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Glomerulonephritis, Emergency Medicine

Melissa H. White and Carolyn Maher Overman Reviewed 06/2017
 


Basics

Description

  • Syndrome characterized by:

    • Hematuria

    • Proteinuria

    • Red blood cell casts

    • Hypertension

    • Renal insufficiency

  • Common pathway of multiple diseases resulting in intraglomerular inflammation and cel...

Diagnosis

Signs and Symptoms

  • Cardinal signs:

    • Hematuria

    • Proteinuria

  • Edema:

    • Owing to renal salt and water retention

    • Periorbital

    • Ascites

    • Pleural effusion

  • HTN

  • Oliguria

  • Azotemia

  • CHF

  • Renal failure

  • Nonspecific manifestati...

Treatment

Pre-Hospital

  • Supportive

  • ABCs and fluid restriction in stable patients with significant edema.

Initial Stabilization/Therapy

ABCs: Airway, breathing, circulation 

Ed Treatment/Procedures

  • Treatment ...

Follow-Up

Disposition

Admission Criteria

  • Unstable vital signs

  • Oliguria, anuria

  • Uremia

  • Acute renal failure

  • Electrolyte abnormality

  • Hypertensive emergency

  • CHF

  • Infectious cause of GN

Discharge Criteria

Healthy pati...

Pearls and Pitfalls

  • Discussion with nephrology if management with immunosuppressives is sought.

  • The finding of proteinuria or hematuria should always prompt follow-up to ensure that the patient is not ...

Additional Reading

  • Balogun  RA, Abdel-Rahman  EM. Therapeutic plasma exchange and renal related vasculitis: Therapeutic apheresis academy 2010. J Clin Apher.  2011;26:291–296.

  • Beck  LH Jr, Salant ...

Codes

ICD9

  • 580.0 Acute glomerulonephritis with lesion of proliferative glomerulonephritis

  • 583.4 Nephritis and nephropathy, not specified as acute or chronic, with lesion of rapidly progressive glomerulo...

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