Renal Pathology

Renal Pathology
By:Kristine Krafts, M.D.

Renal Pathology Outline
* Introductory stuff
* Glomerular diseases
* Tubular and interstitial diseases
* Diseases involving blood vessels
* Cystic diseases
* Tumors
* Introductory stuff
* Functions of the kidney:
o excretion of waste products
o regulation of water/salt
o maintenance of acid/base balance
o secretion of hormones
* Diseases of the kidney
o glomeruli
o tubules
o interstitium
o vessels
* Azotemia: BUN, creatinine
* Uremia: azotemia + more problems
* Acute renal failure: oliguria
* Chronic renal failure: prolonged uremia
* Hematuria
* Oliguria
* Azotemia
* Hypertension
Nephritic syndrome
* Massive proteinuria
* Hypoalbuminemia
* Edema
* Hyperlipidemia/-uria

Nephrotic syndrome
Renal Pathology Outline
* Introductory stuff
* Glomerular diseases

Nephrotic Syndrome
* Massive proteinuria
* Hypoalbuminemia
* Edema
* Hyperlipidemia, lipiduria
* Adults: systemic disease (diabetes)
* Children: minimal change disease
* Characterized by loss of foot processes

Causes
* Introductory stuff
* Glomerular diseases
o Nephrotic syndrome

Minimal Change Disease
* #1 cause of nephrotic syndrome in children
* Loss of foot processes
* Pathogenesis unknown
* Good prognosis

Things you must know
Minimal change disease
Normal glomerulus
Minimal change disease
Focal Segmental Glomerulosclerosis
* Primary or secondary
* Some (focal) glomeruli show partial (segmental) hyalinization
* Unknown pathogenesis
* Poor prognosis

Things you must know
Focal segmental glomerulosclerosis
Membranous Glomerulonephritis
* Autoimmune reaction against unknown renal antigen
* Immune complexes
* Thickened GBM
* Subepithelial deposits/spikes
Things you must know
Nephritic Syndrome
Causes
Post-Infectious Glomerulonephritis
Mnemonic
IgA Nephropathy
Pyelonephritis
Acute pyelonephritis with abscesses
Pyelonephritis
Cellular cast
Pyelonephritis
Urinary Tract Infection
E. coli
uncomplicated complicated
Pyelonephritis
UTI: Causative Organisms
Urinary catheter colonized by Proteus
Chronic pyelonephritis
Drug-Induced Interstitial Nephritis
Acute Tubular Necrosis
Benign Nephrosclerosis
Malignant nephrosclerosis
Malignant Hypertension
Renal Pathology Outline
Adult Polycystic Kidney Disease
Childhood Polycystic Kidney Disease
Medullary Cystic Kidney Disease
Renal Cell Carcinoma
Bladder Carcinoma

Renal Pathology.ppt