Pathology of Renal disease Flashcards
How does kidney work
Filters 180 litres of blood per day Resorbs 178 litres per day 2 litres of urine per day Interstitial exists between glomerular capillary and tubules Tubules are where urine is produced
What passes through
What doesn’t pass through
Urea
Creatinine
Proteins
What can go wrong - glomerular
Lack of filtration - particles accumulate leading to blocked filter
- lack of glomeruli to filter e.g by sclerosis
- groups of glomeruli die off and become granular
- can lead to chronic hypertension
Lack of blood supply therefore flow - blood pressure not high enough to create filtrate
Too much filtration - leaky membranes - particles pass through which shouldn’t be e.g albumin and plasma proteins
- leads to proteinuria
- loss of albumin results in nephrotic syndrome
Cause of blocked filter
3 causes
nothing to see
proteins
cells
Blood pressure starts to rise once certain percentage of filtration apparatus is blocked
minimal change
glomerularnephritis
proteins deposited in filter - membranous glomerular nephritis
inflammatory cells
proliferative glomerular nephritis
What can go wrong - tubular
- too little reabsorption - faulty tubules
- tubular dysfunction - lack of blood supply leads to acute tubular necrosis - susceptible to toxins
- blocked/inflamed - calcium phosphate crystals involved in bowel prep - bacteria, neutrophils and macrophages colonise and block tubules
- tubule mass necrosis
What can go wrong - neoplasia
- tumours can develop e.g renal cell carcinoma
Renal cell carcinoma
Risk factors
3% of all cancers
cigarette smoking
Obesity
dialysis