Causes of Glomerulonephritis: Autoimmune Diseases – (Nursing)

00:01 So in continuing our discussion on the causes of glomerulonephritis, we just look at infection, right? streptococcal, bacterial endocarditis and nasty viruses like HIV or hepatitis.

00:14 Now, we're looking at autoimmune diseases when the body kind of turns on itself.

00:19 The first one is systemic lupus erythematosus.

00:23 That's why we shortened it to SLE.

00:25 Now this disease looks different in just about every patient it can progress rapidly or slowly, but we think of it more as a chronic autoimmune disease.

00:35 Now we can involve the joints, skin, but particularly the kidneys is what we're focusing on today.

00:41 So systemic lupus erythematosus is an autoimmune disease and if it chooses to it can go after the kidneys and cause glomerulonephritis.

00:51 Now, you'll see there on the patient they have that classic butterfly rash that's a red patch on both cheeks.

00:58 That's just one of the classic signs that a patient has systemic lupus erythematosus.

01:04 It can also be caused by some other conditions, but it's most often associated with SLE.

01:08 Now the next autoimmune disease is Scleroderma.

01:13 I mean look at that picture.

01:15 This is really kind of miserable for patients.

01:18 It's a chronic disease its connective tissue disease.

01:21 So this is a chronic autoimmune disease and it goes after the connective tissue that can also cause the tissues in many of your organs to become hard and fibrous specifically the kidneys is again our focus.

01:36 So Scleroderma is a chronic autoimmune disease and it goes after connective tissue.

01:42 Now goes a after a lot of organs, But particularly we're thinking about the kidneys in terms of glomerulonephritis.

01:49 So Scleroderma think of it as like scarring of the skin Sclero Derma.

01:54 but it goes after connective tissue and they become hard and fibrous.

01:59 So you can see what this skin looks like in that photo it's doing the same thing to your kidneys.

02:05 Now goodpasture's syndrome is really this bizarre kind of thing.

02:10 Your body ends up producing antibodies against collagen.

02:13 Okay, that makes sense because this is an autoimmune disease meaning you turn on yourself the body starts attacking itself and goodpasture's syndrome the body produces these antibodies against collagen specifically in the lungs and the kidneys.

02:29 So think about what would happen if you started attacking your lungs and your kidneys.

02:35 The lungs develop bleeding and the kidneys develop glomerulonephritis.

02:40 That is incredible.

02:42 So my own body starts producing antibodies against collagen into rather important organ systems Lungs and kidneys.

02:51 The lungs start to bleed and the kidneys develop glomerulonephritis.

02:57 Now the last autoimmune disease we're going to look at is IgA nephropathy.

03:01 So these IgA things deposit in the glomerulus.

03:05 They have recurrent blood in their urine.

03:08 So when I see IgA nephropathy if you break that down, we know what IgA is that's part of our immune system because this is an autoimmune disease and pathy that's not good in the nephro.

03:21 So so we've got this autoimmune problem with IgA depositing in the glomeruli.

03:28 That's why you end up with problems in the kidneys and external sign would be blood in their urine.

03:35 Okay so, we've looked at infections, now we've looked at four different autoimmune diseases.

03:40 Stop for just a minute and think back through these four autoimmune diseases make sure that you have kind of a brief understanding of what they are and what the impact is on the kidney how it causes glomerulonephritis before you go on to the next factor.

04:01 So we just talked about four specific autoimmune diseases.

04:05 Now, I want to talk about another autoimmune problem vasculitis.

04:09 That's an inflammation of the vessels.

04:11 Now, normally you take a look at how blood should be flowing take a look at the graphic that we have there for you.

04:18 Look at that healthy vessel blood is just shooting right through the vessel not impeded at all.

04:24 But in vasculitis that vessel wall becomes really inflamed and thick.

04:30 Now look how difficult it is for blood to flow through that.

04:34 There's far less blood being able to be delivered by those vessels.

04:38 So that's the problem with vasculitis.

04:41 Now, let's look at some very specific examples of vasculitis.

04:44 One of them is called polyarteritis nodosa.

04:49 Now again, we always break down the word for you.

04:51 So "poly" means many, "arteritis" is an inflammation of the arteries.

04:56 So this causes this just spontaneous inflammation of the arteries in any orient.

05:01 But it's really most common in the heart and in the kidneys and for the sake of this video, we're focusing on glomerulonephritis.

05:08 But remember, oftentimes the kidneys don't suffer alone, right? These autoimmune diseases attack other organs.

05:15 So in polyarteritis nodosa, it's spontaneous inflammation of the arteries of multiple organs, but usually it's most common in the heart and in the kidneys.

05:27 Now there's another one called Granulomatosis with polyangiitis It's a necrotizing granulosus think that one through that's an ugly word because it's an ugly thing.

05:38 Necrotizing means death.

05:41 So you have this granulomatosis inflammation of the small and medium-sized blood vessels.

05:48 Okay, so we're talking about vasculitis.

05:51 We talked previously about polyarteritis nodosa that's in the heart and in the kidneys specifically.

05:58 Then we have Wegener's granulomatosis.

06:01 That's necrotizing or death granulomatosis inflammation and inflammation in the very small and medium-sized blood vessels.

06:10 Why are we making such a big deal about the small and medium-sized blood vessels? Well, they have the most narrow blood supply in medium and small.

06:20 So when those vessels become swollen up in difficult to pass through, you can see how problematic that is.

06:27 Also remember coming from your heart or the big vessels and the closer you get to supplying the actual organs the smaller the vessels become so it's going to really impact a supply of blood to your organs.