PATHOLOGY - Patterns of Renal Disease Flashcards
What are the three portals of entry for renal disease?
Haematogenous
Ascending from the lower urinary tract
Direct entry
What are the six patterns of renal disease?
Developmental
Vascular
Tubular
Tubulointerstitial
Renal pelvis/ascending
End stage kidney disease
What are the three renal defence mechanisms against disease?
Basement membranes
Mesangial cells
Host immune system
List six examples of developmental kidney disease
Renal aplasia
Renal hypoplasia
Renal dysplasia
Ectopic kidneys
Fused (horseshoe) kidneys
Polycystic kidney disease
In which animal is polycystic kidney disease most common?
Feline (cats)
What are the two types of vascular lesions seen in the kidneys?
Infarction
Haemorrhage
What are two common causes of renal infarction?
Thromboemboli
In situ thrombosis
What causes renal haemorrhage?
Renal haemorrhage can be caused by any systemic vascular injury
List three systemic vascular injuries which can be the cause of renal haemorrhage
Septicaemia
Vasculitis
Disseminated intravascular coagulation (DIC)
List four examples of glomerular disease
Glomerulonephritis
Glomerulonephropathy
Glomerular amyloidosis
Glomerulosclerosis
What is the endpoint of glomerular disease?
Protein-losing nephropathy
What is the most common cause of Glomerulonephritis?
Immune complex deposition (autoimmune disease) resulting in damage to the glomerular basement membrane due to podocyte effacement
What is the gross appearance of Glomerulonephritis?
Glomerulonephritis typically has a normal gross appearance
What should be done to diagnose Immune-mediated Glomerulonephritis?
Renal biopsy followed by histology, electron microscopy and immunofluorescence
What is the histological appearance of Immune-mediated Glomerulonephritis?
Immune complex deposits seen as red dots along the glomerular capillaries
What is Glomerular amyloidosis typically associated with?
Glomerular amyloidosis is typically associated with chronic inflammation
What is the gross appearance of Glomerular amyloidosis?
Enlarged, pale and waxy kidney(s)
What stain should be used to diagnose Glomerular amyloidosis?
Congo-red stain
What is Glomerulosclerosis?
Glomerulosclerosis is fibrosis (scarring) of the glomerulus
What is Glomerulosclerosis typically associated with?
Glomerulosclerosis is typically associated with chronic inflammation and necrosis
What are two common causes of acute tubular necrosis?
Nephrotoxins
Ischaemia
Give an example of a nephrotoxin that can cause acute tubular necrosis
Ethylene glycol forming calcium oxalate crystals leading to oxalate nephrosis and acute tubular necrosis
Give an example of a disease which can cause tubulointerstitial nephritis
Leptospirosis
What stain can be used to identify Leptospirae within the tubulointerstitium?
Warthin-starry stain
What are two common causes of renal pelvis lesions?
Hydronephrosis
Pyelonephritis
What is Hydronephrosis?
Hydronephrosis is dilation of the renal pelvis caused by urine accumulation
What is a common cause of Hydronephrosis?
Hydroneprhosis is often caused by an obstruction of urine outflow due to a build up of calculi
List three examples of renal neoplasia
Renal carcinoma
Transitional cell carcinoma
Nephroblastoma
(T/F) Renal tumours are very common
FALSE. Renal tumours are very rare however do have malignant potential
What is the typical appearance of a renal tumour?
Renal tumours are typically one solid white mass at one pole of the kidney
What is the gross appearance of end-stage kidney failure?
Pale, shrunken, pitted, firm and fibrotic kidney(s)
What is the histological appearance of end-stage kidney failure?
Increased connective tissue, atrophied tubules and sclerotic glomeruli