4. Renal Histology and Physiology Flashcards
What is the most common cause of death in chronic kidney disease?
LV hypertrophy
What are the histological regions of the glomerulus?
Mesangial cells
Mesangial matrix
Endothelial cells
Epithelial cells
What are mesangial cells?
Extension of the smooth muscle from the afferent arteriole
Allow dilation and constriction
What is the mesangial matrix?
BM between mesangial cells
Negatively charged to repel albumin
Which cells have foot processes?
Parietal epithelial cells
Creates a slit diaphragm which is smallest level of filtration
What is the hydrostatic pressure in the glomerulus?
50-60mmHg
What is different about an inflammatory reaction inside the glomerulus vs in Bowman’s capsule?
On the endothelial surface there is a rapid WBC response; kidney receives 25% each heart beat
On epithelial side nothing is inside glomerulus; hydrostatic is too high for inflammatory mediators to come back in so not seen by WBCs
Which of the renal tubules is most susceptible to ischaemia and why?
Proximal as it has more mitochondria
Give some congenital abnormalities of the kidneys
Potter syndrome Unilateral agenesis Horseshoe kidney Hypoplasia Ectopia Dysplastic kidney
What is Potter syndrome?
Bilateral renal agenesis
What age do patients present with AD polycystic kidney disease?
30s to 50s
What chromosome is most associated with AD polycystic KD?
Chromosome 16
What do cysts in the kidneys increase the risk of?
Renal cell carcinoma
What chromosome is most associated with AR polycystic KD?
6
When does AR polycystic KD present?
Babies are usually stillborn
What is von Hippel Lindau syndrome?
AD
Cysts in kidneys, pancreas and epididymis
Haemangiomas in retina and CNS
What chromosome is associated with von Hippel Lindau syndrome?
3
Next to gene for RCC so high risk
What is the treatment for von Hippel Lindau syndrome?
Bilateral nephrectomy
How are acquired cysts formed?
Vascular disease causes ischaemia and fibrosis, destroying tubules
Cysts filled with urine from destroyed tubules form
What scoring system is used to score age related cysts?
Bosniak scoring system
How do scarred kidneys cause anaemia?
Reduced epo production