ACUTE GLOMERULONEPHRITIS

PATHOPHYSIOLOGY
Post streptococcal infection (group A betahemolytic) Impetigo Acute viral infections

PATHOPHYSIOLOGY
Antigen
Antigen-Antibody product Deposition of Ag-Ab complex in glomeruli Increased production of epithelial cells lining the glomerulus Leukocytes infiltrate the glomerulus

Thickening of the glomerular filtration membrane

Scarring and loss of glomerular filtration membrane Decreased GFR

CLINICAL MANIFESTATIONS
Hematuria (blood in urine) Cola-colored urine Proteinuria (primarily albumin) BUN & creatinine serum levels increased Some degree of edema & hypertension In severe cases: headache, malaise, & flank pain Azotemia

ASSESSMENT & DIAGNOSIS

Kidneys are enlarged, swollen and congested Kidney biopsy Serial determination of antistreptolysin O or anti-Dnase B titers

COMPLICATIONS
Hypertensive encephalopathy Heart failure Pulmonary edema

MEDICAL MANAGEMENT
Treat symptoms Treat complications promptly Penicillin Corticosteroids Restriction of dietary protein Sodium restriction Antihypertensive drugs Loop diuretics

NURSING MANAGEMENT
Liberal carbohydrates in the diet MIO Fluids regulation Health education WODAC