Pathology of Kidney 2 Flashcards
What are the clinical presentations of urinary calculi (stones)?
- renal colic (extremely painful)
- haematuria
- pyelonephritis (chronic inflammation in pelvis)
- obstructive uropathy (cannot get urine out)
- hydronephrosis (kidney replaced by space)
^ all capable of causing post-renal renal failure
What are the different types of calculi and their causes?
- calcium: hypercalcaemia (from sarcoid, renal tubular acidosis, hyperparathyroidism)
- uric acid: gout
- infection: obstruction (eg. vesico-ureteric reflex)
- cysteine: genetic/dehydration
What are the common cancers of the bladder and kidney?
- bladder: uroepithelial carcinoma (transitional cell)
- renal: clear cell carcinoma (ccRCC)
Describe the features of Wilms’ tumour?
- renal nephrobastoma
- affects children usually
- mutation of WT1 tumour suppressor gene
Where do renal cell carcinomas originate?
ducts especially in PCT
Why are renal carcinomas histologically clear? What are the possible consequences?
- clear because the cells are filled with glycogen and fat
- they can spread through the veins into the inferior vena cava and damage the heart
What are the main risk factors for renal carcinomas?
- smoking
- obesity
- genetic predisposition
What is the clinical presentation of renal cell carcinomas?
- haematuria (most common)
- mass
- pain
- metastases
- paraneoplastic syndromes (a group of rare disorders caused by an abnormal immune response to a neoplastic tumour)
What are the different types and morphologies of uroepithelial (bladder cancer)?
- papilloma: growing out into the urine (can be invasive/non-invasive)
- carcinoma in situ: flat (invasive/non-invasive)
What are the main risk factors for uroepithelial cancer?
- smoking
- industry (eg. analine dyes)
What is the clinical presentation of uroepithelial cancer?
- haematuria
- dysuria
- obstruction
What are the different causes of acute renal failure?
- pre-renal: shock, major trauma
- renal: some glomerulonephritides, toxic, drugs, malignant hypertension, vasculitis, analgesics
- post-renal: obstruction
What are the effects of acute renal failure?
- high potassium
- high creatinine
- oliguria
- hypertension
- lipids in nephrotic syndrome
What are the different causes of chronic renal failure?
- pre-renal: atherosclerosis
- renal: glomerulonephritis, diabetes, hypertension, polycystic
- post-renal: obstruction
What are the effects of chronic renal failure?
- high potassium
- high creatinine
- oliguria
- hypertension
- anaemia
- small kidneys
