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Renal Pathology Overview: Understanding Kidney Diseases

Explore the functions of the kidney, common renal diseases affecting glomeruli, tubules, vessels, and more. Learn about nephrotic and nephritic syndromes, focusing on causes, symptoms, and prognoses of diseases like minimal change disease and IgA nephropathy.

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Renal Pathology Overview: Understanding Kidney Diseases

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  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

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