Chronic Glomerulonephritis Disease

Injury to the glomerulus and the tubules presents the onset of Intra-renal failure (Matzke, 2011). Some of the frequent causes for Intra-renal failure are glomerulonephritis; pyelonephritis; and tubular injury. Post-renal failure develops from things like ureteroliths, tumors, or anatomic impediments. Opposite of the acute form, the chronic form has a slow onset that has no early stage symptoms. It is important to know that following an acute episode a chronic renal episode often follows, and at this juncture the damage is irreversible. Glomerulonephritis and pyelonephritis combined, has been reported to be the forerunner in as much as half the cases from acute to chronic renal failure. Diabetes mellitus, renal vascular disease, such as atherosclerosis, hypertension, polycystic kidney disease, drug damage, and nephrolith are all examples of other causes of CKD (Pradeep, 2014). Biopsies of kidneys that suffered with CKD reveal smaller kidneys with scarring on the tubules.

Nephritis is the inflammation of one or both kidneys. Causes may include: kidney conditions, lupus nephritis, neuropathy etc. Types of nephritis include: acute, chronic, glomerulonephritis, and autoimmune. Symptoms include: cloudy and bloody urine or reduced urine, and loin pain.

The word “focal” refers to only some glomeruli being scarred while “segmental” indicates that a specific area of a single glomerulus is damaged (U.S. National Library of Medicine, 2015). Minimal change disease is the most prevalent form of nephrotic syndrome in children. It signifies a “histopathologic lesion” in the glomeruli which is consistent with lesions in nephrotic syndrome. Although this form of GN is primarily found in children, it can be seen in adults as well (Mansur, 2015). Poststreptococcal acute glomerulonephritis (PSAGN) is a form of GN which typically follows pharyngitis (inflammation of the pharynx) due to group A, β- hemolytic streptococci (Kalia, 2008). Membranous glomerulonephritis is a type of GN which is immunologically mediated and results from the deposition of immune complexes in the subepithelial space (Mansur, 2014). Membranoproliferative glomerulonephritis is a type of nephritis that is particularly common in children and young adults and is characterized by three histological findings. These findings are the spread of mesangial and endothelial cells, stiffening of peripheral capillary walls, and mesangial interposition. There are two types of MPGN with type I being the most common and type II being quite rare (Kathuria, 2015). IgA neuropathy is a renal disorder which arises when IgA deposits in the kidneys. IgA is a protein that aids the body in fighing against infections. Excessive deposition of IgA in the kidneys can lead to protein and blood leaking into the urine (National Institute of Diabetes and Digestive and Kidney Diseases, 2010). Pauci-immune glomerulonephritis is the primary type of rapidly progressing glomerulonephritis. It refers to the lack of immune deposits witnessed via immunofluorescence. Necrotizing glomerular inflammation is a key histological component of this disease (Moreland, 2004). Crescentic

CKD will cause the body to retain many excess fluids and waste that are normally filtered out to prevent internal harm throughout the body. With kidney disease there will be a rise in blood pressure due to the amount of extra fluid that is retained in the blood vessels. This fluid retention will cause the passageways to become narrow and make blood passage through the vessels increasingly difficult, in turn causing an increase in blood pressure. There will also be an increase in protein and blood found in the urine because it is not filtered out properly by the kidneys. Swelling will occur in the extremities and around the eyes because of the fluid retention as well. The longer the urine goes unfiltered the harder it may become to urinate due to pain or blockage or there may be more frequent night time urination (The National Kidney Foundation, 12).

Lupus nephritis causes inflammation of the nephrons, which is caused by systemic lupus erythematosus (SLE or lupus). The kidney’s main function is to remove waste from blood and to balance the amount of fluids in your body. When inflammation of nephrons occur it makes it harder to filter the blood and can cause significant swelling. It is an autoimmune disease that causes the immune system to mistake harmful substances from healthy ones which results in the immune system attacking the healthy tissues and cells. It is still unknown on how the disease comes about except for these two assumptions; genetic predisposition and research found on Renal DNase1 enzyme activity. Genetic predisposition refers to environmental factors

ESCRF is often considered an asymptomatic condition with a reduction of up to 70% in kidney function symptoms may still not be present (5).

To begin with, there are two primary causes of Chronic Kidney Disease, diabetes and high blood pressure (National Kidney Foundation, 2015). Diabetes, reasons harm to the kidney because of high sugar levels, while the pressure of blood against the vessel wall causes high blood pressure increases (National Kidney Foundation, 2015). In addition to this, some diferent groups of disease additionally influence the kidney, which are: Glomerulonephritis, inherited diseases, malformations, which occur as a baby develops, Lupus, and repeated urinary infections (National Kidney

Haematuria, microscopic and macroscopic, is the earliest sign and is almost universal.In case of microscopic the disease may remain unnoticed for decades. Hypertension is also very common. Proteinuria can also occur but is usually a later feature. In many cases, there is slowly progressive loss of renal function leading to end stage renal disease. Clinical presentations are protean and vary with age. A particular hallmark of IgA nephropathy in young adults is the occurrence of acute self-limiting exacerbations, often with gross haematuria, in association with minor respiratory infections. This may be so acute as to resemble acute post-infectious glomerulonephritis, with fluid retention, hypertension and oliguria with dark or red urine. Characteristically, the latency from clinical infection to nephritis is short: a few days or less. Asymptomatic presentations dominate in older adults, with haematuria, hypertension and loss of GFR. Occasionally, IgA nephropathy

Chronic kidney disease is associated with the aging population, whereby the kidneys are impaired in terms of functionality (Giordano et al., 2016). The basic role of the kidney is to maintain a balance of fluids in the body and remove waste products from blood. The symptoms of CKD appear in stages and in it severity state causes insomnia, body weakness, dry and itchy skin, loss of appetite, fluid retention leading to swelling of feet among others.

Glomerulonephritis is a group of kidney diseases in which the glomeruli of the kidney becomes inflamed. The glomeruli of the kidney filters protein and blood out of the incoming blood vessels and redistributes them back into circulation. In the case of Glomerulonephritis, the inflamed glomeruli are unable to redistribute the blood and protein back into circulation and thus is released in the urine. Glomerulonephritis is a broad term used for a few specific types of glomerular damage. The specific name is given once tissue samples are examined under a microscope and key features have been identified (www.hopkinsmedicine.org/nephrology/glomerulonephritis.html). While it cannot be used as definitive diagnosis, a few key symptoms can help to determine the tests needed for diagnosis. Commonly abdominal pain, diarrhea, excessive urination (polyuria), fever and edema of the ankles, feet, abdomen, and face (including eyes) are experienced. Once these symptoms have been evaluated by a doctor, a complete urinalysis would be requested in helping to diagnose the disease. With Glomerulonephritis protein (proteinuria) and blood (hematuria) would be found in the urine sample. (www.nlm.nih.gov/medlineplus/ency/article/000484.htm). If the urinalysis is returned positive with these findings a kidney biopsy will be performed. Positive confirmation of which type of Glomerulonephritis can then be made if the results of the biopsy show abnormal tissue and the result of the

Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,

Kidney failure; Acute loss of kidney function can be immediately life-threatening, while chronic kidney failure involves more gradual, progressive deterioration. The kidney’s primary role in clearing the blood of waste products can be affected suddenly by severe conditions such as shock, burns, blood loss, infection, and heart failure; by diseases of the kidney itself; and by conditions that cause obstruction of urinary flow. Certain drugs including NSAIDs, anti-inflammatories, some antibiotics, and drugs for cancer and heart disease, may also reduce kidney function.

infection and inflammation of the kidney e.g glomerulonephritis and acute tubular necrosis) and post renal (obstruction e.g Acute obstructive uropathy, benign prostatic hyperplasia and kidney stone).This

High blood pressure which is called hypertension is another common disease which can cause chronic renal failure. This

Glomerulonephritis (GN), or the inflammation of glomeruli, is a leading cause of renal failure worldwide. Inflammation is characterized by vascular fragility, infiltration of leukocytes, and edema. Glomerular disease may manifest by three major syndromes: nephritic syndrome, nephrotic syndrome, and rapidly progressive glomerulonephritis (RPGN). Nephritic syndrome consists of sudden onset of hematuria, non-nephrotic range proteinuria (1.5 g/24 h), active sediment with red blood cell (RBC) casts or dysmorphic RBCs, acute renal failure, and hypertension. Nephrotic syndrome is characterized by heavy proteinuria (>3.5 g/24 h), edema, hypoalbuminemia, and hyperlipidemia. RPGN is characterized by active sediment (RBC casts and dysmorphic RBCs) and rapid development of acute renal failure usually over a period of weeks to months. Glomerulonephritis accounts for the majority of progressive renal disease in many parts of the world.