VetPath Exam 3 (Lectures 31-41)

filter blood to remove products for excretion in urine

conserve water, electrolytes/protein

hemodynamic regulation

RBC production via erythropoietin production

Vitamin D activation

What are the renal functions?

regulate blood pressure, sodium and water reabsorption

What is the major function of the RAAS system?

renin

What is produced in response to decreased renal perfusion, secreted into circulation, and converts circulating angiotensinogen into angiotensin I?

angiotensin converting enzyme (ACE)

Angiotensin I converts to angiotensin II via what?

angiotensin II

What maintains renal and systemic blood pressure which constricts arterioles, stimulates aldosterone secretion from adrenal gland to promote sodium and water retention, and stimulates ADH release from the pituitary gland?

cats, dogs, and small ruminants

Which species has unipyramidal kidneys with fused renal papillae/crests?

equids and pigs

Which species has multi-pyramidal kidneys with multiple renal papillae forming major papillae form major calyces?

large ruminants

Which species have externally lobulated kidneys?

larger

Species adapted to the desert have a far larger/smaller medulla, which allows for better urine concentration and water conservation.

nephron

What is the functional unit of the kidney?

randomly distributed pink/tan/red cortical foci

What changes to the glomerulus will be seen with glomerular disease?

Glomerulus

What part of the kidney has the function of ultrafiltration of plasma to remove waste products from blood to be excreted in urine?

molecule size, electric charge, and capillary pressure

What is filtration based on in the glomerulus?

Bowman's space

Where does filtered fluid accumulate in the kidney?

tubules

What part of the kidney is highly sensitive to hypoxic states?

interstitium

What part of the kidney has scant fibrovascular connective tissue storm that supports renal tubules and responsible for local production of prostaglandins?

25%

The vascular components of the kidney receives approximately _ percent of the cardiac blood flow (main supply from the renal artery).

vasa recta

What is the peritubular capillary network that extends into the deeper portion of the medulla?

glomerular filtrate circulating through kidney, hematogenous, ascending via ureter, and direct penetration

What are the different portals of entry into the kidney?

primary glomerular injury

What do these things cause- deposition of immune complexes, entrapment of thromboembolism, bacterial or tumor emboli, and direct viral or bacterial infection of glomerular components?

albumin and antithrombin III

What are the most important proteins in leakage during renal corpuscular injury?

reepithelialization

IF the basement membrane remains intact during renal tubular injury, it can be reversibly repaired via what?

vascular (hypoxia/ischemia) and direct (nephrotoxicity)

What causes damage during acute tubular injury?

proximal convoluted tubules

What part of the kidney is most severely affected in acute tubular injury because of their high metabolic demands and the first line of exposure?

preglomerular vasoconstriction and reduced glomerular filtration

What is the result of severe hypotension associated with shock in the kidneys?

nephrotoxins

antibiotics like ahminoglycosides, hemoglobin, myoglobin, iron, and ethylene glycol are all what?

glycogenic degeneration

What is the term for cytoplasmic vacuolation of renal tubular epithelium due to glycogen accumulation?

tubulointerstitial nephritis

What can be caused by bacteria (leptospirosis or E.coli) or viruses (adenovirus, EAV, PRRS) with gross lesions of diffuse or multifocal foci of inflammatory cells with pale tan, swollen with scattered grey mottling on capsular surface, and grey/tan foci obscure normal architecture on cut surface?

petechial hemorrhage

What is commonly seen on the surface and throughout the cortex of kidneys from pigs that die of viremia or septicemia?

gross renal cortical ecchymotic hemorrhages

What are diagnostically important lesions on the kidneys of viremia in neonatal puppies infected with herpesvirus?

thrombosis

What can be seen on the kidneys in systemic diseases like DIC?

infarction

What is the term for when areas of coagulative necrosis result from local ischemia caused by vascular occlusion in the kidneys?

kidneys

What organ is a common site of infarction due to high circulating blood volume?

renal infarct

What is grossly present as a wedge/triagnular foci due to the interloper/arcuate artery orientation?

acute infarcts

What type of renal infarct is initially slightly swollen with pink/red color?

subacute infarcts

What type of renal infarct is more pale and surrounded by a peripheral zone of hyperemia?

chronic infarcts

What type of renal infarct is depressed below the cortical surface because of fibrosis contracting tissue, white to tan, and firm on palpation?

glomerular filtration barrier

tubular basement membranes

immune system

What are the defense mechanisms of the kidney?

immune complex mediated glomerulonephritis

glomerular amyloidosis

embolic/suppurative glomerulonephritis

What disorders affect the renal corpuscles?

circular lesions in the renal cortex

What will you see grossly if the glomerulus is affected?

immune complex mediated glomerulonephritis

What is renal disease is most commonly seen in dogs and cats, seen in persistent infections or familial predispositions including Bernese mountain dogs, bull terriers, Dalmatian, and dobermans?

IgG and IgM

What immunoglobulins are most commonly involved in dogs with immune complex mediated glomerulonephritis?

gross lesions are nonspecific, diagnosis via demonstration of immunoglobulin and complement components in glomerular tufts

How do you diagnose immune complex mediated glomerulonephritis?

Canine lyme nephritis

Which specific disease can cause immune complex mediated glomerulonephritis that is caused by a spirochete bacterium Borrelia burgdorferi, most commonly in young golden and Labrador retrievers, and can cause arthritis, dermatologic, neurologic and cardiac disease but are less common?

Canine lyme nephritis

Which specific disease will grossly have a light tan-red kidney with multifocal tan/red pinpoint cortical foci, and histology shows a unique triad of changes including glomerulonephritis, tubular necrosis and regeneration, and lymphoplasmacytic interstitial nephritis?

porcine glomerulonephritis

Which specific disease can cause immune complex mediated glomerulonephritis in pigs that can either be a sequela to chronic infection, inherited form in Yorkshire pigs, or porcine circovirus 2 infection?

glomerular amyloidosis

Which specific syndrome can result clinically in nephrotic syndrome, glomeruli are the site of deposition for dogs and medullary interstitium for cats, can occur in association with other diseases or hereditary predisposition in Abyssinian cats or shar-pei dogs?

glomerular amyloidosis

What syndrome is grossly seen as renomegaly, pale tan kidneys with a smooth waxy to finely granular capsular surface that is firm on palpation, mostly cortical, and when stained with Lugol's iodine, deposits dark brown?

acute suppurative glomerulonephritis

Which specific disease can cause immune complex mediated glomerulonephritis is caused from bacteria losing in glomerular capillaries leading to multifocal regions of inflammation and grossly multifocal, randomly distributed, and pinpoint white to tan foci in cortex?

acute suppurative glomerulonephritis

Which specific disease is associated with bacteria, specifically foals: actinobacillus equuli, pigs: erysipelothrix rhusipathiae, and sheep and goats: corynebacterium pseudotuberculosis?

equine embolic glomerulonephritis

Which specific disease can cause immune complex mediated glomerulonephritis is caused by actinobacillus equuli, most commonly associated with sleepy foal disease- foal neonatal infections resulting in septicemia most commonly associated with failure of passive transfer, and grossly has microabscesses secondary to embolic showering?

Diamond skin disease in pigs

Which specific disease can cause immune complex mediated glomerulonephritis is caused by erysipelothrix rhusiopathiae which is the most common bacterial cause of embolic nephritis in pigs, bacteremia related to septic valvular endocarditis, and grossly has petechial hemorrhages throughout the renal cortex?

Canine herpesvirus

Which specific disease can cause immune complex mediated glomerulonephritis occurs in puppies younger than 3-5 weeks of age due to intrauterine or neonatal infections, with pathognomonic kidney lesions consisting of cortical petechial and ecchymotic hemorrhages?

hemoglobin

Which nephrotoxic pigment is due to when hemoglobin is generated from intravascular hemolysis or red cell death and if hemolysis is severe and haptoglobin are oversaturated, hemoglobin becomes free in the plasma resulting in hemoglobinemia and hemoglobinuria?

Chronic copper toxicity in sheep

What occurs in sheep due to a prolonged dietary copper consumption, grossly diffuse, uniformly, and strikingly blue-black renal cortex described as gunmetal blue with the medulla diffusely dark red or has patchy red streaks, and histologically has hemoglobin casts that appear as a red-black stippling of the capsular surface?

Bacillary hemoglobinuria (Red water disease)

What is typically fatal in cattle caused by clostridium haemolyticum, most common predisposing factor is the trematode fasciola hepatica, and is characterized by hemolytic anemia, jaundice, and hemoglobinuria?

Bacillary hemoglobinuria (Red water disease)

What is grossly seen in cattle as extensive hepatic necrosis, hemorrhage in multiple organs, kidneys are mottled dark red, and dark red urine present, and histologically extensive acute tubular necrosis and hemoglobin casts in tubular lumens?

myoglobin

Which nephrotoxic pigment is due to myocyte damage or necrosis, secondary to acute and extensive muscle necrosis or severe direct trauma to muscle, grossly seen with renal cortices diffusely stained red-brown to blue-back and histologically intratubular myoglobin casts?

myoglobinuric acute tubular injury, Monday morning disease, tying up

Which condition can occur resulting in renal ischemia and severe tubular necrosis due to exertional rhabdomyolysis (in horses), and clinical signs occur intermittently during or after exercise with dark urine (myoglobinuria), renal damage, and high CK?

amino glycoside antibiotics

NSAIDs

Cisplatin

Oxytetracycline

Which medications can cause renal damage- acute tubular injury?

aspergillus sp

penicillium sp

fusarium sp

What nephrotoxic mycotoxins come from various fungi?

pigweed, oak toxicosis, lilies, and oxalate containing plants

What plant toxins cause acute tubular necrosis +/- perirenal edema?

ethylene glycol toxicity

What toxicity occurs following ingestion of antifreeze, which contains toxic metabolites glycolic acid and oxalate resulting in tubular necrosis in dogs and cats, with gross lesions of pale yellow foci of calcium oxalate crystals that can also be seen histologically and fluoresce under polarized light?

grape/ raisin toxicity

What toxicity can result in a syndrome of acute renal failure in dogs with clinical signs including vomiting, lethargy, anorexia, diarrhea, and sometimes neurological signs, with grossly enlarged pale tan bulging kidneys and histologically acute proximal tubular necrosis seen?

vitamin D toxicity

What toxicity occurs with the ingestion of excessive vitamin D can induce hypercalcemia and in chronic cases the surface of the kidney is finely granular from fibrosis with white, chalky deposits seen in the renal cortex and extensive calcification of tubular basement membranes?

pulpy kidney disease

What disease occurs from clostridium perfringens D, usually in small ruminants with sudden access to starch/lush pastures results in intestinal bacterial overgrowth, and a pulpy appearance to kidney occurred from rapid necrosis secondary to the developing enterotoxemia?

hydronephrosis

What disorder of the renal pelvis is the dilation of the renal pelvis, secondary to renal parenchymal atrophy, resulting from anything causing urine outflow obstruction and can either be congenital or acquired?

pyelonephritis

What disorder of the renal pelvis is the inflammation of the renal pelvis with extension into the renal parenchyma causing concomitant tubulointerstitial inflammation, most commonly resulting from a bacterial infection arising in the lower urinary tract that ascends to the renal pelvis, and rarely resulting from a descending bacterial infection?

pyelonephritis

What disorder of the renal pelvis occurs more frequently in females and Escherichia coli is one of the most common causes of lower urinary tract disease?

aspergillus sp. cryptococcus sp. candid sp. fusarium sp

Rarely, granulomatous and necrotizing pyelonephritic is caused by what?

acute pyelonephritis

What type of pyelonephritis is grossly thickened, reddened, roughened, or granular with thin exudate?

chronic pyelonephritis

What type of pyelonephritis has grossly visible deformities of the renal parenchyma because of extensive interstitial inflammation and scarring?

papillary necrosis

What disorder of the renal pelvis is the necrosis of the renal papillae in response of inner medullary ischemia, can be caused by NSAIDs, and acute lesions will be irregular discolored areas of necrotic inner medulla delineated from the surviving medullary tissue?

parasites of the renal pelvis

What disorder of the renal pelvis can be caused by atephanurus dentatus (in pigs) and dicotophyma renal (dogs, cats, fish-eating mammals)?

Lymphoplasmacytic interstitial nephritis (white spotted kidney)

What disorder of the renal interstitium is multifocal lymphoplasmacytic interstitial nephritis in ruminants most commonly caused by Escherichia coli and is grossly multifocal to coalescing foci ranging from pinpoints to a few centimeters in diameter visible from the capsular surface?

malignant catarrhal fever

What disorder of the renal interstitium is caused by gammaherpesvirus which is fatal in ruminants and can occasionally affects pigs, grossly grey/white variable sized nodules within the renal cortex and histologically lymphoplasmocytic interstitial nephritis and vasculitis?

leptospirosis

What disorder of the renal interstitium is caused by an obligate aerobic spirochete, affects multiple species due to close contact with urine or contaminated water, reservoir hosts shed spirochetes in urine and can have carrier animals?

leptospirosis

What disorder of the renal interstitium is grossly multifocal, pale tan streaks of coalescing inflammatory infiltrates that extend from the conical medullary junction to the capsular surface and in chronic cases variable amounts of fibrosis and subcapsualr scarring is present?

leptospirosis

What disorder of the renal interstitium has a special stain called Warthin Starry that will stain the spirochetes (bacteria) in tubules black?

granulomatous nephritis

What disorder of the renal interstitium is caused by a variety of infectious microbes, grossly seen as small gray/white to tan granulomatous foci or larger nodules scattered randomly throughout the kidneys, and histologically central foci of necrosis and degenerate neutrophils surrounded by epithelioid macrophages?

Viral- feline infectious peritonitis

What example of granulomatous nephritis is multifocal pyogranulomatous nephritis, secondary to severe primary vasculitis, can be misinterpreted as neoplastic infiltrates, and have extensive accumulations of macrophages interspersed with variable numbers of lymphocytes, plasma cells, and neutrophils?

parasitic- toxocara canis

What example of granulomatous nephritis is caused by migratory larvae that can induce small, gray/white granulomas in dogs?

toxicity- hairy vetch (vicia villosa)

What example of granulomatous nephritis is seen in cattle and rarely horses, causes a granulomatous nephritis as part of the multi systemic granulomatous disease, grossly multifocal to coalescing cortical granulomas, and on histology has infiltrates of monocytes, lymphocytes, plasma cells, eosinophils, and multinucleate giant cells seen within the interstitium of the renal cortex?

neoplasia

What is rare in kidneys, usually unilateral with majority being epithelial in orgigin, may present with hematuria, and most are malignant in dogs, cats, and horses and benign in cattle?

renal adenoma

What is a benign epithelial neoplasm composed of proliferations of renal cortical epithelial cells most often reported in dogs, cats, and horses, and tend to be clinically asymptomatic?

renal carcinoma

What is the most common primary renal neoplasm occurring most frequently in older dogs, but sometimes seen in cats and horses, prognosis is poor because of high rate of metastasis to the lungs, lymph nodes, liver, and adrenal glands, and polycythemia is an associated paraneoplastic syndrome?

nephroblastoma (Wilms tumor)

What arises from metanephric blastema most commonly occurring in young animals, is the most common renal neoplasm of pigs and chickens which is usually an incidental finding at slaughter, second most common primary renal tumor in dogs, often soft to rubbery and tan/gray with foci of hemorrhage and often multilobulated, and in dogs and cats greater than 5-% may metastasize to lymph nodes and visceral organs?

metastatic tumors

What are randomly scattered nodules that usually involve both kidneys?

renal lymphoma (lymphosarcoma)

What occurs with some frequency in cattle and cats and often as part of generalized or multicentric lymphoma?

renal lymphoma

What is the most common neoplasm in cats that predominantly affecting the kidney as part of a systemic syndrome, most affected cats are FeLV positive, masses are not vasocentric, and typically have bulging masses of variable sizes?

renal aplasia

What is the failure of development of one or both kidneys with no recognizable renal tissue that is present, and a familial relationship with dobermans, shetland sheepdogs, and beagles?

renal hypoplasia

What is the incomplete development of the kidney, is an inherited disease of purebred or crossbred large white pigs in New Zealand, can be unilateral or bilateral, and unless significant renal mass is absent, hypoplasia is clinically silent?

renal dysplasia

What is the altered structural organization because of abnormal differentiation, resulting in the presence of structures not normally present at the end of nephrogenesis, can be unilateral or bilateral, kidneys can be small and/or misshapen, and is typically congenital but may be secondary to renal disease if early in postnatal life?

renal cysts

What causes a spherical mass with a thin fibrous connective tissue wall containing clear, watery fluid, range in side, and are congenital in pigs and calves?

polycystic kidney disease

what occurs sporadically in many species including Persian cats, bull terriers, pigs, lambs, cairn and west highland white terriers, caused by the mutations of PKD1 and PKD gene, and grossly is multiple cysts arising within the cortical tubules with renal cortical atrophy being a common sequela?

progressive juvenile nephropthy

What is a noninflammatory degenerative and developmental chronic progressive renal disease that is hereditary in some breeds (Samoyeds) and typically under 2-3 years of age with clinical signs related to renal insufficiency and are notably shrunken, pale tan to white firm kidneys diffusely pitted capsule with a finely granular pattern?

ectopic kidneys

What is misplaced from their normal location because of abnormal migration during fetal development which is most common in pigs and dogs that is usually unilateral?

ectopic and fused kidneys

What is the fusion of the left and right cranial or left and right caudal poles of the kidneys during nephrogenesis with one large kidney with two ureters and the function of the fused kidneys is usually normal?

ureter

What is the tubular continuation of the renal pelvis?

ureter

What has the function of propelling urine from the renal pelvis to the bladder via peristalsis?