| ChronicGlomerulonephritis
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Etiology
Since chronic glomerulonephritis is not a
single disease but a common final pathway for many types of
glomerulonephritides, the etiology is diverse.
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Pathogenesis
Regardless of the initiating type of glomerulonephritis, the term chronic
glomerulonephritis implies persistent or irreversible glomerular injury in
the majority of the glomeruli, usually in the form of sclerosis. The
progression to a state of chronic glomerulonephritis may be rapid (months)
or insidious and slow (decades).,
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Epidemiology
Since chronic glomerulonephritis is not a single disease
but a common pathway for many types of glomerulonephritides, the
epidemiology is diverse.
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General Gross Description
The kidneys in long standing
glomerular diseases are bilaterally small due to marked reduction in renal
mass. The cortex is thin and the surface of the kidney is diffusely
granular. Because of reduced renal parenchyma, the fat in the renal
sinus appears grossly increased.
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General Microscopic Description
The glomeruli in chronic
glomerulonephritis show the results of persistent and progressive injury,
namely sclerosis. Regardless of the type of glomerular disease, eventually
the histology is one of hyalinized, acellular sclerotic glomeruli, atrophic
tubules, intestitial fibrosis and arterial intimal fibroelastosis.
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Clinical Correlation
Patients with chronic glomerulonephritis are in varying stages of renal
insufficiency or in chronic renal failure. Patients will have a
variety of non-specific complaints and tend to be hypertensive and proteinuric
with laboratory values reflecting azotemia.
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References
Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 958-959. Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 1150-7.
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| ChronicGlomerulonephritis
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| Synopsis by: Harold Yamase M.D. (T71200M43000)[113]
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