Pathology of Renal disease

Question 1

How does kidney work

Answer 1

Filters 180 litres of blood per day 
Resorbs 178 litres per day
2 litres of urine per day 
Interstitial exists between glomerular capillary and tubules 
Tubules are where urine is produced

Question 2

What passes through

What doesn’t pass through

Answer 2

Urea
Creatinine

Proteins

Question 3

What can go wrong - glomerular

Answer 3

Lack of filtration - particles accumulate leading to blocked filter

• lack of glomeruli to filter e.g by sclerosis
• groups of glomeruli die off and become granular
• can lead to chronic hypertension

Lack of blood supply therefore flow - blood pressure not high enough to create filtrate

Too much filtration - leaky membranes - particles pass through which shouldn’t be e.g albumin and plasma proteins

• leads to proteinuria
• loss of albumin results in nephrotic syndrome

Question 4

Cause of blocked filter

3 causes

nothing to see

proteins

cells

Answer 4

Blood pressure starts to rise once certain percentage of filtration apparatus is blocked

minimal change
glomerularnephritis

proteins deposited in filter - membranous glomerular nephritis

inflammatory cells
proliferative glomerular nephritis

Question 5

What can go wrong - tubular

Answer 5

1. too little reabsorption - faulty tubules
2. tubular dysfunction - lack of blood supply leads to acute tubular necrosis - susceptible to toxins
3. blocked/inflamed - calcium phosphate crystals involved in bowel prep - bacteria, neutrophils and macrophages colonise and block tubules
4. tubule mass necrosis

Question 6

What can go wrong - neoplasia

Answer 6

1. tumours can develop e.g renal cell carcinoma

Question 7

Renal cell carcinoma

Risk factors

Answer 7

3% of all cancers
cigarette smoking

Obesity
dialysis