Pathology of kidney Flashcards
What does a kidney do?
• Fluid and electrolyte balance • Resorption of solutes • Excretion eg of conjugated xenobiotics • Endocrine – Renin blood pressure – Erythropoietin – RBC
Potter Syndrome –
bilateral renal agenesis
Glomerular disease
- Immunological
* MHC/HLA association
primary glomerular disease
– Glomerulonephritis or glomerulopathy
secondary glomerular disease
– Vascular, autoimmune eg SLE, amyloid, diabetes, acquired
Glomerulonephritis type 2 - good pastures syndrome
Anti-GBM antibodies Complement fixation Damage
Fibrin leakage
look for crescents, these are a result of proliferation of parietal epithelium and inflammatory cells
hardly any urine space
clinical effects and causes of Glomerulonephritis type 2 - good pastures syndrome
- autoimmune if good pastures
- vasculitis - ANCA
- SLE
- organic solvents
rapidly progressive fast progressing haematuria initialy onuria little protein initially but none after lung involvement (with alveolar basement membranes) less urine
Glomerulonephritis type 3 - proliferative GN (big immune complexes)
Immune complexes
Size determines where deposition occurs
+/- Complement fixation
increased mesangial cells
Glomerulonephritis type 3 causes - proliferative GN
- Postinfectious–Strep.
- Vasculitis-ANCA
- SLE
Glomerulonephritis type 3 effects - proliferative GN`
slow OR FAST it depends haematuria (red cells leaking through) less urine proteins in urine pain due to inflammation
= NEPHRITIC AS INFLAMMATION
Glomerulonephritis type 3 - membranous GN (small immune complexes)
erode through membrane and get stuck under podecytes
screwed up electrical charge in basement membrane causing leaking
Glomerulonephritis type 3 effects - Membranous GN`
protein in urine thickened capillary walls slower onset no haematuria more urine hypercholesterolaemia
oedema
not inflammatory
= nephrotic syndrome (leakage of large amounts of protein and hypercholesterolaemia and OEDEMA)
Glomerulonephritis type 3 causes - Membranous GN`
Male>female • Adults • 15%over70yhave cancer • HepatitisB • Idiopathic • Penicillamine • SLE
Mesangiocapillary GN: 1 & 2
MIXED
Glomerulonephritis type 4
nephrotic syndrome in children is caused by lymphocytes
flattened podecytes
protein in urine
sometimes Hodgkins lymphoma
remission with measles
