Acute glomerulonephritis

Abrupt onset of hematuria and proteinuria, often associated with azotemia and renal salt and water retention.

Has two components: structural changes and functional changes.

Associated with cellular proliferation with increase in number of endothelial, mesangial, and epithelial cells in the glomerular tuft (endocapillary growth).

Proliferation may be in the glomerular tufts or in the Bowman space involving the epithelial cells (extra capillary growth).

Extra capillary proliferation of parietal cells leads to the formation of crescents, the characteristic feature of certain types of rapidly progressive glomerulonephritis.

Rapidly progressive glomerulonephritis is caused by three major types of disease: anti-GBM disease in approximately 10 % of cases, , pauci-immune crescentic glomerulonephritis in approximately 60% of cases, and immune complex glomerulonephritis in approximately 30% of cases

Often accompanying cellular proliferation is leukocyte activity with infiltration of neutrophils and monocytes in the glomerular capillary lumen.

Associated with glomerular basement membrane thickening with the deposition of electron dense material in the endothelial or epithelial side of the basement membrane.

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