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Renal - PowerPoint PPT Presentation


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Renal. Pathology. Renal Pathology Outline. Introduction Glomerular diseases Tubular and interstitial diseases Diseases involving blood vessels Cystic diseases Tumors. Renal Pathology Outline. Introduction. Introduction. Functions of the kidney: excretion of waste products

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Renal


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    Presentation Transcript
    1. Renal Pathology

    2. Renal Pathology Outline • Introduction • Glomerular diseases • Tubular and interstitial diseases • Diseases involving blood vessels • Cystic diseases • Tumors

    3. Renal Pathology Outline • Introduction

    4. Introduction • Functions of the kidney: • excretion of waste products • regulation of water/salt • maintenance of acid/base balance • secretion of hormones • Diseases of the kidney • glomeruli • tubules • interstitium • vessels

    5. Introduction • Azotemia:  BUN, creatinine • Uremia: azotemia + more problems • Acute renal failure: oliguria • Chronic renal failure: prolonged uremia

    6. Nephritic syndrome Nephrotic syndrome • Hematuria • Oliguria • Azotemia • Hypertension • Massive proteinuria • Hypoalbuminemia • Edema • Hyperlipidemia/-uria Introductory Stuff

    7. Renal Pathology Outline • Introductory stuff • Glomerular diseases

    8. Normal glomerulus

    9. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis • Membranous nephropathy • Nephritic syndrome • Postinfectious GN • IgA nephropathy

    10. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome

    11. Symptoms of Nephrotic Syndrome • Massive proteinuria • Hypoalbuminemia • Edema • Hyperlipidemia, lipiduria

    12. Causes of Nephrotic Syndrome • Adults: systemic disease (diabetes) • Children: minimal change disease • Characterized by loss of foot processes

    13. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease

    14. Minimal Change Disease • #1 cause of nephrotic syndrome in children • Loss of foot processes • Pathogenesis unknown • Good prognosis Things You Must Know

    15. Minimal change disease

    16. Normal glomerulus

    17. Minimal change disease

    18. Minimal change disease

    19. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis

    20. Focal Segmental Glomerulosclerosis • Primary or secondary • Some (focal) glomeruli show partial (segmental) hyalinization • Unknown pathogenesis • Poor prognosis Things You Must Know

    21. Focal segmental glomerulosclerosis

    22. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis • Membranous nephropathy

    23. Membranous Nephropathy • Autoimmune reaction against unknown renal antigen • Immune complexes • Thickened GBM • Subepithelial deposits/spikes Things You Must Know

    24. Membranous nephropathy

    25. Membranous nephropathy

    26. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis • Membranous nephropathy • Nephritic syndrome

    27. Symptoms of Nephritic Syndrome • Hematuria • Oliguria, azotemia • Hypertension

    28. Causes of Nephritic Syndrome • Post-infectious GN, IgA nephropathy • Immunologically-mediated • Characterized by proliferative changes and inflammation

    29. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis • Membranous nephropathy • Nephritic syndrome • Postinfectious GN

    30. Post-Infectious Glomerulonephritis • Child after strep throat • Immune complexes • Hypercellular glomeruli • Subepithelial humps Things You Must Know

    31. Post-Infectious Glomerulonephritis “Sore throat, face bloat, pee coke”

    32. Post-infectious glomerulonephritis

    33. Post-infectious glomerulonephritis

    34. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Nephrotic syndrome • Minimal change disease • Focal segmental glomerulosclerosis • Membranous nephropathy • Nephritic syndrome • Postinfectious GN • IgA nephropathy

    35. IgA Nephropathy • Common! • Child with hematuria after URI • IgA in mesangium • Variable prognosis Things You Must Know

    36. IgA nephropathy

    37. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Tubular and interstitial diseases • Inflammatory lesions • pyelonephritis • drug-induced interstitial nephritis • Toxic/ischemic lesions • Acute tubular necrosis

    38. Renal Pathology Outline • Introductory stuff • Glomerular diseases • Tubular and interstitial diseases • Inflammatory lesions • pyelonephritis

    39. Pyelonephritis • Invasive kidney infection • Usually ascends from UTI • Fever, flank pain • Organisms: E. coli, Proteus Things You Must Know

    40. Acute pyelonephritis with abscesses

    41. Acute pyelonephritis

    42. Acute pyelonephritis

    43. Cellular cast

    44. Urinary Tract Infection • Women, elderly • Patients with catheters or malformations • Dysuria, frequency • Organisms: E. coli, Proteus