00:01
Hi! Welcome to our video
series on glomerulonephritis.
00:05
We're going to talk
about the similarities
and the differences
between chronic and rapidly
progressive glomerulonephritis.
00:13
Now, what is glomerulonephritis?
We want to start out with
that again as a quick review.
00:18
Glomerulonephritis is an
inflammation of the glomeruli.
00:22
Remember the glomerulus.
00:24
One of them is one of
three important parts
of the nephron, the nephron are
those working units of your kidney.
00:31
The Glomeruli is a really
fragile tangle of capillaries
when it becomes inflamed.
00:37
We're going to have lots
of problems in the kidneys.
00:40
Now, it can be acute
or it can be chronic.
00:42
We're talking about rapidly
Progressive as an example
of an acute glomerulonephritis.
00:48
Now chronic glomerulonephritis
is one of the major causes
of end stage renal disease
and that's really a
difficult diagnosis
because end-stage renal disease
represents renal failure.
01:00
Patients likely going
to be on dialysis
and all other types of
life-altering treatments.
01:05
Now while there are lots of
causes of glomerulonephritis
you seen these in other videos,
we're going to focus on chronic
and rapidly Progressive.
01:14
So let's get started
with the slower moving one
to kind of ease you into it.
01:19
Now, you see our chart there.
01:20
We're using to compare treatments
and symptoms with glomerulonephritis.
01:25
In this one since we're looking
at Chronic glomerulonephritis
the loss of renal function is
going to happen slowly over time.
01:32
Sometimes it's even over
many years in the patient
may not even be aware
that they're having
kidney damage progress.
01:40
Okay.
01:40
So chronic is really slow moving
and the damage may be done
before the patient realizes
that they've had kidney damage.
01:49
Now causes we may not know
and nobody likes that answer
but it might be an
inherited disorder
and that might be like an end-stage
glomerulo-inflammatory disease
so sometimes we know the cause
sometimes we do not
but often times it
isn't discovered
until significant
damage is done.
02:09
Now clinical symptoms.
02:10
If you compare this
with the other forms
of glomerulonephritis,
they're going to look the same.
02:15
See that's the cool part about
studying all this together
because these are just
the signs and symptoms
when the kidney is struggling
when it's not functioning
at optimal level.
02:25
Remember the glomerulus
is a really important
part of the nephron,
the working. Unit of the kidney.
02:31
So one of those three
important parts,
so if it's not doing well,
the rest of the kidney
isn't doing well.
02:38
That's why protein leaking
into the urine instead
of staying in the blood bad
thing, blood in the urine
not a good sign,
uremia and elevated
BUN and creatinine.
02:49
These are just the classic signs
that the kidney is not doing well.
02:53
It's not able to do its
job to filter out the waste
and return the things we
want it to hang on to.
03:00
So how we treat it is we're gonna
have to look at the fluid overload.
03:03
How overloaded is the patient
because the kidneys are
not functioning well,
they can't get rid of that excess
water that the body needs it to,
so the body hangs onto excess
water you have that edema.
03:15
So if there's edema present
we're going to need
to address that
so depending on how
severe the edema is
will depend on how intense
the therapy needs to be.
03:25
So we're going to look at
potential or actual fluid overload.
03:28
We're going to watch
the blood pressure.
03:30
Anytime a patient has
extra volume on board.
03:33
Their blood pressure
is elevated.
03:36
Also they may also have
some arthrosclerosis
that goes along with it.
03:39
So hypertension
is pretty common with a
chronic glomerulonephritis.
03:44
Now, we're going to watch
for uremia and also look at
injury of the kidneys and
what needs to be done.
03:50
So we may treat the injury to
the kidneys with medications
or may treat it
with dialysis just depends on
how severe the symptoms are.
03:58
So the medications
that we put on,
goes back to whatever
symptoms of patient is having.
04:03
Now don't let this get you
confused might feel like,
this is kind of vague,
it is because we're just looking
at this as a giant category.
04:13
So, you know how it happens,
happens slowly over
a period of time,
patient may not be
aware that it happened,
Causes?
well ranges from we don't know
do you might have glomeruli
inflammatory disease.
04:27
Clinical symptoms
whoo! At least that's
starting to look
familiar because that's just science
at the kidneys aren't working well.
04:33
And treatment and
medications will depend on
what symptoms your
patient is exhibiting.
04:39
So that's chronic
glomerulonephritis.
04:42
Remember it can sneak
up on your patient
over a period of years.
04:45
And so it's almost too late
for us to make the kind
of intervention we could
if it had been caught earlier.