Intro To Renal Pathology Flashcards
Define GFR
Volume of fluid filtered from the kidney into the Bowman’s space per unit time (ml/min)
Gives an estimate of the number of working nephrons
Formula for creatinine clearance:
Urine Creatine / plasma creatine x (vol/time)
What are pre renal causes of renal failure
- inadequate blood supply: HF so ↓ renal perfusion, volume depletion, sepsis, severe bleeding
What are examples of kidney diseases with a systemic etiology
- SLE, DM, amyloid, PAN, Wegeners (ANCA), HS purpura
What are some features of glomerular disorders?
- heavy proteinuria
- RBC casts
- oval fat bodies
Features of tubulointerstitial disorders:
- mild proteinuria
- functional tubular defects
- WBC
Features for neophrotic glomerular diseases
- heavy proteinuria
- oval fat bodies
- free fat droplets
- few cellular elements
- fatty casts
Features of nephritic glomerular disease
- red cells
- red cell casts/ granular casts
- variable proteinuria
- WBC
What are the antibody mediated mechanisms of renal disease
- in situ immune complex: fixated antigens that are intrinsic to the GBM or antigens planted there (exogenous or endogenous)
- circulating immune complexes: endogenous antigens like DNA or exogenous antigens
- cytotoxic antibodies: direct cell injury or can happen WITHOUT immune complex deposits
What are the factors that determine where the immune complexes are deposited in the kidneys
- charge
- location
- size
Another mechanism of kidney diseases is the activation of the ________ complement pathway in which involves the activation of ________
Alternative;
C3;
Seen in dense deposit disease (type II MPGN)
In what conditions can you expect patients to have ↓ renal mass?
Hypertension because it destroys some of the functional glomeruli
What are reasons for using electron microscopy in diagnosing renal diseases?
- irregularities in GBM
- expansion of mesangium
- ## mainly for: looking at the deposits and their location and see the pattern of deposits
What disease would you see “subepithelial humps”
Post infectious glomerulonephritis (PSGN)
A young child has renal issues and the EM shows dense deposits in the capillary basement membrane, what is the most likely diagnosis?
Dense deposit disease
EM shows splitting of the basement membrane, what is the disease and the type?
Alport’s; it is a hereditary cause of kidney disease
Where do you see granular deposits in the kidneys?
Outer aspect of the basement membrane such as the subepithelium or mesangium
