8. Renal Flashcards
The renal calyces and pelvis are lined by
urothelium (transitional epithelium)
Functions of mesangial cells and mesangial matrix include
TGF mechanism
structural support of capillary loops
secretion of vasoactive factors and cytokines
phagocytosis
contraction to control glomerular capillary blood flow
Proximal convoluted tubule cells
have a brush border and are more numerous in cross sections (longer tubule)
Distal convoluted tubule cells
have no brush border, are smaller cells with more nuclei visible, a paler cytoplasm, and a larger well-defined lumen, fewer per slice than PCT
What 3 cell types are within the glomerulus?
Mesangial (support stalk), epithelial (podocytes), and endothelial (capillaries)
Glomeruli are located
in the cortex
What will happen to the tubules associated with a sclerosed glomerulus?
atrophy (ischaemic; due to lack of blood flow to peritubular capillaries and vasa recta)
How does a kidney with extensive glomerulosclerosis present macroscopically?
very small (ES kidney)
End-stage kidneys present with
hyalinised glomeruli, tubular atrophy, interstitial fibrosis, cystic dilation of tubules, protein casts
What is membranous nephropathy?
damage to the glomerular basement membrane causing proteinuria and nephrotic syndrome
Where do immune complexes deposit in membranous nephropathy?
epithelial side of the glomerular BM
Which immune complexes are involved in membranous nephropathy?
IgG and C3
Where does IgA deposit in IgA nephropathy?
mesangium
Membranous nephropathy typically presents with
proteinuria
IgA nephropathy usually presents with
haematuria
Primary essential hypertension
most common, no defined cause
Malignant hypertension
medical emergency; 180-200mmHg
Secondary hypertension
has an identifiable underlying cause (less common) such as endocrine or kidney disease,, tumors, or as a side effect of medications
Renovascular hypertension
a type of secondary; usually due to athlerosclerosis of the renal arteries (renal stenosis)
What organs show hypertension-related damage?
Retinas, kidneys, heart, brain, lungs, circulation (blood)
Benign nephrosclerosis occurs with
primary essential hypertension
What changes occur in the kidney as a result of primary hypertension?
intimal thickening of smaller arteries, hyalinisation of arterioles, reduced lumen size; causes ischaemic damage to the glomerulus (hypertensive nephrosclerosis)
Renal ischaemia causes
coagulative necrosis, can be with haemorrhage; dead and dying neutrophils may be present
Renal infarction is most likely caused by
emboli, most commonly from LV (post-MI thrombus) por LA (AF)
