What is the role of glomerular diseases in the pathophysiology of azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Glomerulonephritis or vasculitis is suggested by the presence of hematuria, red blood cells (RBCs), WBCs, granular and cellular casts, and a variable degree of proteinuria. Nephrotic syndrome usually is not associated with active inflammation and often presents as proteinuria greater than 3.5 g/24 h.

Glomerular diseases may reduce GFR by changing basement membrane permeability and stimulating the renin-aldosterone axis. Such diseases are often manifested as nephrotic or nephric syndrome. In nephrotic syndrome, the urinary sediment is inactive, and there is gross proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, and edema. Azotemia and hypertension are uncommon initially, but their presence may indicate advanced disease.


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