?
What is dialysis?
Dialysis filters the blood to manage the waste product due to the kidneys not being able to; this could for weeks or months (Cleveland Clinic, 2024)
In response to glomerular damage, this type of immune cell infiltrates the kidneys, contributing to inflammation and kidney injury.
What are T lymphocytes?
T lymphocytes are activated and migrate to the site of damage (the kidneys). These T cells release cytokines and other inflammatory molecules that increase the inflammatory response (Capriotti, 2024).
This condition, commonly seen in glomerulonephritis, involves an elevated force of blood flow in the arteries, which is also known as this.
What is hypertension?
The Kidneys play an essential role in regulating blood pressure. This is done by the filtration of the blood which then allows the body to maintain the correct electrolyte balances so that all body systems can function properly. When the kidneys are unable to filter properly this can cause an increase in the solutes in the blood such as sodium. This excess sodium draws water out of cells and into the extracellular space causing edema. This increase in fluid volume in the blood increases the force exerted on the walls of the blood vessels which causes the increase in blood pressure, (Capriotti, 2024).
How does acute glomerulonephritis affect blood volume and blood pressure?
What is increased blood volume and hypertension?
Fluid retention is the result of the kidneys poor filtering of water and salt. Blood pressure rises as a result of the retained fluid's increase in blood volume (Tampa General Hospital; Cleveland Clinic, 2024).
This vital sign should be closely monitored in acute glomerulonephritis due to its potential to rise, increasing the risk of complications
What is blood pressure?
Acute glomerulonephritis typically leads to raised blood pressure because of increased vascular resistance and fluid retention. (Mayo clinic, 2024).
This class of medications is commonly used to treat the underlying bacterial infection that may trigger post-streptococcal glomerulonephritis.
What are antibiotics?
Antibiotics help to cure the initial infection and limit the underlying cause to acute glomerulonephritis (Mayo Clinic, 2024)
This process, in which immune complexes trigger inflammation and damage to the glomerular walls, can result in the leakage of what substances into the urine.
What is proteins and red blood cells?
Immune complexes formed by antibodies and antigens deposit in the glomeruli, triggering inflammation and damage to the glomerular walls. This damage increases the permeability of the glomerular filtration barrier, allowing substances like proteins and red blood cells to leak into the urine (Capriotti, 2024)
People with glomerulonephritis may experience this symptom, which involves difficulty breathing due to fluid buildup or kidney dysfunction
What is shortness of breath?
As fluid builds up because the kidneys are no longer correctly filtering out excess fluid, that fluid can accumulate in lung tissue which can cause difficulty breathing characterized by shortness of breath, (Mayo Clinic, 2024).
What life-threatening complication may develop if acute glomerulonephritis severely reduces kidney function?
What is acute kidney injury?
An acute kidney injury is considered a sudden or rapid decline in kidney function. This is mainly caused by an infectious agent (Mayo Clinic, 2024).
This urinary test result is key for diagnosing acute glomerulonephritis, as it often shows the presence of red blood cells or excess protein.
What is urinalysis?
In acute glomerulonephritis hematuria; blood in the urine, and proteinuria; high protein levels in the urine, are common findings, often detected through a urinalysis. (Tampa General Hospital).
What medication might be used to reduce inflammation in cases of severe acute glomerulonephritis?
What are steroids?
Steroids, like prednisone, suppress the immune response and reduce inflammation (National Kidney Foundation, 2024).