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