Term | Definition |
glomerulonephritis | acute or chronic damage to glomerulus |
components of filtering membrane | 1. fenestrated endothelial cells 2. glomerular basement membrane (GBM) 3. visceral epithelial cells (podocytes) |
mesangial cells | support GBM, contract and stimulate collagen formation |
circulating immune complex nephritis | type III hypersensitivity where antigen-antibody complexes lodge in the glomerulus and cause inflammation and increase protein filtration
-can lodge {subendothelially, subepithelially, or within mesangial cells}
-produces {granular pattern} of IF |
immune complex nephritis in-situ | mediated by antibodies directed by glomerular antigens
-when directed against {fixed antigens}, produces {diffuse linear pattern} |
Goodpasture syndrome | when anti-GBM cross react with lung alveoli basement membrane causing lung and kidney problems |
implanted antigens | did not originate in kidney but already in glomerulus; react with antibody to produce {granular pattern} |
nephrotic syndrome | clinical pattern of glomerular disease; proteinuria, edema, hyperlipidemia and {anasarca} |
minimal change disease | common cause of nephrotic syndrome
loss of podocyte foot processes in electron microscope |
membranous glomerulonephritis (GN) | form of immune complex nephritis in-situ; deposition of immune complexes causes thickening of capillary walls |
nephritic syndrome | hematuria, fluid retention, azotemia and hypertension; more acute than nephrotic with abrupt disease onset: fever, malaise and nausea first |
acute post streptococcal GN | after endogenous antigens, especially after strep |
IgA nephropathy | IgA deposited in mesangium in young people; hematuria 1-2 days after upper respiratory infection
-{most common causes of recurrent hematuria and is most common glomerular disease revealed by renal biopsy} |
chronic glomerulonephritis | extensive scarring of glomerulus; hypertension very common |
tubule-interstitial nephritis | infection of tubules and interstitiium; most often involving the renal pelvis {pyelonephritis} |
vesico-ureteral reflux | urine propelled up to renal pelvis during micturition |
acute pyelonephritis | benign bacterial infection, usually a UTI of {Escherichia coli} but can develop to {cystitis} |
chronic pyelonephritis | gross renal scarring of calyces and pelvis, leads to renal failure |
drug-induced interstitial nephritis | both acute and chronic forms from use of analgesics or antibiotics |
acute drug-induced interstitial nephritis | from taking penicillins or NSAIDs, independent of dose; eosinophilia and rash |
chronic analgesic nephritis (analgesic nephropathy) | cumulative effect of aspirin and acetaminophen that causes {papillary necrosis}
-causes transitional cell carcinoma |
acute tubular necrosis (ATN) | {most common cause of acute renal failure} from destruction of tubular epithelium |
ischemic ATN | associated with shock and inadequate blood flow/ischemia to kidney |
nephrotoxic ATN | occurs from renal poisons like heavy metals or anything directly toxic to tubular cells |
4 phases of ATN | 1. initiating 2. maintenance (very low urine) 3. recovery (lots of urine) 4. final |
benign nephrosclerosis | secondary to benign hypertension, results in {hyaline arteriolosclerosis} |
hyaline arteriolosclerosis | hyalinization and thickening of vessel walls with narrowing of lumen; results in ischemic damage to renal tissues |
malignant nephrosclerosis | results from malignant hypertension (BP>200/120) and leads to {hyperplastic arteriolosclerosis} |
hyperplastic arteriolosclerosis | onion-skin patterns under microscope |
simple cysts | innocuous lesions 1-5 cm with clear fluid, usually in cortex of kidney |
autosomal dominant adult polycystic kidney disease (APKD) | destructive cysts on both kidneys due to defective PKD1 gene; requires a transplant |
urolithiasis | calculus formation in urinary collecting system; painful in ureter and when obstructing lumen
due to: 1. hyper absorption of Ca from intestines or 2. impairment in tubular absorption, not hypercalcemia |
renal cell carcinoma | most common kidney cancer; arises from tubular epithelium and spreads |
Wilms tumor (nephroblastoma) | most common tumor in young kids; arises from mesoderm and can spread to lungs |
carcinoma of the urinary bladder | most are transitional cell, hallmark is painless hematuria
can also be squamous cell carcinoma and adenocarcinomas |