Angeles University Foundation

College of nursing

A report about:

Acute Glumerulonephritis (AGN) VS Nephrotic Syndrome

Submitted by: Quinn Ramos Justine Lacanlale BSN III-3

Acute Glumerulonephritis Definition: Acute glomerulonephritis (AGN) 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. The inflammatory process usually begins with an infection or injury (e.g. GABHS, burn, trauma), then the protective immune system fights off the infection, scar tissue forms, and the process is complete. Causes: Nephritic syndrome

Clinical Manifestations: y y y y y y y y y y y y Fever Hematuria with RBC casts Proteinuria Edema- it could be generalized or facial edema or swelling of extremities. HPN Weakness Pallor Anorexia Nausea and vomiting Chills Oliguria Visual acuity

Diagnostics and Laboratory: y y y y y ASO titer- It determines if the infection is caused by GABHS Urinalysis BUN CBC Renal ultrasound

Renal biopsy- essential to establish a diagnosis of AGN, determine the cause, and create an effective treatment plan.

Treatment: y y y y y Diet: y y Low salt diet Decrease fluid intake Anti-HPN drugs (such as ACE inhibitors) Furosemide Antibiotics Paracetamol D5W

Definition: Nephrotic syndrome is a condition that is often caused by any of a group of diseases that damage the kidneys' filtering system, the glomeruli. The structure of the glomeruli prevents most protein from getting filtered through into the urine. Normally, a person loses less than 150 mg of protein in the urine in a 24-hour period. Nephrotic-range proteinuria, the urination of more than 3.5 grams of protein during a 24-hour period, or 25 times the normal amount, is the primary indicator of NS

Classification: Nephrotic syndrome can be primary; being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a systemic general illness. In all cases, injury to glomeruli is an essential feature

Causes of NS: Primary Minimal-change disease (MCD) also known as lipoid nephrosis or nil disease is the most common single form of nephrotic syndrome in children. It refers to a histopathologic lesion in the glomerulus that almost always is associated with nephrotic syndrome. It typically is a disease of childhood, but it also can occur in adults Focal segmental glomerulosclerosis (FSGS) The condition causes asymptomatic proteinuria or nephrotic syndrome NS with or without renal insufficiency. A diagnosis of FSGS is confirmed only by histopathology findings Membranous nephropathy (MGN) is one of the more common forms of nephrotic syndrome in the adult population

Secondary Causes: Amyloidosis - the stiffening and subsequent malfunction of the kidney due to fibrous protein deposit in the tissue

Glomerulonephritis Pre-eclampsiararely associated with NS, more often associated with heavy proteinuria Complications: Nephrotic syndrome is associated with renal failure. The disease that causes NS can damage the glomeruli and can interfere with their ability to clean the blood. The edema that is present in the legs may also be occurring in the kidney tissue itself and can interfere with the kidneys' ability to clean the blood. Renal failure can either be gradual (CRF) or acute (ARF)

Drugs: ACE Inhibitors ARBs Paracetamol Laboratory Test:

y y y y y

Creatine - blood test Blood urea nitrogen (BUN) Creatinine clearance Albumin blood test - may be low Urinalysis - reveals large amounts of urine protein