Renal Pathology

• Fill in the blanks

  A) mesangial cells

  B) bowmans capsule

  C) afferent arteriole

  D) capillary loop

  
• Fill in the blanks

  A) endothelium

  B) glomerular basement membrane

  C) podocyte foot processes

  
• Minimal change disease - under microscope

  Effacement/fusion of podocyte foot processes
• Membranous nephropathy - under microscope

  Immune complex deposits (subepithelial)

  Appearance of spikes
• Focal segmental glomerulosclerosis - under microscope

  Primary disorder of podocytes

  scarring of some glomeruli and fusion of foot processes
• Diabetic nephropathy - under microscope

  Initial -> diffuse glomerulosclerosis (increased mesangial matrix)

  Later -> nodule formation (Kimmelstiel-Wilson lesion)
• Amyloidosis

  Extracellular deposition of protein fibrils with a characteristic beta-pleated sheet conformation

  Under microscope -> pale pink deposits of amyloids within glomeruli, Congo Red Stain

  
• Nephrotic Syndrome

  
• Nephritic syndrome

  Haematuria (RBCs & red cell casts)

  Proteinuria (usually subnephrotic range) -> with or without oedema (ACR < 300 mgm/mmol)

  Uraemia

  HTN
• Does stage 5 SLE cause nephrotic or nephritic syndrome?

  Nephrotic
• Nephritic Syndrome causes

  Immune-mediated GN

  • IgA nephropathy
  • SLE
  • Post-infectious
  • Membranoproliferative glomerulonephritis

  Pauci-immune GN

  • ANCA associated microscopic vasculitis

  Anti-GBM disease
• Most common cause of glomerulonephritis

  IgA nephropathy
• What is shown in the image?

  Red cell casts

  
• What is rapidly progressive glomerulonephritis?

  Clinical syndrome

  Rapid deterioration in renal function

  Severe oliguria & signs of nephritic syndrome

  If untreated -> death from renal failure within wks to months

  Under microscope -> crescentic glomerulonephritis
• What is shown in the image?

  Crescentic glomerulonephritis

  
• Anti-GBM disease

  Autoimmune disease

  Antibodies against alpha-3 change of type 4 collagen in the GBM (basement membrane of glomeruli & lung)