Injury to the Glomeruli as a
Cause of Chronic Renal Failure— lomerulonephritis
Chronic glomerulonephritis can be caused by several diseases that
cause inflammation and damage to the capillary loops in the glomeruli of the
kidneys. In con-trast to the acute form of this disease, chronic
glomeru-lonephritis is a slowly progressive disease that often leads to
irreversible renal failure. It may be a primary kidney disease, following acute
glomerulonephritis, or it may be secondary to systemic diseases, such as lupuserythematosus.
In most cases, chronic glomerulonephritis begins with accumulation
of precipitated antigen-antibody com-plexes in the glomerular membrane. In
contrast to acute glomerulonephritis, streptococcal infections account for only
a small percentage of patients with the chronic form of glomerulonephritis. The
results of the accumu-lation of antigen-antibody complex in the glomerular
membranes are inflammation, progressive thickening of the membranes, and
eventual invasion of the glomeruli by fibrous tissue. In the later stages of
the disease, the glomerular capillary filtration coefficient becomes greatly
reduced because of decreased numbers of filter-ing capillaries in the
glomerular tufts and because of thickened glomerular membranes. In the final
stages of the disease, many glomeruli are replaced by fibrous tissue and are,
therefore, unable to filter fluid.
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