See also GLOMERULONEPHRITIS; MEDICARE COVER-
AGE FOR PERMANENT RENAL FAILURE; NEPHROTIC SYN-
DROME.
glomerulus The coiled capillary network within
the NEPHRONof the kidney through which BLOOD
passes for filtration. Glomeruli are abundant
within the KIDNEYSas each kidney contains more
than a million nephrons. The walls of the
glomerulus are only a few cells in thickness. The
glomerular walls are semipermeable, allowing
smaller molecules such as water, metabolic wastes,
GLUCOSE, and electrolytes to pass through and col-
lect in the capsule (called Bowman’s capsule) that
surrounds the glomerulus. Together the glomeru-
lus and Bowman’s capsule are the renal corpuscle.
The fluid and its contents, called filtrate, passes
into the tubules of the nephron, which further fil-
ter and concentrate the filtrate. The nephron
eventually reabsorbs 99 percent of the filtrate back
into the blood; the remaining fluid drains into col-
lecting ducts to move out of the kidneys as URINE.
The glomerular filtration rate (GFR) is an impor-
tant measure of kidney function. The GFR of a
healthy adult kidney is 125 milliliters per minute.
For further discussion of the glomerulus within
the context of the urinary system’s structure and
function please see the overview section “The Uri-
nary System.”
See also GLOMERULONEPHRITIS; GLOMERULOSCLERO-
SIS; RENAL FAILURE.
Goodpasture’s syndrome An autoimmune dis-
order in which the IMMUNE SYSTEMproduces anti-
bodies that attack the glomeruli in the KIDNEYS,
impairing kidney function, and the alveoli in the
LUNGS, causing bleeding into the lung tissue. In
most people who develop Goodpasture’s syn-
drome the symptoms follow a viral INFECTIONof
the upper respiratory tract or exposure to environ-
mental toxins, notably hydrocarbons. Because
Goodpasture’s syndrome tends to run in families,
researchers believe a GENE MUTATION is likely
responsible.
Siphoning gasoline and sniffing aerosols
such as paints and glues are the most
common exposures to hydrocarbons
that can result in Goodpasture’s syn-
drome.Though the coughing up of bloody SPUTUM
(HEMOPTYSIS) is the first and often the more dis-
tressing sign of Goodpasture’s syndrome, GLOMERU-
LONEPHRITIS is the more serious consequence,
leading rapidly in many people to RENAL FAILURE.
ANEMIA (insufficient erythrocytes in the blood)
and HYPERTENSION(elevated BLOOD PRESSURE), conse-
quences of the renal failure, may quickly become
significant.SYMPTOMS OF GOODPASTURE’S SYNDROME
Pulmonary (Lungs) Renal (Kidneys)
HEMOPTYSIS(bloody SPUTUM) HEMATURIA(bloody URINE)
DYSPNEA(shortness of breath) foamy urine (indicates
ALBUMINURIA)
COUGH decreased urine volume
CHEST PAIN edema (fluid retention)The diagnostic path includes blood and urine
tests to assess kidney function, chest X-RAY to
detect accumulated fluid in the lungs, and biopsy
of lung and kidney tissue to confirm the presence
of antibodies. The course of Goodpasture’s syn-
drome may run two months to several years.
Early diagnosis allows aggressive interventions,
including plasmapheresis to remove antibodies
from the bloodstream and IMMUNOSUPPRESSIVE THER-
APYto prevent the immune system from producing
further antibodies. These interventions can medi-
ate the syndrome’s progression, minimizing dam-
age to the kidneys. Though about 90 percent of
those who develop this once-fatal syndrome now
survive, many of them continue to experience
progressive renal failure that results in END-STAGE
RENAL DISEASE(ESRD).
See also ALVEOLUS; ANTIBODY; AUTOIMMUNE DISOR-
DERS; HEMAPHERESIS; GLOMERULUS; RENIN.Goodpasture’s syndrome 193