Diseases and Disorders

Glomerulonephritis, Acute

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INTRODUCTION

DRG Category: 699

Mean LOS: 4.7 days

Description MEDICAL: Other Kidney and Urinary Tract Diagnoses with CC

classification section:

Acute glomerulonephritis (AGN) is an inflammatory disease of the specialized tuft of capillaries within the kidney called the glomerulus. In its several forms, glomerulonephritis was the leading cause of chronic renal failure in the United States until the mid-1980s, but because of more aggressive treatment approaches, it is now third, after diabetes mellitus and hypertension. Glomerulonephritis continues to be a fairly common disorder worldwide, however. The inflammatory changes occur because of deposits of antigen-antibody complexes lodged within the glomerular membrane. Antigen-antibody complexes are formed within the circulation in response to an antigen or foreign protein. The antigen may be of external origin, such as a portion of the streptococcus bacterial cell wall, or of internal origin, such as the changes that occur in systemic diseases like systemic lupus erythematosus (SLE).

If the source of the causative antigen is temporary, such as a transient infection, the inflammatory changes subside and renal function usually returns to normal; if the source of antigen is long-term or permanent, the AGN may become chronic. During the acute phase of the disease process, major complications include hypertension, hypertensive encephalopathy, acute renal failure, cardiac failure, and seizures. Chronic glomerular nephritis leads to contracted, granular kidneys and end-stage renal disease. Rapidly progressive glomerulonephritis (RPGN; also known as crescentic nephritis), an acute and severe form of kidney inflammation, can cause loss of kidney function within days. Inflammation at the sites of renal filtration (the glomerular basement membrane) causes leakage of blood proteins into the urinary space. The condition is caused by inflammation of cells in the urinary space that form crescents, hence the name crescentic nephritis.

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