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28 Cards in this Set

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Differential of concomitant hematuria and proteinuria
1) Postinfectious acute glomerulonephritis
2) Lupus Nephritis
3) Membranoproliferative glomerulonephritis
4) Focal Segmental Glomerulonephritis
Postinfectious acute glomerulonephritis:
proteinuria? hematuria? other markers?
Proteinuria: Sometimes
Hematuria: Always
Other markers: Low C3
Lupus Nephritis
proteinuria? hematuria? other markers?
Proteinuria: sometimes
Hematuria: usually
Other markers: Low C3 and C4; elevated ANA, aDNA Ab
Membranoproliferative glomerulonephritis
proteinuria? hematuria? other markers?
Proteinuria: usually
Hematuria: Always
Other markers: Low C3 and C4
Focal Segmental Glomerulonephritis
proteinuria? hematuria? other markers?
Proteinuria: Always
Hematuria: Sometimes
Other markers:
IGA nephropathy
Proteinuria: Sometimes
Hematuria: Always
Other markers: sometimes high serum IgA
minimal change nephropathy
Proteinuria: Always
Hematuria: Sometimes
Other markers:
membranous nephropathy
Proteinuria: Always
Hematuria: Rarely
Other markers:
alport syndrome
Proteinuria: Rarely
Hematuria: Always
Other markers:
Thin membrane disease
Proteinuria: Rarely
Hematuria: Always
Other markers:
Causes of Hematuria in children?
1) glomerular disease (eg, postinfectious acute glomerulonephritis),
2) hypercalciuria or renal stones,
3) acute pyelonephritis or cystitis,
4) drug toxicity (eg, vancomycin or gentamicin),
5) renal malformation (ureteropelvic junction obstruction or tumor), or
6) cystic disease (autosomal dominant polycystic kidney disease).
7) Another cause is bladder malformation (eg, ureterocele).
What is fixed proteinuria?
Fixed (or nonorthostatic) proteinuria
What random urine protein to creatinine ratio indicates significant proteinuria?
[P/C] ratio >0.5
What causes false positive urine protein tests?
highly concentrated or alkaline urine
What does renin do?
promotes salt (and water) reabsorption
What medication is used to lower mild to moderate elevations of BP in AGN?
loop diuretics and ACEI
nephrotic syndrome plus low C3
Postinfectious acute glomerulonephritis
nephrotic syndrome plus low C3 and C4
membranoproliferative glomerulonephritis
is membranous nephropathy common in younger or older kids?
older
is minimal change nephropathy common in younger or older kids?
younger
3 symptoms of HSP
arthritis, abdominal pain, purpura
What percentage of kids with HSP have renal involvement?
35-50
Most common renal manifestation of HSP?
Hematuria
Pathology of HSP nephritis
IGA deposits in mesangial cells with or without crescents
What do crescents represent?
Extensive inflammation and scarring in glomeruli
treatment of severe crescentic HSP?
intravenous cyclophosphamide or even plasmapheresis if the renal deterioration does not abate
treatment of mild HSP nephritis and Nephrotic syndrome?
a combination of oral steroids and azathioprine
what test is best for monitoring patients with renal involvement in HSP?
intermittent random urine protein (P) and creatinine (C) measurements or the P/C ratio