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.