Pathology Of Renal Disease (Ciancolo) Flashcards
The glomerular filtration barrier allows what sized and charge of molecules to pass?
Small and positively charged
Define glomerular filtration
Blood in the glomerular capillary loops is selectively filtered across the glomerular filtration barrier to create ultrafiltrate of plasma
Name the 3 main components of the glomerular filtration barrier
Capillary endothelium,
glomerular basement membrane,
podocytes
List 2 tidbits about glomerular capillary endothelium
It’s fenestrated
It’s covered by glycocalyx
List 2 tidbits about the glomerular basement membrane
It’s made of mostly TYPE 4 collagen
Also contains glycosoaminoglycans
List 2 tidbits about podocytes
Has foot processes
Has slit diaphragms (connect one foot process to the other)
Molecules pass through the glomerular endothelium via:
Fenestrations (trans cellular holes; like a colander!)
Glomerular endothelial cells are covered by:
A glycocalyx!
= a sugar coat that is (-) charged
The glomerular basement membrane has what charge overall?
Negative
Podocytes produce what to maintain endothelial cell health?
VEGF
(Vascular endothelial growth factor)
Podocytes are _____ epithelial cells
terminally differentiated
(They can’t really undergo mitosis!)
The slit diaphragm between the foot processes of podocytes is a ________ selective barrier
Size
The interdigitating foot processes of the podocytes attach to underlying:
Glomerular basement membrane
Mesangial cell function is:
Maintain structure of glomerular tuft
= tree trunk of the glomerulus!
True or false: mesangial cells are a part of the glomerular basement membrane
False
Mesangial cell functions include:
Synthesis and breakdown of ECM (collagens)
Produce cytokines (to bring inflammatory cells to glomerulus)
True/False: Mesangial lesions are always clinically significant
FALSE
What is a hallmark of glomerular disease?
Proteinuria
4 classic signs of nephrotic syndrome are:
- Proteinuria
- Hypoalbuminemia/hypoproteinemia
- Edema/ascites
- Hypercholesterolemia
AZOTEMIA IS NOT A CRITERIA FOR DIAGNOSING NEPHROTIC SYNDROME
What does a kidney pathology report describe when looking for glomerular lesions?
- Hypercellularity present?
- Is MESANGIUM expanded?
- Is there SCLEROSIS or HYALINOSIS
- Are IMMUNE DEPOSITS present?
- Is CAPILLARY WALL smooth or irregular?
- Are there adhesions (SYNECHIA) between capillary tuft and Bowman’s capsule?
2 types of hypercellularity in glomerulus are:
Mesangial: in mesangial matrix
Endocapillary: too many nuclei in capillary loops
True/false: mesangial and endocapillary hypercellularity are mutually exclusive
False
Define synechia
Adhesions between glomerular tuft and Bowman’s capsule
If you see synechiae (adhesions), you can say that:
Podocytes have been damaged
Segmental sclerosis is defined as ____
And it causes _______
Scarring of the glomerulus
Collapse of the capillary lumens
What causes hyalinosis in the glomeruli?
Extra pressure; plasma gets pushed into mesangium or glomerular basement membrane
What happens when the glomerular basement membrane ruptures?
Material in circulation pours into Bowman’s space;
= crescents occur
If you see crescents on renal histopath, is the prognosis good or bad?
BAD
seen often in pigs, rare to see crescents in small animal kidneys
What are the 2 large categories of glomerular disease in animals?
Immune complex mediated glomerulonephritis
Non-immune mediated glomerulonephritis
Immune complex mediated glomerulonephritis can be treated with _______
Non-immune-complex glomerulonephritis cannot be treated with ______
Immunosuppressive drugs
Immunosuppressive drugs
What are the 3 main patterns seen with immune-complex glomerulonephritis?
Membranoproliferative glomerulonephritis
Membranous glomerulonephritis
Mesangioproliferative glomerulonephritis
What are 4 main causes of non-immune-complex mediated glomerulonephritis?
Amyloidosis
Focal segmental glomerulosclerosis
Podocytopathy
GBM abnormalities
What are 5 molecular mediators that PROMOTE fibrosis?
TGF-beta,
Angiotensin II,
Connective tissue growth factor,
FGF-23,
Smads
What are 5 molecular mediators that are ANTI-FIBROTIC?
BMP-7
Smads
HGF
Some RAAS components
