Sunday, 26 September 2010

MRCP revision battle 21.4: Rapidly progressive glomerulonephritis

Rapidly progressive glomerulonephritis, AKA crescentic glomerulonephritis (don't you just love the way that in renal medicine everything has multiple names just to make it even more complicated than it already is?!) is, as the name suggests, a particularly aggressive form of glomerulonephritis.  It often presents with acute renal failure, and can progress to end stage renal failure in a matter of days.

It causes crescent-shaped scarring of the glomeruli, hence its name.

Causes of rapidly progressive glomerulonephritis include:
  • Wegeners 
  • microscopic polyangiitis
  • Goodpastures (a topic to be tackled tomorrow)
  • transformation from other glomerulonephritis'

Treatment is with high dose steroids.

The prognosis is poor, especially if the initial creatinine is higher than 600.

Since I find anything renal hard to swallow, achalasia seemed an appropriate next battle...