Renal pathology Flashcards
Acute renal failure causes
- reduced blood flow to kidney
- Severe dehydration
- Hypotension
Acute renal failure clinical presentation
- Malaise
- fatigue
- nausea
- electrolyte imbalance
Acute renal failure complications
- cardiac failure due to fluid overload
- arrhythmia due to electrolyte imbalance
- GI bleeding
- Jaundice and infections
Chronic renal failure
- Permanently reduced GFR, reduced number of functional nephrons
- Severe scarring with loss of glomeruli and tubules
Chronic renal failure presentation
- Reduced excretion of water - oedema and hypertension
- Reduced excretion of toxic metabolites - poisoning
- Reduced production of EPO - anaemia
- renal bone disease
Functions of the kidney
- Regulates BP
- balance water+electrolytes
- Production if renin + EPO
- Filters toxins and wastes
Renal artery stenosis
- due to atherosclerosis
- Results in ischaemia of affected kidney
- Leads to activation of RAAS = hypertension
What systemic diseases cause kidney disease
- Vasculitis
- Hypertension
- Diabetes mellitus
- Myeloma
- Amyloidosis
Hypertensive nephropathy
- Granular surface with scattered petechial haemorrhages
- Fibrosis of arcuate sized artery
- resembles flea-bitten surface
Diabetic nephropathy
- Most common cause of end stage renal disease
- hyperglycaemia damages glomerular basement membrane - thickens
- Production of excess extracellular matrix
- Ischaemia
Light chain cast nephropathy (myeloma kidney) pathology
Cytotoxic and obstructive accumulation of monoclonal light chain casts in distal nephron segments which can trigger tubular atrophy and surrounding interstitial inflammation and fibrosis = renal failure.
Light chain cast nephropathy (myeloma kidney) charateristics
- LLCN has 30-50% incidence among patients with multiple myeloma
- fractured tubular cast with straight edges
- scattered inflammatory cells with plasma cells present
Nephrotic syndrome
- Always due to pathology to glomerulus
- Proteinuria of more than 3.5g/24hrs
- increased glomerular permeability to albumin and other plasma proteins
Nephrotic syndrome causes
- Membranous nephropathy
- Idiopathic glomerular disorder
- Autoantibodies attack PLA2R
Nephrotic syndrome symptoms
- Hypoalbuminemia
- Oedema
- Hyperlipidaemia
- Lipiduria
Nephrotic syndrome complications
- Thromboembolism
- Infection - sepsis, peritonitis
- Anaemia
Nephritic syndrome
- Loss of function due to decreased glomerular blood flow and salt retention
Nephritic syndrome symptoms
- Haematuria, proteinuria
- Elevated creatinine
- Hypertension
- Oedema
Nephritic syndrome common causes
- Post infectious glomerulonephritis
- IgA nephropathy
PIGN = post-infectious glomerulonephritis
- Neutrophils infiltrate glomerular capillary loop
- Cause injury by digesting the GBM
IgA nephropathy
- Most common cause of glomerulonephritis
- dominant or co-dominant IgA deposits in mesangium
Vasculitis: ANCA-associated glomerulonephritis
- Focal necrosis and crescent (two or more layers of proliferating cells in Bowman’s space)
Haematuria
- Manifestation of subtle or mild glomerular abnormalities
- Normal renal function
- Blood in the urine
Haematuria causes
Nephrological:
- IgA nephropathy
- thin basement membrane
- Alport’s disease - abnormality of type 4 collagen
Interstitial nephritis + symptoms
- Inflammation in between kidney tubules
- Acute or chronic
- Symptoms = fever and flank tenderness
Interstitial nephritis causes
Acute - Diabetes, Female ascending infections
Chronic - Urinary tract obstruction, reflux
Interstitial nephritis complications
- Acute - Abscess formation
- Chronic - Scarring, chronic renal failure
Polycystic kidney disease
- Inherited kidney disease
- clusters of cysts develop primarily within your kidneys, causing your kidneys to enlarge and lose function over time
- Cysts can spread to liver
