Glomenoro nefritis akut

Document Sample
Glomenoro nefritis akut Powered By Docstoc
					Nephritis GLOMERULO ASKEP ACUTE (GNA)




A. DEFINITIONS

Glomerulo Nephritis is a disorder of the kidney characterized by inflammation of the glomerular
capillary filtration of fluid that functions as the body and the remains of disposal. (Suriadi, et al, 2001)

Glomerulo Nephritis is a syndrome characterized by inflammation of the glomerulus followed by the
formation of several antigens.

(Engran, Barbara, 1999)

Acute Nephritis Glomerulo (GNA) is an immunological reaction to bacterial kidney / specific viruses.
(Ngastiyah, 2005)

Acute Nephritis Glomerulo (GNA) is a widely used term that refers to a group of kidney diseases in which
inflammation occurs in the glomerulus. (Brunner & Suddarth, 2001)

Acute Nephritis Glomerulo (GNA) is the most common form of nephritis in childhood where the specific
cause is streptococcal infection. (Sacharin, Rosa M, 1999)



B. Etiology

Causes of Acute Nephritis Glomerulo are:

1. The existence of extra-renal infection especially disaluran upper respiratory or skin by the bacteria
streptococcus beta hemolyticus group A, type 12, 16, 25, and 49).
2. Syphilis

3. Bacteria and viruses

4. Poisoning (Lead, tridion)

5. Amyloid diseases

6. Renal vein thrombosis

7. Collagen disease



C. PATHOPHYSIOLOGY

An inflammatory reaction in the glomerulus with sebukan leucocytes and cell proliferation, and
exudation erythrocytes, leucocytes and plasma proteins in Bowman's space.

Disturbances in the renal glomerulus considered as an immunological response that occurs in the
presence of antibodies to microorganisms that resistance streptococcus A.

Antigen and antibody immune complexes are formed which cause an inflammatory response that
causes damage to the capillary walls and makes the vessel lumen becomes smaller which will reduce
glomerular filtration, renal insuffisiensi and capillary permeability changes so that large molecules like
proteins dieskresikan in the urine (proteinuria).



D. CLINICAL

1. Hematuria (urinary red brown)

2. Proteinuria (protein in urine)

3. Oliguria (decreased urine output)

4. Pelvic pain

5. Edema, this tends to be more apparent on the face in the morning, then spread to the abdomen and
extremities during the day (edema is probably not seen by someone who does not know the child well).

6. Body temperature is generally not how high, but can occur very high on the first day.
7. Hypertension is present in 60-70% of children with the GNA on the first day and will return to normal
by the end of the first week as well. But if there is damage to kidney tissue, blood pressure will remain
high for several weeks and become permanent if the condition becomes chronic illness.

8. Gastrointestinal symptoms may occur such as vomiting, no appetite, and diarrhea.

9. If there is hypertensive encephalopathy may arise headaches, seizures and decreased consciousness.

10. Fatigue (tiredness or fatigue)



E. DIAGNOSTIC EXAMINATION

1. Erythrocyte sedimentation rate (ESR) increased

2. Hb levels decreased as a result of hypervolemia (salt and water retention)

3. Blood urea nitrogen (BUN) and blood creatinine increase when renal function begins to decline.

4. Reduced amount of urine

5. Density rises

6. Macroscopic hematuria was found in 50% of patients.

7. Also found albumin (+), erythrocyte leukocyte (++), (+), leukocytes, and hyaline cylinders.

8. Antistreptolisin O titer (ASO) is generally increased if found infection of the throat, unless a preceding
streptococcal infection only on the skin only.

9. Culture samples or upper respiratory intake tool for identification of microorganisms.

10. Renal biopsy may be indicated if performed possibility findings is the increasing number of cells in
each glomerulus and subepithelial protrusions that contain immunoglobulin and complement.
F. COMPLICATIONS

Complications of acute glomerulonephritis:

1. Oliguri until anuria that can last 2-3 days. Occurs as a result of reduced glomerular filtration. Picture
such as acute renal insufficiency with uremia, hyperphosphatemia, hyperkalemia and hidremia.
Although oliguria or anuria old rare in children, if this happens required peritoneal dialysis (if necessary).

2. Hypertensive encephalopathy, the cerebral symptoms due to hypertension. There are symptoms such
as vision problems, dizziness, vomiting and convulsions. This is due to spasm of local blood vessels to
anoxia and brain edema.

3. Impaired circulation in the form dipsneu, ortopneu, there are wet crackles, cardiac enlargement and
elevated blood pressure is not only due to spasm of blood vessels but also due to the increase in plasma
volume. Membesardan heart can occur with heart failure due to hypertension and abnormalities that
persist in the myocardium.

4. Anemia that occurs due to hypervolemia in addition to a decreased synthesis eritropoietik.

5. Acute Renal Failure (ARF)

				
DOCUMENT INFO
Shared By:
Tags:
Stats:
views:135
posted:8/27/2011
language:English
pages:4