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Renal 08 Gen.Ren.Pat

Leonard: General renal pathology and Basic lab considerations

Gerota's Fascia Covers the kidney (not the sinus) Important in staging of tumors
Glomerular endothelial cells are... Fenestrated Allows for easier filtration
Principle Kidney Functions 1. Form and excrete urine 2. Regulate body water 3. regulate electrolytes and mineral content 4. maintain acid-base balance
Principle Kidney Function (cont.) 5. Regulate BP -intravascular vol -vascular tone 6. Regulate erythropoiesis 7. Synthesize active Vit. D
Kidney receives __% of total cardiac output 20-25%
Renal plasma flow (RPF) 600 mL/min
Autoregulated PF: Angiotensin Vasoconstriction Decreases flow
Autoregulated PF: Prostaglandins Vasodilation Increases flow
How to classify kidney disease 1. Renal compartment involved -Glomerular -Tubulointerstitial -Vascular 2. "Focality" (1° V 2°) 3. Acute V Chronic
How to classify kidney disease (cont.) 4. Clinical manifestations -Acute V chronic injury/failure -Nephrotic/nephritic -Hematuria
Light microsocopy stains: Silver Trichrome PAS S: glomerular filtration barrier T: too much extracellular material P: certain types of protein deposited normally
Glomerular Filtration: The GFB 1. Endothelial cells 2. GBM 3. Visceral podocytes 4. Mesangial cell 5. Mesangial matrix No GBM bewteen 1 & 4
The GBM provides a _____ barrier. Major charge-exclusion barrier
Podocyte filtration slit diaphragms acts as the ______ barrier Primary size-exclusion barrier
Pathologic alterations in glomerular disease 1. Cellularity 2. GFB alterations 3. Hyalinosis 4. Sclerosis
Pathologic alterations in glomerular disease: Cellularity Increased number of cells Inflammation and proliferation
Pathologic alterations in glomerular disease: GFB alteration Deposition of electron-dense material Increase synthesis of GBM/ECM components
Pathologic alterations in glomerular disease: Hyalinosis Insudation of plasma proteins in capillary/vessel wall from endothelial injury
Pathologic alterations in glomerular disease: Sclerosis Accumulation of E/C collagens in mesangium or capillary loops
Created by: bcriss