Glomerulonephritis

Synonyms in a broader sense

  • Filter ignition
  • inflammable filter destruction
  • Inflammation of the kidneys
  • nephritis
  • Ball inflammation
  • nephrotic syndrome
  • Inflammation of the kidney corpuscles

definition

Glomerulonephritis is an inflammation (hence the ending -itis) of the filter system (or the vascular cluster = glomeruli) of the kidneys (nephr-) with influx of inflammatory cells.
Glomerulonephritis is the second most common cause of chronic renal insufficiency (kidney failure) in Europe. A characteristic feature is that the inflammation always occurs in both kidneys at the same time.
Glomerulonephritis is a common cause of nephrotic syndrome.

Read more about this at: Nephrotic Syndrome

introduction

Both Glomerulonephritis there are different classifications. She can after the Symptoms take place or after the miroscopic features (histopathological or electron microscopic). Classification based on immunohistochemical characteristics (behavior of the kidney tissue) is also common.

The classification used here is based on the characteristics that can be found under the light microscope (histological):

  • Minimal-change glomerulonephritis
  • Endocapillary proliferative glomerulonephritis (= post-streptococcal GN)
  • Mesangioproliferative glomerulonephritis of the IgA type
  • focal segmented glomerulosclerosis
  • Membranous glomerulonephritis
  • Membrane proliferative glomerulonephritis
  • Necrotizing intra- / extracapillary proliferative (= rapidly progressive) glomerulonephritis

The infestation can affect all filters (diffuse) or only certain glomeruli (focal). If the loops of blood vessels are also affected, this is called semgenic infestation designated.

You can find out more about the different shapes at: Forms of glomerulonephritis

Cause of glomerulonephritis

The exact cause of some forms is still unclear. Only in the forms that occur after an inflammation (post-infectious = triggered by an inflammation), the connection to the triggering factors seems clear. In the case of the other forms, connections with infections are also only suspected.

Structure and function of the kidney filter

To better understand this disease and its various forms, it is helpful to briefly refer to the Structure and function of the kidney filter too busy.
The Kidneys will be in bark and mark assigned. The filters are in the kidney cortex. The central functional unit is the nephron.
Each kidney has about 1 million nephrons. They contain the glomeruli, which are also called Malphigi bodies and each contain about 30 tiny loops of blood vessels for filtering the blood.
From the inside out, the following are involved in the filter system:

  • the fenestrated endothelial cell layer (a layer of blood vessels)
  • a basement membrane
    and
  • so-called foot cells (podocytes).

The size of the "pores" are chosen so that only certain, relatively small components of the blood can be filtered. This is supported by the charge on the filter (it is negatively charged). Since equally charged substances repel each other, only neutral and positively charged substances are filtered.
You can find out more about the function of the kidneys under our topic: kidney.

Disease development (pathogenesis)

The exact one Development of glomerulonephritis is still with most forms speculative.
So far it has been found that immunological processes, at least in some forms, are an important factor. In these immunological processes, when infected with certain pathogens (e.g. streptococci), the body produces antibodies to combat these germs (they are also called antigens). Whole ones are formed in the course of the defense reaction Antigen-antibody complexesthat can be deposited in the small kidney vessels. An inflammation then occurs there, which disrupts or destroys the filter function.
In another form, antibodies are formed by the body directly against the filter system (e.g. against the basement membrane), which is often not only the kidneys but also Lungs concerns (Goodpasture Syndrome = renopulmonary syndrome). In the case of Goodpasture syndrome, a preceding inflammation in the lungs or the air duct system is currently being discussed.

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