renal disease pathology

Question 1

What do the kidneys do?

Answer 1

Glomeruli filter 180l/day
Tubules resorb 178l/day

Question 2

How do the kidneys work?

Answer 2

Blood passes through the glomerular capillary
There are large proteins such as albumin in the blood
Small molecules such as creatinine and urea pass through the pores, through the interstitium and end up in the tubules to be passes out in urine

Question 3

What can go wrong in the kidneys?

Answer 3

NOT ENOUGH FILTRATION (build up of waste products in blood)
-not enough blood flow ACUTE
—>haemodynamic shock
-blocked filter ACUTE
—>acute glomerulonephritis (minimal change/membranous/proliferative)
-lack of glomeruli CHRONIC
—>chronic hypertension

TOO MUCH FILTRATION (proteinuria)
-leaky membranes ACUTE
—>acute glomerulonephritis (minimal change/membranous)

TOO LITTLE REABSORPTION
-faulty tubules ACUTE
—>acute tubular necrosis (ischaemia/toxins eg. Myoglobin, ethylene glycol)
-blocked/inflamed tubules CHRONIC/INFECTION
—>tubulointerstitial disease (crystals/casts)
—>pyelonephritis
-tubules die off in chunks INFECTION
—>papillary necrosis

TUMOURS DEVELOP
—>renal cell carcinoma
—>transitional cell carcinoma
Risk factors- obesity, smoking, von Hippel Lindau syndrome, acquired renal cystic disease

Question 4

How might the cancer spread?

Answer 4

Direct
Lymphatic
Peritoneum
Blood
Bone