Page 122 - Physiology and Pathophysiology MNU 2024-2025 نظرى

Clinical pharmacy 2024/2025 Level 2 Pharm D Physiology and Pathophysiology
(MD303)

Renal System Pathophysiology

Kidney Disorders

1- Glomerulonephritis

A) Acute Glomerulonephritis
It is an inflammation of the glomerulus.

▪ It occurs:
✓ Most commonly 7-10 days following an infection with group A streptococcus.
✓ May also be related to systemic conditions such as lupus erythematosus where there
are excess levels of circulating antibodies or antigen–antibody complexes.
▪ Pathogenesis:
✓ Trapping of antigen-antibody complexes in glomerular capillaries causes inflammation
of the glomerulus and alters its selective permeability, allowing plasma proteins and
blood cells to enter plasma filtrate.
✓ The active inflammatory process draws white blood cells which may increase the
inflammatory process.
▪ Complications: Glomerular damage may result, and chronic glomerulonephritis may occur.

B) Chronic glomerulonephritis

It is a chronic inflammation of glomeruli.
▪ It may occur :
✓ Prior acute glomerulonephritis.
✓ It may be associated with hypertension, diabetes mellitus.
▪ It may remain asymptomatic for years before proteinuria, hematuria occurs.
Progressive loss of renal functions occurs over a number of years leading to renal insufficiency and
renal failure.
▪ It may be accompanied with decreased urine volume and fluid retention.

❖ Manifestations of glomerulonephritis:
• Proteinuria (appearance of protein in the urine, primarily albumin).
• Hematuria (appearance of blood in the urine).
• With chronic forms of glomerulonephritis, decreased urine volume and fluid retention may occur as
renal insufficiency and renal failure develops.
• Hypertension is a possible consequence of reduced renal blood flow and activation of renin–

angiotensin system.

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