Kidney Mega

What is the difference between polycystic kidney disease and polycystic kidneys?

Polycystic kidney disease is congenital and polycystic kidneys are acquired

What are the functions of the urinary system?

Urine formation and voiding

Acid base balance

Water and electrolyte regulation

What are the endocrine roles of the kidney?

EPO

RAAS

Vitamin D

What are the two types of nephrons?

Cortical nephrons and juxtamedullary nephrons

Describe cortical nephrons?

Make up 85% of nephrons and are deep in the renal cortex

Describe juxtamedullary nephrons

Make up 15% of nephrons, are in the renal cortex but close to the renal medulla

What is an end artery?

An artery that is the only supply of oxygenated blood to a portion of tissue

What is the significance of end arteries?

There is no collateral circulation because they do not anastomose to their neighbors

What nephron type is longer?

Juxtamedullary

How does the kidney manage acid base balance?

Bicarbonate reclamation

How doe sthe kidney manage extracellular potassium concentration?

Aldosterone and PCTs

Where is the RAAS located?

Juxtaglomerular apparatus

What does the RAAS system do?

Maintain renal blood pressure

Stimulate aldosterone from adrenals to change sodium reabsorption

What does the kidney do in regards to Vitamin D?

Conversion to active form, calcitriol

Unilobar kidney

Unilobar kidney grossly

Multilobar

What species has a multilobar kidney?

Cattle

What species has a grossly unilobar kidney?

Pigs

What species has a unilobar kidney?

Dogs, cats

What disease can reach the kidney from lymphatics?

FIP

Why does adrenal cancer travel to the kidney so easily?

The adrenal vein is right next to kidney vessels

What are branches of the renal artery called?

Interlobar vessels

When do interlobar vessels become intralobular vessels

Corticomedullary junction

What is the juxtaglomerular apparatus?

Feel the pressure of the bowman’s capsule to increase pressure if needed

How does the juxtaglomerular apparatus change blood pressure?

If it is low, they stimulate the RAAS system and causes constriction of afferent vessels

What suffers the most from ischemia?

Tubules because they get the oxygenated blood last

What are stable cells?

Cells that have a limited ability to regenerate

What type of cells are nephrons?

Stable cells

What happens if a nephron takes irreversible damge?

They are unable to regenerate for ever

What is the intact nephron theory?>

Damage to one segment of the nephron affects functions in other segments of the nephron

How many nephrons do humans and horses have per kidney?

1 million

How many nephrons do dogs have per kidney?

400,000

How many nephrons do cats have per kidney?

200,000

How many nephrons do mice have per kidney?

14,000

How many nephrons do rats have per kidney?

30,000-35,000

How many nephrons do cattle have per kidney?

several million

Polycystic kidney disease

Kidney cancer

When is it classified as renal failure?

When you lose 75% functional capacity

Kidney stones

Kidney failure

What species has the maximum number of nephrons?

Cattle

What are the congenital diseases of the kidney?

Aplasia

Hypoplasia

Dysplasia

Polycystic Kidney Disease

What are the acquired diseases of the kidney?

Nephritides can lead to polycystic kidney

Hemorrhage/infarction

Nephropathy (degeneration)

What are the routes that a pathogen can get to the kidney?

Blood or urine or lymphatics

What is an example of renal dysplasia?

Juvenile progressive nephropathy

What are the causes of having one large and one small kidney?

Hypoplasia if it is young

Atrophy if it is old

What animal gets polycystic kidney disease the most?

Cheetahs due to inbreeding

What mutation causes polycystic kidney disease?

Polycystin 1,2 or fibrocystin

What part of the kidney does a polycystin 1 or 2 mutation effect?

Tubule

What part of the kidney does a fibrocystin mutation effect?

Interstitium

What 3 things cause the cysts during polycystic kidney disease?

Abnormal extracellular matrix

Cell proliferation

Fluid secretion

What type of inheritance if polycystic kidney disease?

Autosomal dominant (more in males)

What species can get polycystic kidney disease?

Pigs, and lambs

Dogs

Persian cats

What breeds of dogs are more likely to get polycystic kidney disease?

Cairn, West Highland terriers, Collie

What organs can get get cysts with polycystic kidney disease?

Kidneys

Liver

Pancreas

What is the origin of embolic bacteria causing a spotted kidney?

Aorta/bacteremia

What is the morphology of the kidney with an ascending bacterial infection?

What are the ascending infection agents seen in the kidney?

E. coli

Proteus

Enterobacter

What is a predisposing factor to ascending bacterial infecitons in the kidney?

Diabetes Mellitus due to increased sugar

Septic (embolic) nephritis

What is the main cause of hemolytic uremic syndroume?

E. coli O157:H7 causing DIC with tubular necrosis usually from eating rare meat

What is a viral cause of acute renal hemorrhage?

Herpes

What is a bacterial cause of acute renal hemorrhage?

Embolic nephritis

What does trauma look like with acute renal hemorrhage?

Suffusive hemorrhage

What are the general causes of acute renal hemorrhage?

Viral

Bacterial

Trauma

Thrombosis

Anticoagulants

What causes a wedge shape necrosis in a kidney?

An acute renal infarct of an end artery

Cause

An acute renal infarct of an end artery

How can you feel an acute renal infarct with your hands?

It will be significantly raised

What is a line of demarcation in the kidney?

It is caused by a subacute renal infarct. They kidney dilates vessels to try and save it after multiple infarcts

How can you feel a subacute renal infarct with your hands?

It will be slightly raised

Subacute renal infarct

How do feel a chronic renal infarct with your hands?

It will be depressed

Chronic renal infarct

How do you measure the chronicity of a renal infarct?

If it is raised or depressed

What are the components of the renal tubules?

Epithelium and basement membranes

How do you differentiate a toxic or an infarct in a kidney?

If nothing is viable then it is an infarct

If the basement membrane is intact it is a toxicity

What are the main etiologies of direct tubular damage?

Ischemia and toxin

What are 2 toxins that affect the renal tubules?

Mercury and lead

How can tubules respond to injury?

With casts

T/F toxins target different parts of the tubules than each other?

True

What do cellular casts indicate?

Tubular damage

How does hyperglycemia cause a thickened GBM?

Collagen type IV, fibronectin are increased, and decreased heparan sulfate proteoglycan are

What are the damages caused from hyperglycemia during diabetic nephropathy?

Thickened GBM due to metabolic defect

Nonenzymatic glycosylation of proteins

Hemodynamic changes

What are the glomerular hemodynamic changes of hyperglycemia?

Increased GFR

Glomerular hypertrophy

Describe SGLT-2s role in diabetic treatment?

You can give them jardiance to keep SGLT-2 open and reduce the hyperglycemia

What is type 1 diabetes?

The pancreas cannot make enough insulin

What is type 2 diabetes?

There is insulin resistance

What is Fanconi syndrome?

There is proximal renal tubular acidosis causing a lack of reabsorption of some solutes form urine

What are the most commonly affected solutes with Fanconi Syndrome?

Glucose and Bicarbonate

What breed is predisposed to Fanconi Syndrome?

Basenji

What is an example of paradoxical glucose uria?

Fanconi syndrome

What are the gross lesions of fanconi syndrome?

None, only hitologic

What are two causes of renal tubular necrosis due to pigments?

Hemoglobin and myoglobin

How can hemoglobin get to the kidney?

Hemolysis

Copper toxicity

What is the color of hemoglobin pigment in the kidney?

Gunmetal color (dark)

Why can you not give your goat sheep feed?

There is more copper causing toxicity

How does myoglobin cause renal tubular necrosis due to pigment?

Myonecrosis due to exertional myopathy or consumening monensin

How can you differentiate from hematuria and hemoglobinuria?

RBCs will pellet when centrifugated