IgA Nephropathy

by Carlo Raj, MD

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    00:01 With Nephritic, their primary disorder is dealing with neutrophils.

    00:05 Keep that in mind.

    00:06 Because I've asked you to focus on that H.

    00:08 Let's take a look at hypertension. I understand.

    00:11 Whenever there is issues of renal failure or issues with the kidney in general, you are going to retain that sodium.

    00:18 Therefore, contributing to that hypertension.

    00:22 Now, when I say there is massive protein loss with Nephritic syndrome, I understand that even if you are going to lose protein, but it will not be as much as three and a half grams of protein loss per day.

    00:38 Greater than 3.5 grams of protein loss per day automatically puts you in the category of Nephritic and it's edema and nephritic will be significant.

    00:48 You are still going to lose protein with Nephritic syndrome, but not as greatly.

    00:55 So therefore, here the type of edema will be periorbital type of puffiness.

    01:00 And once again, usually your due to that salt retention and resulting in increase hydrostatic pressure.

    01:08 Edema can be more generalized.

    01:10 However, remember, the typ of edema is not going to be as profound as what you find with Nephritic. Next.

    01:18 Along with hypertension and mild edema, periorbital puffiness.

    01:24 The fact that you are producing very little urine oligo Last time we looked at the term prefix oligo was when we're dealing with highdromnius, little amniotic fluid.

    01:36 This is little urine production.

    01:39 Oliguria, we have approximately and you must know the definition of approximately 400 milliliters of urine being produced per day. Day.

    01:48 You pay attention to units due to once again decreased GFR from a inflamed glomeruli.

    01:57 Hence the neutrophils coming in.

    01:59 Here's your second h the hematuria.

    02:02 Now with the hematuria, what does that mean? What type of RBC have we discussed earlier that would then lead you to think that the damage you actually took place at the glomerulis.

    02:11 And that in fact would be a dysmorphic RBC? What does that mean as an RBC passes through the glomerulis? There's every possibility that there might be a part of that by concave RBC, which might not be a out pouching at the dysmorphic RBC.

    02:29 Irregular membrane due to inflamed glamor lie from immune complex deposition.

    02:37 Let me give you a prototype for the nephritic syndrome and actually let me give you two of them.

    02:41 One was called IGA Nephropathy, a.k.a.

    02:44 a berger, and the other one will be posted to post streptococcal glomerulonephritis.

    02:49 And as the RBC is trying to make it through, it might then become dysmorphic.

    02:54 Now your laboratory findings are relevant for nephritic. Include the fact that you would find neutrophils in the sediment, particularly in the immune complex type.

    03:03 So that's more involved with inflammatory processes.

    03:08 The RBC casts are key findings now.

    03:10 Let me walk you through this real quick.

    03:11 With nephritic, number one H hypertension under hematuria We have RBC casts and we have dysmorphic RBCs, this is how that fits in perfectly.

    03:24 You just need to make sure that you organize your patterns and thoughts accordingly.

    03:29 The proteinuria will be less than three and a half grams per day.

    03:34 That's important that you pay attention to.

    03:35 Yes, greater than 150 milligrams, but in Duffy, less than three and a half grams per day.

    03:42 Because anything beyond is what category does that put you in very good.

    03:47 Nephritic Under Nephritic, you BUN ratio.

    03:52 Well, tubular function is intact.

    03:54 An acute acute glimmering nephritis.

    03:57 And that's very important for you to understand. Why? Give me a condition in which your tubules are also damaged.

    04:06 Good.

    04:07 It's called acute tubular necrosis, isn't it? So when you have acute tubular necrosis, the physiology behind that is the fact that you cannot reabsorb any, any urea.

    04:21 Where is urea in this ratio B blood, U urea, N nitrogen. Ahh there is urea.

    04:29 So an acute tuber necrosis, you can expect that ratio to be decreased.

    04:33 However, in acute glomerulonephritis, you can still expect your asitimea to be relatively elevated.

    04:40 Isn't that interesting?

    About the Lecture

    The lecture IgA Nephropathy by Carlo Raj, MD is from the course Glomerulonephritis.

    Included Quiz Questions

    1. Mesangial
    2. Subepithelial
    3. Subendothelial
    4. Intramembranous
    5. Membranous

    Author of lecture IgA Nephropathy

     Carlo Raj, MD

    Carlo Raj, MD

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