From the Guidelines
Acquired glomerular disease is associated with inflammation and is a result of systemic abnormalities such as diabetes and hypertension. Acquired glomerular diseases develop after birth due to various factors including immune-mediated processes, infections, systemic diseases, or exposure to toxins. Inflammation is a key component in many acquired glomerular diseases, such as post-streptococcal glomerulonephritis, lupus nephritis, and IgA nephropathy, where immune complexes deposit in the glomeruli and trigger inflammatory responses 1. Additionally, systemic conditions like diabetes and hypertension are major causes of acquired glomerular damage, as highlighted in the management of diabetic kidney disease, which is a leading cause of chronic kidney disease and kidney failure 1. In diabetic nephropathy, chronic hyperglycemia leads to glomerular basement membrane thickening and mesangial expansion, while hypertension causes pressure-related injury to glomeruli. Some key characteristics of acquired glomerular disease include:
- Development after birth due to various factors
- Involvement of immune-mediated processes, infections, or systemic diseases
- Association with inflammation and systemic conditions like diabetes and hypertension
- Not linked to chromosome abnormalities, which are typically associated with genetic or hereditary glomerular disorders present from birth. The management of acquired glomerular diseases often involves addressing the underlying cause, such as controlling blood sugar levels in diabetes or managing blood pressure in hypertension, as well as using immunosuppressive therapies to reduce inflammation and slow disease progression 1.
From the Research
Characteristics of Acquired Glomerular Disease
- Acquired glomerular disease is associated with inflammation, as evidenced by studies that highlight the role of systemic inflammation in the development and progression of chronic kidney disease (CKD) 2.
- It is also a result of systemic abnormalities such as diabetes (Diabetes Mellitus) and hypertension (High Blood Pressure), with research indicating that these conditions are leading causes of mortality in glomerular diseases 3, 4, 5.
- The relationship between hypertension and glomerular disease is complex, with hypertension representing a cause and consequence of progressive renal disease 6.
- Glomerular hyperfiltration, which can occur in various clinical conditions including kidney disease, is another characteristic of acquired glomerular disease, and can be caused by factors such as afferent arteriolar vasodilation and efferent arteriolar vasoconstriction 4.
Association with Systemic Abnormalities
- Diabetes Mellitus is a major cause of CKD and end-stage renal disease (ESRD), with hypertension being a prevalent condition in this cohort 5.
- Control of blood pressure is crucial in reducing CKD progression, with recommended blood pressure targets of less than 140/90 mmHg for all patients with CKD 5.
- The renin-angiotensin-aldosterone system (RAAS) blockers play an important role in reducing cardiovascular risk and progression of CKD in patients with advanced proteinuric nephropathy 5.
Inflammation and Glomerular Disease
- Systemic inflammation is a key factor in the development and progression of CKD, with evidence highlighting the role of inflammation in the pathogenesis of hypertension in glomerular diseases 3, 2.
- The inflammatory mechanisms responsible for the pathologic conditions associated with CKD are complex, involving factors such as oxidative stress and inflammatory status 2.