m , also known as 
 

 ,
abbreviated , is a renal disease (usually of
both kidneys) characterized by inflammation of
the glomeruli, or small blood vessels in the
kidneys. It may present with isolated
hematuria and/or proteinuria (blood or protein
in the urine); or as a nephrotic syndrome,
a nephritic syndrome, acute renal failure, or
chronic renal failure.
m Àhey are categorized into several different
pathological patterns, which are broadly
grouped into non-proliferative or proliferative
types. Diagnosing the pattern of GN is
important because the outcome and treatment
differs in different types. Primary causes are
ones which are intrinsic to the kidney, whilst
secondary causes are associated with certain
infections (bacterial, viral or parasitic
pathogens), drugs, systemic disorders (SLE,
vasculitis) or diabetes.
m 


  xidney disease where the kidney's
have problems removing waste material and excessive
fluid.
m 


  glomerular disease characterized by
an inflammatory reaction, with leukocyte infiltration and
cellular proliferation of the glomeruli, or that appears to
be the result of immune glomerular injury.
m 


  nephritis marked by inflammation of
the glomeruli of the kidney; characterized by decreased
production of urine and by the presence of blood and
protein in the urine and by edema.
m Ôcute glomerulonephritis
m Chronic glomerulonephritis
m Primary Glomerulonephritis - an
autoimmune disease
m Post streptococcal glomerulonephritis
m IgÔ Glomerulonephritis
m Ôcute glomerulonephritis (ÔGN) is active
inflammation in the glomeruli. Each kidney is
composed of about 1 million microscopic
filtering "screens" known as glomeruli that
selectively remove uremic waste products. Àhe
inflammatory process usually begins with an
infection or injury (e.g., burn, trauma), then the
protective immune system fights off the
infection, scar tissue forms, and the process is
complete.
m Àhere are many diseases that cause an active
inflammation within the glomeruli. Some of
these diseases are systemic (i.e., other parts of
the body are involved at the same time) and
some occur solely in the glomeruli. When there
is active inflammation within the kidney, scar
tissue may replace normal, functional kidney
tissue and cause irreversible renal impairment.
m Àhe severity and extent of glomerular
damage³focal (confined) or diffuse
(widespread)³determines how the
disease is manifested. Glomerular
damage can appear as subacute renal
failure, progressive chronic renal failure
(CRF); or simply a urinary abnormality
such as
m In diffuse glomerulonephritis (GN), all
of the glomeruli are aggressively
attacked, leading to acute renal
failure (ÔRF). Disorders that attack
several organs and cause diffuse GN
are referred to as secondary causes.
m Cryoglobulinemia
m Goodpasteur·s syndrome (membranous
antiglomerular basement membrane disease)
m Lupus nephritis
m Schönlein-Henoch purpura
m Vasculitis (e.g., Wegener's granulomatosis,
periarteritis nodosa)
m Immunoglobulin Ô nephropathy (IgÔ
nephropathy, Berger·s disease)
m Membranoproliferative nephritis (type
of kidney inflammation)
m Postinfectious GN (GN that results
after an infection)
Patients who have secondary causes of ÔGN
often exhibit these symptoms:

m Cough with blood-tinged sputum

m Fever
m Joint or muscle pain
m Rash
m Patients with acute glomerulonephritis (ÔGN) have an active
urinary sediment. Àhis means that signs of active kidney
inflammation can be detected when the urine is examined under
the microscope. Such signs include red blood cells, white blood
cells, proteinuria (blood proteins in the urine), and "casts" of
cells that have leaked through the glomeruli and have reached
the tubule, where they develop into cylindrical forms.
m Ô kidney biopsy is essential to establish a diagnosis of ÔGN,
determine the cause, and create an effective treatment plan.
m Àhe goal of treatment is to stop the
ongoing inflammation and lessen the
degree of scarring that ensues. Depending
on the diagnosis, there are different
treatment strategies. Often the treatment
warrants a regimen of immunosuppressive
drugs to limit the immune system·s activity.
Àhis decreases the degree of inflammation
and subsequent irreversible scarring.
m Chronic glomerulonephritis causes destruction of the
glomeruli in the kidneys. Each glomerulus is made up
of blood vessels that filter the blood and help to
produce urine. Ôs the glomeruli become dysfunctional,
the kidneys begin to show problems with blood
filtration. Àhis can lead to initial symptoms like small
amounts of blood in the urine. Some types
of chronic glomerulonephritis resolve without
treatment, but for many, treatment is necessary in
order to sustain life.
White blood cell casts from patient with chronic glomerulonephritis
m Many times the causes
for chronic glomerulonephritis are not identified.
Certain illnesses may predispose one toward
developing chronicglomerulonephritis. Some
autoimmune disorders like end stage
ÔIDs, lupus, and some blood sugar disorders
like diabetes may
cause chronicglomerulonephritis. However, in
about 25% of people
with chronic glomerulonephritis, the cause is
unknown and those affected have had no
earlier problems with kidney health.
m Often chronic glomerulonephritis is diagnosed
through urinalysis, which will show blood and protein in
the urine. Ôlso,
since chronicglomerulonephritis frequently causes high
blood pressure, those with hypertension are screened
for the disease. Ôdditional tests that may
confirm chronic glomerulonephritis are ultrasounds of
the abdomen and the kidneys, and chest X-ray. Àhose
with chronic glomerulonephritisoften retain fluid, which
can be shown in the lungs. Some doctors also prefer to
do a biopsy of the kidneys, since identifying cause
when possible can alter treatment
m Àreatment for chronic glomerulonephritis can depend upon
cause. One of the main concerns is controlling high blood
pressure, which though a cause of the illness, can also contribute
to worsening it. Further, high blood pressure alone represents
greater risk for stroke and must be treated. Normally,
hypertension is treated with a variety of blood pressure
medications. Patients may also need to go on a salt and fluid
restricted diet.
m In severe cases of chronic glomerulonephritis, kidney dialysis or
kidney transplant is required to help the body adequately filter
blood products through the kidneys. Àransplant can often halt
the disease, but can be difficult to obtain. Further if the disease
is caused by conditions like ÔIDs, lupus, or diabetes, transplant
may not be successful. Àhe condition can recur in the
transplanted kidney
m Outcome of treatment depends upon the degree to which
symptoms can be controlled or arrested. Serious damage to the
kidneys, called nephrotic syndrome may be irreversible. When
such damage can be controlled, patients may recover well. Of
course, outcome of treatment forchronic glomerulonephritis also
depends upon cause, and with illnesses like ÔIDs, the condition
tends to progressively worsen.
m Renal failure is a serious medical condition affecting the
kidneys. When a person suffers from renal failure, their kidneys
are not functioning properly or no longer work at
all. Renal failure can be a progressive disease or a temporary
one depending on the cause and available treatment options.
m Àhe kidneys are glands that are located in the abdominal
region just above the pelvis on either side of the body. When
functioning normally, the kidneys separate and filter excess
water and waste from the blood stream. Àhe kidneys are
responsible for producing urine, which is used to flush away the
toxins. Àhe kidneys also maintain a healthy balance of fluids
and electrolytes, or salt compounds, in the body.
m In renal failure the kidneys undergo
cellular death and are unable to filter
wastes, produce urine and maintain fluid
balances. Àhis dysfunction causes a build
up of toxins in the body which can affect
the blood, brain and heart, as well as
other complications. Renal failure is very
serious and even deadly if left untreated.
m Àhere are two types of renal failure: acute and
chronic. Ôcute renal failure occurs suddenly and
is usually initiated by underlying causes, for
example dehydration, infection, serious injury to
the kidney or the chronic use of over the counter
pain medications like Àylenol (acetaminophen)
or Ôdvil (ibuprofen). Ôcute renal failure is often
reversible with no lasting damage.
m Chronic renal failure is more serious than
acute renal failure because symptoms may not
appear until the kidneys are extremely
damaged. Chronic renal failure can be caused
by other long term diseases, such
as diabetes and high blood pressure.
Chronic renal failure can worsen over time,
especially when the problem has gone
undiagnosed and treatment is delayed.
m Àhe symptoms
of renal failure include edema, which is an
accumulation of fluid characterized by
swelling, and a decrease in urination.
Other symptoms may include a general ill
feeling, exhaustion and headaches. Often,
a person with renal failure does not
experience any symptoms.
m With treatment, a person with
kidney failure can live a relatively normal life.
Depending on the severity of
kidney failure, renal function may be restored
by treating the primary disease that is
responsible for the damage, or by treating the
kidneys with medication. In severe cases
ofrenal failure, a person might
require dialysis and a kidney transplant
m In renal dialysis, the patient must be connected
to a machine that mechanically filters the blood.
Dialysis does not treat renal failure, but instead
keeps a person alive by performing the crucial
functions of the kidneys. Ô person may have to
undergo dialysis as often as several times a
day or as little as weekly, depending on the
severity of the renal failure. Ô person with
acute, reversible renal failure may need
dialysis while the kidneys recover.
m When the kidneys fail completely, the patient
will need a kidney transplant. Fortunately,
human beings can function with only one kidney,
so relatives and other living donors are an
option. Àhis reduces the need for deceased
donors that is common with other organ
transplants and requires long waiting lists.
However, it is necessary to find a donor that has
a similar tissue and blood type, which means
that finding a kidney may still be difficult. Most
people who need a kidney transplant must also
be on dialysis until a match is found.
m Àhe main difference between acute and chronic renal failure is
that chronic one develops slowly and the kidneys functioning
gets worse slowly. Àhe range is between mild dysfunction and
end-stage renal disease (ESRD). Chronic kidney failure is a
result of conditions that last for years and slowly damage
kidney unlike acute where kidney is damaged very quickly. Àhe
two most common causes of chronic failure are diabetes
and high blood pressure. Àhere are other conditions that can
cause it such as analgesic nephropathy,glomerulonephritis,
kidney stones and infection, obstructive uropathy, polycystic
kidney disease, reflux nephropathy, etc. Result of chronic failure
is accumulation of toxins and other waste products in organism.
Àhey can't be eliminated by damaged kidneys.
m Ôcute renal failure has a sudden onset and can occur within
hours or days as a complication of medical conditions, surgery,
or trauma. Diminished blood volume due to hemorrhage or
severe dehydration, very low blood pressure, septicemia, which
is bacteria in the blood, urinary tract obstruction, and
nephrotoxins, which are substances harmful to the kidneys such
as certain drugs, solvents, and metals, these are all causes of
ÔRF. ÔRF can often be reversed with no permanent damage to
the kidney. Ào prevent this permanent damage treatment must
start as soon as possible, which they usually use dialysis to
remove toxic substances from the body or to take over the
kidney function until the kidney can be corrected.
m Chronic renal failure is when the kidneys have become
damaged. In most casesCRF is progressive and can eventually
lead to kidney failure. Àhere is no cure for CRF except for
transplantation , there will be a diet to help slow down the
progression which is a low sodium diet, with restrictions on
excessive protein, and on the intakes of potassium, water, and
phosphorus. Àhere is also medications that are used to help
supplement foods. Both chronic and acute kidney disease
diminish the kidney·s ability to filter blood and remove water
and wastes.