Pathology of Kidney 1 Flashcards
What is the most common cause of haematuria?
Infection
What does a kidney do?
- Fluid and electrolyte balance
- Reabsorption of solutes
- Excretion e.g of conjugated xenobiotics
- Endocrine
Renin + Erythropoietin
How can renal artery stenosis be diagnosed?
Ultrasound
What is potter’s syndrome?
It describes the typical physical appearance caused by pressure in utero due to oligohydramnios, classically due to bilateral renal agenesis.
- Also pulmonary hypoplasia + extremity defects
What is polycystic disease mainly due to?
A genetically dominant disease
What is primary glomerular disease usually due to?
Immunological disease (MHC/HLA association)
What is primary glomerular disease called?
Glomerulonephritis (plural glomerulonephritides)
What can secondary causes of glomerular disease be due to?
- Vascular
- Autoimmune e.g
SLE, Amyloid, diabetes, aquired
Where is the mesangium located?
Inside the basement membrane
What antibodies are compliment activated?
- IGg1 and 3
- IgM
How does a type 2 hypersensitivity reaction affect the glomerulus?
- Membrane attack complex forms a hole in the basement membrane
- plasma proteins, platelets, neutrophils, fibrin can all move through the BM into the urinary space
- Parietal cells which line bowmans capsule activated and proliferate
- Acute inflammation, shrinks glomerulus, glomerular function rapidly lost, ability to excrete lost, glomerular flow decreased and urinary output decreased significantly
- Oliguric with proteinuria plus haematuria or anuric
What is a type 2 hypersensitivity reaction which affects the kidneys?
Goodpasture syndrome
What can cause renal hypoplasia?
- Congenital renal artery stenosis
What is vesicoureteric reflux?
- Urine flows backwards from bladder into ureter and possiblt kidneys
What can be seen histologically in goodpasture syndrome?
Crescents - proliferation of parietal epithelium and inflammatory cells
How is goodpasture syndrome treated?
- Filtering the blood and antibodies
- High dose immunosuppressants
- Must be treated quickly
What other organ can goodpastures syndrome affect?
Lungs
What can cause nephritic syndrome?
- Postinfectious - strep
- Vasculitis - ANCA
- SLE
What does nephritic syndrome present with?
- Pain
- Haematuria
- Protenuria
What is nephrotic syndrome?
- Leaky capillaries - filter problem
- Proteinuria, no blood loss
- Hypertension
- Hyperlipidemia
- Associated with cancer, hep B can be idiopathic
- More common in males
What is minimal change disease?
- Nephrotic syndrome
- Podocytes flattened no foot processes, causes flooding of proteins
- No histological abnormalities seen on biopsy
- Associated with measels, thought to be caused by CD8 lymphocyte
- Most common in children
- Treated with steroids
What is focal and segmental glomerulosclerosis?
- Type of nephrotic syndrome
- Biopsy would show segmental sclerosis and hyalinosis
- Common in african origin
What vascular diseases can cause kidney disease?
- Hypertension
- Vasculitis
- Mesangial IgA disease
- TTP
- HUS
How do you differentiate between focal and segmental glomerulosclerosis?
> 50% of nephrons involved = segmental
< 50% = focal
What can cause tubulointerstitial disease?
- Drug hypersensitivity
- Acute tubular necrosis
- Shock
- Ascending infection
- SLE
- Ischaemia
