5 GNAPS English
5 GNAPS English
5 GNAPS English
GLOMERULONEPHRITIS
Confirm hematuria:
1. Dipstick
2. Microscopic
Hematuria:
1. Macroscopic Hematuria (gross hematuria)
2. Microscopic hematuria (> 3-5 RBCs/hpf)
Red urine, RBCs (-), dipstick (-)
Caused by:
Causes of Hematuria:
1. Glomerular
• Erythrocyte cast
• Deform urinary RBCs
2. Non Glomerular
• Cast (-)
• Normal urinary RBC morphology
Etiology of hematuria
1.Renal bleeding
1.1. Glomerular hematuria
Acute glomerulonephritis
Membranoproliferative glomerulonephritis
Hereditary nephritis ( Alport Syndrome)
IgA nephropathy (Maladie de Berger)
Familial hematuria
Benign or persistent hematuria
1.2. extra glomerular hematuria
acute or chronic pielonephritis
kidney TBC
kidney tumor
hemangioma
policystic kidney
hidronephrosis
papillary necrosis
malformation (trombosis vena renalis)
trauma
idiopatic hypercalciuria
2. Extra renal bleeding
Urinary Tract Infection: cystitis, urethritis,
Urolithiasis
Trauma
Urinary Tract congenital anomaly
phymosis
stenosis meatus
“jengkol” intoxication
3. Systemic Disease
Henoch Schonlein syndrome
Systemic Lupus erytematosus nephritis
polyarteritis nodosa
subacute bacterial endokarditis
4. Hemolytic Disease
Leukemia
hemolytic uremic syndrome
idiopatic thrombocytopenia purpura
haemofilia
sickle cell glomerulopathy
5. Exercise
Substance and medicine which
caused hematuria
A. Metal: Arsenic
Gold
Phosphate
B. Chemotherapy medicine:
• Amfoterisin
• Ampisilin
• Kolistiimetat
• Kanamisin
• Metisilin
• Penicillin
• Polimiksin
• Sulfonamide
C. Drugs:
Acetylsalicylate Indometasin
Klorotiazid Fenasetin
Chlorpromazine Fenilbutason
Klonosin
Probenesid
Corticosteroid
Trifluoperasin
Cyclophosphamid
D. Organic substance
Carbon tetrachloride
Phenol
Propilenglikol
Turpentine
E. Anticoagulant
Heparin
Warfarin
APSGN
- This disease is a classic example of acute
nephritic syndrome, characterized by :
- gross hematuria
- edema
- hypertension
- kidney insufficiency
- APSGN is one of the most common gross
hematuria in children
Aetiology
– Infection of the throat or skin by strains of
group A β-Hemolytic streptococci (serotype
12 for throat) & (serotype 49 for skin)
Pathogenesis & path physiology
Immunologic Disease (complex
immune)
Ag-Ab complex in GBM → Immune
complex activated (alternative
pathway)
GFR & reabsorbs Na → edema