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OPT Kidney

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
Created by: aharnold