Glomerular Diseases Flashcards
what are the functions of the renal corpuscle/glomerulus?
plasma ultrafiltration
blood pressure regulation
peritubular blood flow regulation
tubular metabolism regulation
circulating macromolecule removal
what does primary glomerulopathy arise from?
involvement of glomeruli in processes that initiate renal injury
what is the hallmark finding that points to glomerular disease?
proteinuria
what can severe proteinuria cause?
protein-losing nephropathy (PLN)
what does early damage to the glomerulus lead to?
loss of negative charges
podocyte damage or loss
what is the general glomerular response to damage?
increased permeability of barrier to protein
prolonged, severe protein-losing nephropathy can result in _____________________
nephrotic syndrome
what is nephrotic syndrome defined by?
combination of 4 abnormalities:
marked renal proteinuria
hypoalbuminemia
hypercholesterolemia
ascites/generalized edema
+/- hypertension
partial more common
do isosthenuria and azotemia follow glomerular damage?
inconsistent findings
what in long term damage to glomeruli leads to decreased GFR?
secretion of endothelin by podocytes
mesangial cell proliferation
thickening of basement membranes and mesangial matrix
+/- leukocyte infiltration
eventual atrophy or fibrosis of glomerular tuft
what is the hypercoagulable state that can result from glomerular damage from?
loss of antithrombin: endogenous anticoagulant
low albumin and high cholesterol increase platelet aggregation
what is a downstream effect of proteinuria?
overload proximal tubule capacity to reabsorb: +/- eosinophilic “hyaline droplets” in renal epithelium
what are the two main categorizations of glomerular disease?
glomerulonephritis: inflammation
glomerulonephropathy
glomerulonephritis is usually caused by deposition of _____________________ within glomeruli
solute immune complexes
what size complexes are most damaging in deposition of solute immune complexes within glomeruli?
small or intermediate complexes: deposit on either side of basement membrane
what are some diseases known to cause immune-complex glomerulonephritis?
chronic infection
chronic parasitism
neoplasia
inflammatory diseases
certain drugs and foreign substances
amyloid deposits in glomeruli stain with ________ and stand out on cut surface of kidney
iodine
what is amyloid?
abnormally folded proteins: beta pleated sheets
amyloid binds _________________: only amyloid is stained in orange red
congo red stain
what is the most common form of amyloidosis?
reactive amyloidosis
what is familial amyloidosis and shar pei fever?
immune system dysregulation
progressive renal failure and amyloid deposits in numerous tissues
renal deposits often in medullary interstitium
in which cats is amyloidosis not uncommon?
abyssinian cats
siamese, oriental shorthair
where do cats usually deposit amyloid if they have amyloidosis?
often in medulla
can direct bacterial infection cause glomerular disease?
occasionally
bacteremia can cause bacteria to lodge in glomerular capillaries
white spotted kidney in cows can be due to ______________________________________
an embolic shower of bacteria
what is the histology of white spotted kidney?
multiple foci of inflammation: microabscesses
what viruses can cause glomerular disease via direct viral insult?
canine hepatitis
avian polyoma virus
equine viral arteritis virus
hog cholera
porcine cytomegalovirus infection
what do familial glomerulopathies vary in?
inheritance
age of onset
underlying structural disorders
microscopic abnormalities
what emboli are most common in hypercoagulable state?
pulmonary thromboemboli
also in portal vein or other arteries
how can glomerulosclerosis be identified?
trichrome stain
