Chronic Glomerulonephritis (Nursing)

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.