Renal Pathology

• What are the two types of renal failure discussed?

  Acute and chronic renal failure
• What are the four major changes in renal function due to renal disease?

  Impaired blood flow, Uraemia, Nephrotic Syndrome, Nephritic Syndrome
• What causes most types of Glomerulonephritis (GN)?

  Injury from antigen-antibody complexes

  
• What is the role of podocytes in the kidney?

  They form the inner wall of Bowman’s capsule
• What is the function of mesangial cells?

  Regulate blood flow through glomerular capillaries
• What are the symptoms of Glomerulonephritis (GN)?

  • Proteinuria
  • Haematuria
  • Increased permeability to proteins
  • Generalised oedema
• What is the significance of proteinuria in nephrotic syndrome?

  It indicates increased permeability to proteins
• What is the most common cause of intra-renal failure?

  Acute tubular necrosis

  
• What can cause acute tubular necrosis (ATN)?

  Ischaemia and exposure to toxic chemicals

  
• How does diabetic nephropathy progress through its stages?

  From renal reserve to renal insufficiency to end-stage

  
• What are the stages of chronic renal failure?

  1. Diminished Renal Reserve
  2. Renal Insufficiency
  3. End-Stage Renal Failure
• What is the normal Glomerular Filtration Rate (GFR)?

  ~125 ml/min
• What happens to GFR in acute renal failure?

  It decreases significantly
• What is the typical GFR in acute tubular necrosis?

  $< 5 - 10 \text{ ml/min}$
• What is the effect of septic shock on renal function?

  It leads to decreased total peripheral resistance
• How does chronic renal failure affect remaining nephrons?

  They work harder and increase in size
• What is the relationship between hypertension and diabetic nephropathy?

  Hypertension is a characteristic of diabetic nephropathy

  
• What is the normal serum sodium level?

  134 - 146 mmol/litre
• What happens to serum potassium levels in advanced renal disease?

  They become elevated
• What is the normal serum creatinine level?

  <125 µmol/litre
• What is the outcome of chronic renal failure?

  Dialysis or renal replacement therapy
• What are the systemic effects of chronic renal failure?

  • Dialysis
  • Renal replacement therapy
  • Potential for wearable artificial kidneys
• What is the primary cause of end-stage renal disease in diabetic patients?

  Diabetic nephropathy

  
• What is the role of angiotensin II in renal pathology?

  It increases blood flow and pressure
• What is the significance of Bence Jones protein in urine?

  It indicates Multiple Myeloma
• What can cause post-renal failure?

  Obstruction of the urinary tract

  
• What are common causes of obstruction leading to post-renal failure?

  Calculi, tumours, congenital defects
• What is the effect of chronic kidney disease on electrolyte balance?

  It disrupts normal electrolyte balance
• How does chronic renal failure progress through its stages?

  From diminished renal reserve to end-stage

  
• What is the impact of hyperglycaemia on kidney function?

  It leads to tissue destruction and fibrosis

  
• What is the normal serum phosphate level?

  0.8 - 1.2 mmol/litre
• What happens to serum bicarbonate levels in metabolic acidosis?

  They fall as metabolic acidosis develops
• What is the typical outcome for patients with chronic renal failure?

  Dialysis or renal replacement therapy
• What is the significance of systemic effects in chronic kidney disease?

  They indicate the need for renal replacement therapy
• How does chronic renal failure affect the remaining nephrons?

  They become larger and work harder
• What is the role of cytokines in chronic kidney disease?

  They contribute to inflammation and tissue destruction
• What is the typical GFR in end-stage renal failure?

  ~10% of normal
• What is the relationship between chronic renal failure and cardiovascular mortality?

  Increased risk of cardiovascular mortality
• How does the immune response relate to glomerulonephritis?

  It involves antigen-antibody complex deposition

  
• What is the impact of renal vascular occlusion?

  It impairs renal blood flow