Glomerulonefritis

Overview
Anatomy Physiology Pathophysiology

Epidemiology Diagnosis Workup

Definition Treatment

Clinical Presentation Complication

Clasification Prognosis

Etiology Prevention
Anatomy
Physiology
Anatomy
Physiology
Anatomy
Physiology
Anatomy
Physiology
 Definition
The glomerular diseases are defined by their clinical presentations and the
histologic findings associated with the diseases.

Primer sekunder
• Systemic Disease impacts the kidney
Clnincal
Presentation
Clnincal
Presentation
Clnincal
Presentation
Clnincal
Presentation
Clnincal
Presentation
Clnincal
Presentation
Clasification – 1. Minimal
Change Disease
Clasification – 1. Minimal
Change Disease
Clasification – 1. Minimal
Change Disease
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 2. Focal
Segmental Glomerulosklerosis
Clasification – 3. Membranous
Glomerulonefritis
Clasification – 3. Membranous
Glomerulonefritis
Clasification – 3. Membranous
Glomerulonefritis
Clasification – 3. Membranous
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 4.
Membranoploriperativeus
Glomerulonefritis
Clasification – 5. Post Streptococal
Glomerulonefritis
Clasification – 5. Post Streptococal
Glomerulonefritis
Clasification – 5. Post Streptococal
Glomerulonefritis
Clasification – 5. Post Streptococal
Glomerulonefritis
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 6. Ig A Nefropathy
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 7. Lupus Nefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
Clasification – 8. Rapidly
Progresive Glomerulonefritis
 Treatment – General Treatment
1. Proteinuria Ace-I, ARB

2. Hypertension Non Pharmacologic

• Life Style Modification
• Stop Smoking
• Exercise
Pharmacologic
• Ace-I, ARB
• CCB
• Beta Blocker
•
 Treatment – General Treatment
3. Edema Sodium Retention
Thiazide
Loop Diuretik
4. Hyperlipidemia Statin
Gemfibrozil
5. Hypercoagulability Warfarin
LMWH
 Treatment – Spesific Treatment
1. Imunosupresan Metylprednisolone
Cylosporine
Azatioprine
MMF

2. Plasmapharesis
 Treatment – Spesific Treatment
1. Minimal High Dose Metylprednisolon
4-16wk, extended 5-6mo
Change 2nd : Cyclosporine
Disease Cyclophosphamide
Tacrolimus
MMF
 Treatment – Spesific Treatment
2. Focal High Dose Metylprednisolon
Segmental 12-16wk, extended 5-6mo

Calcineruin Inhibitor :
Cyclosporine
Glomerulosklero Tacrolimus

sis
 Treatment – Spesific Treatment
Membranous Ace-I, ARB
Glomerulonefritis
Persisten Proteinuria
- Steroid 6mo
- Cyclophosphamid
- CNI : Cyclosporine
Tacrolimus
- MMF
 Treatment – Spesific Treatment
MembranoploriperativeusSecondary Etiology ?
lomerulonefritis No Specific Treatment

Steroid?
Imunosupresan?
 Treatment – Spesific Treatment
Post Streptococal Eradication Infection

Glomerulonefritis Steroid can be used

No Improved Outcame
 Treatment – Spesific Treatment
. Ig A Nefropathy Steroid 6mo

Fish Oil can reduce progress

Cyclophosphamid still
investigational
 Treatment – Spesific Treatment
. Lupus Nefritis High Dose Steroid

MMF
Cyclophosphamid
 Treatment – Spesific Treatment
. Rapidly
Progresive High Dose Steroid

Glomerulonefritis Cyclophosphamid
Tipe 1
Plamapharesis
 Treatment – Spesific Treatment
. Rapidly
Progresive High Dose Steroid

Glomerulonefritis Cyclophosphamid
Tipe 3 or Rituximab
Plamapharesis
Thank You