renal diseases and metabolic disorders

nephron

The functional unit of the kidney is the

glomerular

When the glomerulus is affected, the renal disease is

— in nature.

renal tubules

Tubular disease if the — are considered to

be damaged or affected.

1. Glomerular

2. Tubular

3. Interstitial

4. Vascular

4 types of kidney diseases

glomerular

[4 types of kidney diseases ]

either caused by immune or non-immune in nature;

immune-mediated

most of the time, glomerular diseases is

immune reaction

There must be an — that can trigger the glomerular disorder.

• Bind to the Ag and there will be a production of Ag-Ab complex

• Ab will destroy not only the Ag but also the cells of the host

[glomerular diseases]

antibody then does either of the following to contribute to renal disease:

1. infections

2. exposure to toxic substances

Tubulointerstitial (Tubular and interstitial) diseases are caused by 2 reasons:

vascular

disorder in the renal tissues caused by decrease in the renal perfusion which cause morphological and functional changes to that tissue; manifested by microscopic examination of urine

immunologic

[cause of glomerular diseases]

production of Ab to form Ag-Ab complex that will be deposited in the glomerulus or directly destroy the glomerulus

non-immunologic

[cause of glomerular diseases]

No Ag-AB complex formation;

• Exposure to chemicals or toxins that could

  affect the tubules

• Disruption of electrical membrane changes

  in the GFB

• Deposition of amyloid materials from

  systemic disorders

• Basement membrane thickening

[cause of glomerular diseases]

non-immunologic may be due to 4 reasons

amyloidosis

There is an increase in amyloid in the plasma

diabetic nephropathy

caused by basement membrane thickening

glomerulonephritis

• General term for sterile, inflammatory process affecting the glomerulus

• Causes blood, protein, and casts in urine

1. hematuria

2. proteinuria

3. cylindruria

commonly seen in glomerular disease/damage/glomerulonephritis

cylindruria

presence of RBC casts and other casts in urine

renal damage

The presence of renal proteinuria is indicative of — particularly in the glomerular filtration.

acute or chronic

glomerular diseases may be classified either — or — depending on how gravid the condition is

nephritic syndrome

[nephrotic or nephritic]

Immune mediated

nephritic

[nephrotic or nephritic]

Acute onset of usually gross hematuria

nephritic

[nephrotic or nephritic]

presence of RBC casts

nephritic

[nephrotic or nephritic]

mild-moderate proteinuria

nephritic

[nephrotic or nephritic]

hypertension

nephritic

[nephrotic or nephritic]

hypertension

nephrotic

[nephrotic or nephritic]

disruption of filtration barrier

nephrotic

[nephrotic or nephritic]

heavy proteinuria

nephrotic

[nephrotic or nephritic]

hypoalbuminemia

nephrotic

[nephrotic or nephritic]

severe edema

nephrotic

[nephrotic or nephritic]

lipiduria

1. damaged basement membrane of endothelial cells in the capillary tuft.

2. alterations in the shield of negativity.

3. podocytes are less tightly packed with each other.

Nephrotic Syndrome

Disruption of filtration barrier because of 3 possible

reasons:

3.5 g/dL

in heavy proteinuria, proteins would be more than

albumin

The protein seen in urine is

Albumin wasting

process where the amount of albumin in the blood is decreased because it is secreted in the urine causing hypoalbuminemia.

True

[T or F]

decrease albumin in blood results in the decrease in oncotic pressure

localized edema

• Usually observed in renal damages.

• The problem is in the lower extremities.

general edema

• The whole body is affected. Even the upper extremities.

• This would be observed in cardiac problems.

anasarca

general edema is referred to as —

hyperlipidemia

increased lipid levels in the blood.

lipiduria

presence of lipids in the urine.

False

[T or F]

Oil droplets are a manifestation of lipiduria because oil droplets are a contaminant from oil immersion fields in the microscope.

Fatty Casts

Oval Fat bodies

Cholesterol

manifestations of lipiduria

Acute poststreptococcal glomerulonephritis

Deposition of immune complexes formed after group a strep infection on the glomerular membrane.

• S. pyogenes triggers the production of antibodies, then it attacks the bacteria, leading to the formation of antigen-antibody complexes

• immune system not only reacts to the bacteria but also to heart tissues and renal tissues

There are two mechanisms why acute poststreptococcal glomerulonephritis happens:

1. rheumatic heart fever

2. acute poststreptococcal glomerulonephritis

recurrent streptococcal infection commonly causes:

fatigability

common symptom of glomerular disorder especially if the patient is edematous

dysmorphic RBC

RBC’s with blebs or protrusions, they are pictures of glomerular problems. Origin is renal in nature

Antistreptolysin O

serologic test to determine/ detect the presence of S. pyogenes infection

crescentic glomerulonephritis

other term for rapidly progressive glomerulonephritis

Systemic lupus erythematosus

in this condition there is an immune response that happens which eventually cause cellular and humoral components to attack your tissues or your own body.

macrophages attacks and damages the capillary wall → secretion of substances that may destroy tissue/cells of nephrons → bowman’s capsule

process of the production of crescentic formation

macrophage and fibroblast

crescentic formation contains primarily — and —

goodpasture syndrome

Attachment of cytotoxic antibody formed during viral respiratory infections to glomerular & alveolar basement membrane → Complement activation → Capillary destruction

Anti-glomerular Basement Membrane Antibody

When a person has viral infection, the virus triggers the immune system to produce antibody then there will be a production of

Hemoptysis

expectoration of blood when coughing along with

phlegm

Hematemesis

is the vomitting of blood

wegener’s granulomatosis

Inflammation and granulomas in small blood vessels of kidney and respiratory system

immunofixation test

Immunofixation test in serology to detect the presence of antibody for p-ANCA/C-ANCA