Renal Pathology

Key Concepts from Renal Pathology Presentation

glomerulonephritis

renal disease that occurs when the major changes are confined to the glomerulu

diffuse glomerulonephritis

involves all glomeruli

global glomerulonephritis

involves the entire glomerulus

major mechanisms of glomerulonephritis

deposition of performed immune complexes, formation of immune complexes, direct interaction of circulating antibodies

nephrotic syndrome

characterized by massive proteinuria, this syndrome is a clinical complex of acute onset

(wide range of symptoms: edema, hypoalbuminemia, hyperlupidemia, lipiduria, hematuria, oliguria, azotemia, HTN)

chronic glomerulonephritis

represents the end stage of many entities, characterized by scarring of glomeruli and usually first noted in young and middle aged

acute pyelonephritis

characterized by discrete yellow abscesses on the renal surface, two key symptoms include papillary necrosis and acute cystitis. will display gram-negative rods

hematogenous spread

key clinical symptoms of this acute pyelonephritis are septicemia and endocarditis

ascending infection

the most common type of acute pyelonephritis, seen mostly in females , instrumentation

vesicoureteral reflux

type of acute pyelonephritis that demonstrates reflux of urine and bacteria

papillary necrosis

necrosis of the apical two-thirds of the pyramids

acute cystitis

bladder involvement

chronic pyelonephritis

renal dysfunction resulting from fibrosis and tubular damage of the renal parenchyma, may be bilateral or unilateral, gradual onset of renal insufficiency

morphology of chronic pyelonephritis

uneven scarring, pelvic or calyces involvement, papillary blunting, chronic inflammatory infiltration, glomeruli usually normal

benign nephrosclerosis

renal changes in benign HTN, key symptom is hyaline arteriosclerosis, decreases blood flow, granular cortical surface, and focal tubular atrophy

hyaline arteriosclerosis

key symptoms of benign nephrosclerosis marked by homogenous pink thickening of the vessel

malignant nephrosclerosis

associated with malignant HTN, fibrinoid necrosis of arterioles with inflammatory infiltrates in the vessel wall, intimal thickening by the proliferation of concentric smooth muscle (onion skinning)

simple cysts

multiple or single 1-5cm in diameter, confined to the cortex

adult polycystic kidney disease

multiple expanding cysts in both kidneys, destroy the renal parenchyma, autosomal dominant and defective polycystin protein, no symptoms until the 4th decade

childhood polycystic kidney disease

autosomal recessive, younger age group, numerous small cysts, numerous liver cyts and proliferation of portal bile duct, hepatic fibrosis

renal stones

calcium oxalate & magnesium ammonium phosphate, proteus vulgaris infections associated, can be renal or ureteral colic, gross hematuria

calcium oxalate

most common type of renal stones

magnesium ammonium phosphate

struvite, stones that produce staghorn calculi

proteus vulgaris

infections predispose to staghorn calculi

hydronephrosis

dilation of renal pelvis, calyces and atrophy of parenchyma. removal of obstruction within a few weeks allows full return of renal function

obstruction to the out flow of urine (congential)

feature of hydronephrosis that presents with asteria of the urethra and valve formations

acquired hydronephrosis

hydronephrosis associated with foregin bodies, presents with calculi, tumors, inflammation and paralysis

bilateral hydronephrosis

hydronephrosis that leads to renal failure early

unilateral hydronephrosis

hydronephrosis that may have progressive symptoms and may be asymptomatic for pr

renal cell carcinoma

adenocarcinoma arising from tubular epithelial cells, accounts for 80-90% of malignant kidney tumors, associated with cigarette smokers and Hippel-Lindau syndrome, key clinical symptoms are hematuria, flank pain, and mass

acute and chronic cystitis

seen after cytotoxic antitumor drugs, radiation, truama. associated with E.Coli and Proteus. key symptoms are lower abdominal pain and dysuria.

transitional cell carcinoma

90% of primary tumors of the bladder, presents with hematuria and typically effects >50years old males , prognosis is based on stage

acure pyelonephritis histology

neutrophils in the tubules and the interstitium

chronic obstructive pyelonephritis microscropic findings

under imaging, kidney cortical surface is irregularly shaped with blunting and loss of papillae

chronic obstructive pyelonephritis histology

corticomedullary scar