{"id":5836,"date":"2017-06-08T16:09:36","date_gmt":"2017-06-08T08:09:36","guid":{"rendered":"http:\/\/https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=5836"},"modified":"2020-07-28T14:26:53","modified_gmt":"2020-07-28T06:26:53","slug":"glomerular-diseases-clinicopathologic-correlation","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/glomerular-diseases-clinicopathologic-correlation\/","title":{"rendered":"Glomerular Diseases: Clinicopathologic Correlation"},"content":{"rendered":"\n\t<p>Glomeruli are basically <em>filters.\u00a0<\/em>When things go wrong, they:<\/p>\n<ul> \t\n<li>Leak (protein, RBCs, etc)<\/li>\n<p> \t<\/p>\n<li>Don&#8217;t work (no filtrate)<\/li>\n<\/ul>\n<p><\/p>\n\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">What are the clinical presentations? (Click to expand)<\/a>\n\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t<p><strong><u>1. Nephrotic syndrome (leaky filter)<\/u><\/strong><\/p>\n<p>&#8211; Heavy proteinuria (&gt;3.5g\/day) (importantly, albumin is one of the proteins lost)<\/p>\n<p>&#8211; Hypoalbuminaemia (basically an effect of renal albumin loss)<\/p>\n<p>&#8211; Severe oedema (an effect of low serum albumin &#8211; low serum oncotic pressure)<\/p>\n<p>&#8211; Hyperlipidaemia<\/p>\n<p>&#8211; Lipiduria (urine lipid loss)<\/p>\n<p><strong><u>2, Nephritic syndrome (leaky + cannot filter)<\/u><\/strong><\/p>\n<p>&#8211; Haematuria (usually gross &#8211; RBCs pass through leaky filter)<\/p>\n<p>&#8211; Mild to moderate proteinuria (due to leaky gloms)<\/p>\n<p>&#8211; Oliguria (due to poor filtering function)<\/p>\n<p>&#8211; Oedema (from fluid retention due to poor filtration)<\/p>\n<p>&#8211; Hypertension (due to fluid retention)<\/p>\n<p>&#8211; Azotaemia \u00a0(biochemical abnormality characterised by raised creatinine levels)<\/p>\n<p><strong><u>3. Asymptomatic haematuria and\/or proteinuria (mild leak)<\/u><\/strong><\/p>\n<p>&#8211; Usually associated with mild glomerular abnormalities<\/p>\n<p><strong><u>4. Acute renal failure (Rapidly progressive glomerulonephritis \/ Crescentic glomerulonephritis) &#8211; <\/u><\/strong>(suddenly unable to filter)<\/p>\n<p>&#8211; There is:<\/p>\n<p>i. Rapid development of anuria\/severe oliguria<\/p>\n<p>ii. Rise in serum creatinine<\/p>\n<p>iii. Over 3 months or less<\/p>\n<p><strong><u>5. Chronic renal failure (progressive inability to filter)<\/u><\/strong><\/p>\n<p>Many of the glomerular diseases causing the above clinical syndromes can progress to chronic renal failure.<\/p>\n\t\t\t<a href=\"#\" id=\"fl-accordion--label-1\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-1\">What are some glomerular diseases?<\/a>\n\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-1\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-1\"><i>Expand<\/i><\/a>\n\t\t<p>This chart is taken from Robbins. Take note that some are Primary while others are Secondary (non-primary eg. systemic conditions)<\/p>\n<p><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Glomerular-Diseases-Robbins-2esfz0q.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Glomerular-Diseases-Robbins-2esfz0q.jpg\" alt=\"\" width=\"921\" height=\"983\" \/><\/a><\/p>\n\t<p><strong><u>How do we correlate clinical presentation with specific glomerular diseases and morphology?\u00a0<\/u><\/strong><\/p>\n<p>Here is a Mindmap that helps tie in the clinicopathologic correlation. Many of the conditions mentioned in this mindmap are Primary Glomerular diseases. There are\u00a0<strong>secondary and systemic conditions<\/strong> that can also cause nephrotic and nephrotic syndrome, mentioned in your lecture notes<\/p>\n<p>For specific disease aetiologies, pathogenesis and clinical course, please refer to your notes.<\/p>\n<h3>\n\t\tMINDMAP: Glomerular Diseases with Clinical Correlation\n\t<\/h3>\n\t<p>If you can&#8217;t play the video, watch it here on YouTube: <a href=\"https:\/\/youtu.be\/XnxmvQYh1AI\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/youtu.be\/XnxmvQYh1AI<\/a><\/p>\n\t<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/196259695\" width=\"640\" height=\"475\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/tubulointerstitial-and-vascular-diseases\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tTubulointerstitial and Vascular Diseases\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/i-urogenital-system-where-to-start\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tI. Urogenital System: Where to Start?\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/ii-clinical-manifestations-and-investigations\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tII. Clinical Manifestations and Investigations\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-deystified\/urogenital-pathology\/iii-lower-urinary-tract-and-male-genital-system\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tIII. Lower Urinary Tract and Male Genital System\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/iv-kidney-diseases\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tIV. Kidney Diseases\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/v-ug-system-talking-pots\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tV. UG System: Talking Pots\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/urogenital-system-quiz\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tVI. Urogenital System: Quiz\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/urogenital-system-one-page-summary\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tUrogenital System One Page Summary\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/\" target=\"_self\" role=\"button\" rel=\"noopener noreferrer\">\n\t\t\t\t\t\t\tUrogenital Pathology\n\t\t\t\t\t<\/a>\n","protected":false},"excerpt":{"rendered":"<p>Glomeruli are basically filters.\u00a0When things go wrong, they: Leak (protein, RBCs, etc) Don&#8217;t work (no filtrate) What are the clinical presentations? (Click to expand) Expand 1. Nephrotic syndrome (leaky filter) &#8211; Heavy proteinuria (&gt;3.5g\/day) (importantly, albumin is one of the proteins lost) &#8211; Hypoalbuminaemia (basically an effect of renal albumin loss) &#8211; Severe oedema (an [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":5799,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-5836","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/urogenital-pathology\/glomerular-diseases-clinicopathologic-correlation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"Glomeruli are basically filters.\u00a0When things go wrong, they: Leak (protein, RBCs, etc) Don&#8217;t work (no filtrate) What are the clinical presentations? 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