Flashcards in L56 Deck (22)
What are histo changes that indicate chronic kidney disease?
Lose fxn tissue
↑Fibrosis = renal atrophy
Name some causes of chronic kidney disease
HTN -> nephrosclerosis
Multiple myeloma -> amyloidosis
What is nephrosclerosis?
Changes in kidney due to chronic HTN
Implies benign aka long standing HTN
Gross appearance of the kidneys due to nephrosclerosis
Histology of nephrosclerosis
1. Hyaline arteriosclerosis: PAS+
2. Medial hypertrophy: hyperplasia of elastic layers in the small vessels
- Small cortex
- Thick arteries
- Crowded glomeruli
Describe hyaline arteriosclerosis
Chronic HTN or diabetes
Protein -> vasc wall -> thicker
Seen as pink
↓Vessel diameter -> end organ ISCHEMIA
Glomerular scarring = arteriolo-nephro-sclerosis
What are the 2 effects of ischemia due to nephrosclerosis?
1. Interstitial fibrosis
2. Glomerular sclerosis
What changes happen to the kidney during malignant HTN?
1. "Flea bitten" hemorrhages as arterioles/capillaries rupture w/ high pressure
1. Fibrinoid necrosis of arterioles
2. Onion skinning = concentric, lumen narrows
Describe onion skinning
Ex of hyperplastic arteriolo-sclerosis
Hyperplasia of SM -> thickened vessel wall
What are the 2 causes of renal artery sclerosis?
1. Fibromuscular dysplasia - young women
2. Atherosclerosis - older pts
- Cholesterol plaques
When do you care about heterogenous wall thickening of the artery3 in the setting of renal artery sclerosis?
Causes more turbulent BF
What is the shape of an infarct caused by an embolus to the kidney?
Infarcted area will then scar
What 3 histo changes would make you think diabetic glomerulosclerosis? How do these translate into lab findings?
↑Mesangial matrix (nodules)
Thick basement membranes
2. Non-nephrotic and nephrotic proteinuria
Pathology of kidney changes in diabetes
Glycosylation structurally alters proteins
Vascular basement membrane becomes thick and leaky
PCKD: dominant or recessive? Unilat or bilat?
AD but presents progressively
- PKD1, chr 16
- PKD2, chr 4
Inolved in cell-cell matrix interactions
Initial presentation of PCKD
What are extra-renal manifestations of PCKD that you should be thinking of?
Cysts in other organs
Stains for renal amyloidosis
Apple green birefringence
Pathogenesis of renal amyloidosis
Systemic amyloidosis: deposit of AL or AA`
Clinical presentation of renal amyloidosis
Nephrotic: heavy proteinuria
To chronic renal failure
What type of amyloid deposits in the kidney during multiple myeloma
AL - duh excess light chain