Lecture 13 - Glomerulonephritis And Histolgy Of Glomerulus Flashcards
What is glomerulonephritis?
Inflammation of the glomeruli
What are the 2 types of glomerulonephritis?
Nephritic
Nephrotic
What is the Renal corpuscle?
The Bowmanns capsule and the glomerulus
Go to the last slide (Image 1):
Identify the Renal corpuscle:
-glomerulus
-Bowmanns capsule
Identify:
PCT
DCT
Capilary lumens
Erase the pink on the image below to see
You can distinguish between the PCT and DCT since the PCT has a brush border which is blurry whereas the DCT has no brush border so it is clear near lumen
Go the last slide and look at histology slide 2:
Identify a:
Capillary lumen
Podocyte
PCT
Erase the pink on the image below to see
Go to the last slide, look at slide 3:
Identify the:
Bowmanns capsule
Afferent arteriole
DCT
Juxtaglomerular apparatus/macula densa cells
Peritubular capilaries
Remove the pink to reveal
The afferent arteriole could very well be the efferent arteriole it’s impossible to know without full depth image
Go to the last slide :
Look at slide 4
Label the structures:
What part of the kidney are we in and why?
1 = PCT (brush border visible)
2 = DCT (no brush border visible)
3 = peritubular capillary
Likely medulla not cortex since no renal corpuscles are visible
Not deep medulla since no loops of Henle visible
Look at the last slide:
Look at slide 5
Located the hairpin bend of the Loop Of Henle (remove pink to the right to reveal)
Label the structures 1 and 2
1 = thin descending limb of LoH
2 = thick ascending limb of LoH
What are the 4 structures of the glomerulus than can be inflammed/damaged in glomerulonephritis?
Capillary endothelium
Glomerular basement membrane
Mesangial cells
Podocytes
What is NephrItic syndrome?
Inflammation disrupting the basement membrane of the glomerulus
What is a key presentation of Nephritic syndrome?
Haematuria
Why does Haematuria occur in Nephritic syndrome?
Inflammation of basement membrane leads to the fenestrations of the basement membrane getting larger so RBCs can escape into urine
What colour does the urine appear in Nephritic syndrome?
Brown coloured
What is nephrotic syndrome?
Podocyte damage leading to the charged barrier of the glomerulus being lost
What is a key presentation of Nephrotic syndrome?
Due to Podocyte damage get massive Proteinuria
And therefore
Oedema
Albumin not repelled by the negatively charged footprocesses (they’re damaged)
How can you remember the difference between Nephritic and Nephrotic syndrome?
NephrItic has the I for Inflammation of basement membrane leading to Haematuria
NephrOtic syndrome has the O for Oedema caused by the damage of the Podocyte foot processes
What is the triad seen in nephrotic syndrome?
Proteinuria
Hypoalbuminaemia
Oedema
Why are cholesterol levels often high in nephrotic syndrome?
As a result of the body trying to make more albumin cholesterol levels increase
What is a key change in the urine of a patient with nephrotic syndrome?
Proteinuria
What are some Primary Renal Diseases that cause Nephrotic syndrome?
Minimal change disease (MCD)
Membranous glomerulonephritis
Focal Segmental GlomeruloSclerosis (FSGS)
What is meant by a primary renal disease?
Where the glomerulus itself is affected
What is the most common cause of nephrotic syndrome which is a type of secondary renal disease?
Diabetes
How does diabetic nephropathy lead to end stage renal disease (CKD)?
Chronic hyperglycaemia leads to hyperfiltration (lots of Na+ removed from filtrate)
This leads to activation of RAAS increasing GFR
This hypertension and increased RAAS damages glomerular capillaries
Leads to inflammation and fibrosis in the kidney as well as extracellular matrix accumulation in the glomeruli
Damage to filtration barrier
How is diabetic nephropathy treated?
Anti - Hypertensives
ACEi
Angiotensin receptor blockers
