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Tuesday, 3 December 2013

Nephritis: Glomerulonephritis - The Diagnosis

Nephritis is defined as a condition of inflammation of the nephrons in the kidneys.
Glomerulonephritis is defined as the condition of inflammation of the tiny filters in  kidneys (glomeruli), which filter blood by removing excess fluid, electrolytes and waste and pass them through urination.  

Diagnosis
After completing the physical exam and family history, the tests which your doctor orders include 
1. Urinalysis 
The aim of the test is to check
a. Damage to the glomeruli
If the test shows the presence of red blood cells and red cell in the urine.
b. Infection or inflammation
If the white blood cells are presented in the urine, in mmost case.
c.  Nephron damage
If the presence of protein is found in the urinary test.

2. Blood tests
The aim of the test is to check for the presence of wast products which will provide the information of kidney damage and impairment of the glomeruli

3. Imaging tests
Image test such as an ultrasound examination or a computerized tomography (CT) scan will provide visualization of the the damage of the patient kidneys.  

4. Kidney biopsy
The diagnosis of glomerulonephritis can be confirmed by performing a kidney biopsy. A small sample is extracted from the small pieces of kidney tissue for microscopic examination. The procedure is important in predicting the likely progress, response to treatment and outcome of  glomerulonephritis.

 In the analyzing whether histological diagnosis of glomerulonephritis (GN) at an early stage of chronic kidney disease (CKD) associated with different outcome and compared to diagnosis at a more advanced stage. Patients with CKD stage 1 and 2 at kidney biopsy had fewer endpoints compared to patients with a GFR of <60 ml/min (p < 0.001). Kidney function at the time point of histological glomerulonephritis (GN) diagnosis is associated with clinical outcome, likely due to early initiation of specific drug treatment. This suggests that selection of therapy yields greatest benefit before renal function is impaired in GN(20).
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Sources
(19) http://www.ncbi.nlm.nih.gov/pubmed/8754411
(20) http://www.ncbi.nlm.nih.gov/pubmed/22682295