One of the necessary conditions for diagnosis

One of the necessary conditions for diagnosis

minimal change type

Mesangial proliferative glomerulonephritis

focal segmental glomerulosclerosis

membranous nephropathy

Mesangial capillary glomerulonephritis

Henoch-Schonlein purpura nephritis

Lupus nephritis

diabetic nephropathy

Normally, the glomerulus has a filtration membrane with a molecular barrier and a charge barrier.

Large amounts of protein are lost in the urine

Insufficient hepatic albumin synthesis to resist loss and breakdown

Part of the albumin is broken down in the proximal convoluted tubule

Fatty degeneration can be seen in the proximal tubules

Extensive foot process fusion of glomerular visceral epithelial cells (impaired chemical barrier)

★The glomerular structure is basically normal → the basement membrane is normal (the physical barrier is normal)

★Prevalent acute kidney injury

Belongs to cellular immunity → no immune complex deposition

★Treatment

Iga nephropathy (mainly Iga deposition)

Non-Iga mesangial proliferative glomerulonephritis (mainly IgG or IgM) C3 is deposited granularly in the glomerular mesangium and capillary walls

Diffuse proliferation of glomerular mesangial cells and mesangial matrix

Lesion focus/segment distribution

Diffuse glomerular disease

★★★Renal vein thrombosis is common

Capillary wall thickening, subepithelial immune protein dense deposits forming spikes, foot processes disappearing

Thickening of basement membrane, proliferation of glomerular cells, and increase of mesangial matrix (double-track sign)

Hemoconcentration Hyperlipidemia → Increased blood viscosity

Thrombus anticoagulation indications

Ineffective addition of cytotoxic drugs

Ineffective cyclosporine

Glucocorticoids Cytotoxic drugs

Glucocorticoids should not be used

Glucocorticoids are required