Kidney And Lower Urinary Dr. Damm Pathology

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renal disease most often immunologically mediated

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glomeruler disease

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renal disease most often affected by toxic or infectious agents

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tubular and insterstitial disorders

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axotemia becomes associated with many clinical signs and biochemical abnormalities it is then termed

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uremia

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the term for glomerular diseases as a whole

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glomerular nephritis

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entire glomerular apparatus supported by these cells

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mesangial cells

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most common nephritis, based on type III hypersensitivity. The kidney does not incite rxn, the antigen is not of renal origin. most often the antigen is uknown source

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circulating immune complex nephritis (basically inflammation from nearby antigen harms bystanding nephrons)

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a nephritis where abs are directed against fixed antigens within the glomerulus. The circulating abs. bind along entire length of GBM in a homogenous, linear pattern.

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immune complex nephritis in situ. much less common than circulating immune complex nephritis.

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nephritis that is considered an autoimmune disease

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immune complex nephritis in situ

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disease involving kidney directly

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primary glomerular nephritis

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kidney disease involving other systemic disases

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secondary GN

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3 glomerular groups to be discussed are

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1. nephrotic syndrome
2. nephritic syndrome
3. chronic glomerular nephritis

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the renal disorder characterized by 1. Massive proteinuria
2. Hypoalbuminemia
3. Edema
4. Hyperlipidemia/hyperlipiduria

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nephrotic syndrome, usually more dangerous (oh sh*t)

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main features of nephrotic syndrome

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edema, damage to GBM, which leads to increased permeability. IE the floodgates open.

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this affects kids, frequent precursor to nephrotic syndrome, a diffuse loss of the foot process of podocytes is seen

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minimal change disease (lipoid nephrosis)

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a slowly progressive disease most common between age 30-50, has immune complexes along GBM that cause inflammation and thickening of the capillary wall, can be due to infections. can be fatal. Leads to GN

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membranous GN

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1. Hematuria
2. Oliguria
3. Azotemia
4. Hypertension
Think inflammation

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nephritic syndrome mphage invasion

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most common cause of nephritic syndrome

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diffuse proliferative GN

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immune complex mediated diseases which can be caused by exogenous antigens (previous infection) look for "diffuse cellularity"

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diffuse proliferative GN

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an advanced nephritis w/ destruction and extensive scarring of the glomerulous

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chronic glomerulonephritis

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a group of diseases known for damage of the tubules and interstitial tissues

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tubulo-interstitial nephritis

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a benign, bacterial inflammation of the kidney and renal pelvis. very common and associated w/ a UTI. Principle organism is E. Coli

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acute pyelonephritis

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inflammation of the bladder

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cystitis

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chronic renal disorder w/ gross renal scarring with involvement of the calyces and pelvis. inflammation and tubular atrophy.

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chronic pyelonephritis

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abs and analgesics an cause damage either indirectly due to inflammation or direct or cumulative

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drug induced interstitial nephritis

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drug related nephritis, due to synthetic penicillin, other synthtic abs, diuretics NSAIDS and misc. drugs

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acute drug induced interstitial nephritis

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nephritis that is based on the cumulative effect of excessive analgesic mixtures like phenacetin, *aspirin*, caffeine, *acetominophen* and codeine. requires large quantities over years

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chronic analgesic nephritis

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acute renal failure resulting from destruction of tubular epithelial cells

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acute tubular necrosis ATN

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most common cause of acute renal failure

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acute tubular necrosis ATN

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ATN associated w/ shock

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ischemic ATN

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caused by a variety of renal poisons such as heavy metals, organic solvents abs agents - the agent is directly toxit to the tubular cells

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nephrotoxic ATN

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kidney and vascular diseases

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just splitting things up

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organ that, via angiotensin system reg. blood pressure by controlling peripheral vascular resistance and blood volume

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the kidney

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occurs 2ndary to benign hypertension, resulting in hyaline arteriolar sclerosis. hyalinization and thickening of the vessel wall w/ narrowing of the lumen.

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benign nephroslerosis (rarely renal failure)

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a wave of damages, starts w/ fibrinoid necrosis and intravascular thrombosis, this vascular damage causes ischemic renal damage stimulating the ang. system and ^ BP even more. Hypertension is key.

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malignant nephrosclerosis (a true medical emergency)

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a heterogenous group of abnormalities found in both hereditary and non hereditary forms

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cystic diseases of the kidney

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innocuous lesions that occur in single or multiple cavities 1-5 cm, usually asymptomatic

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simple cysts

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inherited disease characterized by multiple expanding destructive cysts of both kidneys. multiple large cysts, palpable flank pain

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autosomal dominant adult polycystic kidney disease

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calculus formation in the urinary tract collection system

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urolithiasis (renal stones)

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2 pathways most related to kidney stones is

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hyperabsorption of calcium from GI and ^ renal output and impairment in renal tubular reabsorption

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most common cancer of the kidney, male dominance, arises from tubular epithelium. risk factors are tobacco. flank pain present

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renal cell carcinoma

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has tendancy to metastasis widely, often to lungs and bones (and oral cavity)!

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renal cell carcinoma

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most common renal tumor in children less than 10. arises in mesoderm. usually presents as a large abdominal mass

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wilms tumor

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3 types of this carcinoma exist, transitional, squamous and adenocarcinoma, however 90% are transitional cell.

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carcinoma of the urinary bladder

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origins of bladder carcinoma are thought to be

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contents of urine

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the most dominant clinical presentation for urinary bladder carcinoma

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painless hematuria