Renal Pathology Flashcards
Nephrotic syndrome
Chronic
Massive proteinuria - albumin selective
Oedema
Blood changes in Nephrotic syndrome
Hypoalbuminaemia
Hyperlipidaemia
Nephritic syndrome
Acute
Variable unselective proteinuria
Haematuria
Consequences of Nephritic syndrome
Mild oedema
Oligouria
HTN
Blood changes in Nephritic syndrome
Azotaemia - high nitrogen
Pathophysiology of Nephrotic syndrome
Damage to glomerular filtration barrier
Loss of foot processes
No inflammation
Types of glomerular disease (inc. Nephrotic syndrome)
Minimal change disease
Focal segmental glomerulosclerosis
Membranous glomerulonephritis
Pathophysiology of Nephritic syndrome
Inflammation, vascular and epithelial damage
+/- glomerular cell proliferation
Types of Nephritic syndrome
1) Proliferative glomerulonephritis
2) Membranoproliferative (mesangiocapillary) glomerulonephritis
Proliferative glomerulonephritis
Post infective
Membranoproliferative (mesangiocapillary) glomerulonephritis
Diffuse
Crescentic glomerulonephritirs
Lupus nephritis
Causes of golmerulonephritis
Primary
Secondary to systemic disease
Pathophysiology of glomerulonephritis
Immunological
Deposition of immune complex in glomerular capillary wall
Ix for glomerulonephritis
Immunohistochemistry:
- Local deposition of circulating immune complexes
- Anti-glomerular basal membrane antibodies
- Antibodies against glomerular component
Causes of Acute tubular necrosis
Ischaemia
Toxic drug injury - statin
DIC
Urinary obstruction
Presentation of Acute tubular necrosis
Acute renal failure
Causes of Tubulointersitial nephritis
Acute pyelonephritis
Chronic pyelonephritis
Drugs - analgesics
Presentation of acute pyelonephritis
Fever
Elevated creatinine
Histology of chronic pyelonephritis
Dilated colloid filled tubules
Post mortem features of chronic pyelonephrits
Irregularly depressed/scarring of kidneys
Hypertensive kidney disease
Benign nephrosclerosis - focal ischaemia
Malignant HTN and accelerated nephroscerlosis
Types of Cystic kidney disease
Malformative/congenital
Acquired
Hereditary
Malformative cystic kidney disease
Multicystic renal dysplasia
Medullary sponge kidney
Acquired cystic kidney disease
Acquired renal cystic disease - often post dialysis
Simple cysts
Hereditary cystic kidney disease
Autosomal dominant polycystic kidney disease
Nephronophthisis
Nephronophthisis
Medullary cystic kidney disease complex
Autosomal dominant polycystic kidney disease
Bilateral
Presents in middle age
Presentation of Autosomal dominant polycystic kidney disease
Haematuria UTI Abdo mass HTN Cysts in liver, pancreas, lung Cerebral aneurysms
Complication of Autosomal dominant polycystic kidney disease
Ruptured berry aneurysm
Mx of Autosomal dominant polycystic kidney disease
Supportive
Treat HTN
Renal replacement therapy
Causes of CKD
DM
HTN
Stages of CKD and eGFR
1) > 90
2) 60-90
3A) 45-60
3B) 30-45
4) 15-30
5) < 15
Nephrolithiasis
Stone formation
In kidney or renal tract
Types of kidney stone
Calcium oxalate
Triple phosphate
Urate
Cystine
Renal tumours
Wilm’s tumour - childhood
Benign - papiliary adenomas
Malignant - RCC, TCC
Renal cell carcinomas (RCC) RFs
Smoking
HTN
Heavy metals
Von Hippel Lindau syndrome
Histotypes of RCC
Clear cell
Papiliary
Chromophobe
Sx of RCC
Polycythaemia Hypercalcaemia Cushing's Haematuria Back pain
Benign Bladder tumours
Papilloma
Low malignant potential Bladder tumours
Papillary urothelial neoplasm
Malignant Bladder tumours
Low grade papillary urothelial carcinoma
High grade urothelial carcinoma
Bladder tumour RFs
Smoking Dye industry Long term analgesic use Schistosomiasis - SCC Cyclophosphamide
