glomerular disease pathology Flashcards
What aspect of the arterioles prevents large blood pressures reaching the delicate blood vessels in the glomerulus
They contain smooth muscle in their walls
What is the glomerulus
A bag of capillaries sitting in between two arterioles
What is a podocyte
glomerular epithelial cell
What cells always lines capillaries
endothelial cells
How does blood enter the glomerulus
The afferent arteriole
What proteins are not filtered by the glomerulus
All proteins equal to or larger than albumin will not be filtered
What are the 3 layers of the glomerular membrane
Endothelium
Basal lamina
Podocyte foot processes
What are mesangial cells
‘Tree like’ group of cells which support capillaries
Where do the unfiltered substances go
Some fluid, albumin and larger proteins exit the through the efferent arteriole
Where does the efferent arteriole carry blood to
capillaries which are around the tubule
What is glomerulonephritis
Disease of the kidneys
What are the two categories of glomerulonephritis
Immunoglobulin deposition nephritis or non immunoglobulin nephritis
What are the 4 common presentations for glomerulonephritis
Haematuria
Heavy proteinuria
Slowly increasing proteinuria
Acute renal failure
What are the main causes of haematuria
UTI - most common cause
Urinary tract stone (calculi)
Urinary tract tumour
Glomeluonephritis can cause haematuria but it is less common then the other options
What can deposits of IgA cause
Increased IgA deposits causes increased proliferation of mesangial cells
Is IgA removed by the glomerulus
It is not known but is is a important part of the cause of the disease
Does IgA get filtered in the urine
No, the IgA is stuck within the mesangium
What is the prognosis for IgA nephropathy
Usually self limiting but some go onto develop chronic renal failure
Why is albumin measured when glomerular abnormalities are expected
Albumin is slightly bigger than the glomerular basement membrane can filter so when there is an issue at the glomerular basement membrane, albumin is the first substance to be excreted
How does IgG cause glomerulonephritis
It is too big to be filtered and deposits itself between basal lamina and podocyte
IgG then activates compliment 3 which punches holes into the filter - leaky filter allows proteins into the urine which leads to nephrotic syndrome
What is the prognosis of mebranous glomerulonephritis
25% develop chronic renal failure within 10 years
What happens in diabetic nephropathy
Thickened, narrowed arterioles which reduces blood flow to glomerulus
Increased mesangial matrix which compresses capillaries
Thickened capillary wall which is leaking albumin
Adhesions to bowmans capsule are the glomerulus attempt to stop major leakage of protein (albumin) into the urine
What is the kimmelsteil-Wilson lesion which is seen in diabetic nephropathy
A very big excess of mesangial matrich which produces nodules
What is rapidly rising creatinine a sign of
Acute renal failure
