How glomerulonephritis cause renal failure?

Answer 1

Yes it can but not always. There are several pathological patterns of glomerulonephritis grouped into proliferative and non-proliferative types. The prognosis and treatment of each is different and very dependent on whether the disease is a primary or secondary type. That is to say internal to the kidney or external; post infection/viral/bacterial/drugs/diabeties etc.

Generally, Acute Renal Failure is caused by the rapid injury on kidneys. The causes are as following:

1. Hypovolemia: serious loss of blood volume may lead to Renal Failure.

2. Abnormal blood circulation:

Abnormal circulation may lead to obstruction of renal artery or vein, thus causing ischemia state, then aggravate injury on kidneys;

3. Drug abuse:

Due to kidneys are the main organ for eliminating toxins, most drugs will do harm to kidneys. For example, some patients with kidney disease take large amounts of diuretics which will cause the excessive loss of water, which may lead to Acute Renal Failure.

Comparing with Acute Renal Failure, causes of Chronic Renal Failure are complicated.

1. Common disease:

There are two kinds of disease may lead to Renal Failure. On one hand, kidney disease may develop into Renal Failure. Chronic glomerulonephritis is one of the common cause and including IgA Nephropathy, Mesangial Proliferative Glomerulonephritis and focal segmental sclerosing glomerulonephritis, etc. In addition, polycystic kidney disease,

reflux nephropathy, kidney stones and prostate disease can also cause Renal Failure.

On the other hand, other disease can also cause Renal Failure, such as poorly controlled Diabetes, Hypertension and so on.

2. Infectious nephropathy:

Chronic Pyelonephritis, nephrotuberculosis, etc. Serious infection may lead to Renal Failure while patients with Renal Failure should also pay attention to avoiding infection.

3. Accumulation of ECM:

Eextracellular matrix (ECM) is not easily to be degraded, so the abundant deposition and of ECM will replace nephrons, thus leading continuous glomerulus sclerosis.

4. Gene factors:

Polycystic Kidney Disease and Alport syndrome are the main kidney disease relating with gene. Patients with family history of kidney disease should treat the disease timely to avoid Renal Failure.

5. Others:

ureteral obstruction,vasculitis, Multiple Myeloma and so on can also cause injury on kidneys, thus leading to the occurrence of Renal Failure.

Answer 2

The glomeruli of the kidneys are the parts that normally filter the blood. They consist of capillaries that are fenestrated (leaky, due to little holes called fenestrae or windows) and that allow fluid, salts, and other small solutes to flow through, but normally not proteins.

In nephrotic syndrome, the glomeruli become damaged due to inflammation and hyalinisation (membrane formation) so that small proteins, such as albumins, immunoglobulins and anti-thrombin can pass through the kidneys into urine.

Albumin is the major protein in the blood which maintains colloid osmotic pressure- this prevents leakage of blood from vessels into tissue. However, experiments show that the edema formation in nephrotic syndrome is more so due to microvascular damage and intense salt and water retention by the damaged kidneys (due to increased angiotensin secretion). The mechanism is very complex and still not fully understood.

Uremia is the build up of urea, the metabolic by-product of protein metabolism. If the glomerulus is incompetent, then you basically end up poisoning your cells with urea.

Water is lost in glomerulonephritis, but not through the kidneys, it ends up being third-space shifted into tissues due to the loss of the osmotic pressure from the protein plasma leakage. It manifests as ascites, pulmonary edema and generalised edema, (especially of the extremities).