Most common congenital renal anomaly, kidney gets caught on inferior mesenteric artery
Horseshoe Kidney
Absent kidney formation - bilateral = oligohydramnios with lung hypoplasia, flat face with low set ears, defects of the extremities (Potter sequence)
Renal Agenesis
Noninherited congenital malformation of the renal parenchyma, cysts
Dysplastic Kidney
Inherited defect, cysts in cortex and medulla, appears in infants, congenital hepatic fibrosis and hepatic cysts
Autosomal Recessive Polycystic Kidney Disease
Inherited defect, cysts in cortex and medulla, appears in young adults with HTN, hematuria, and worsening renal failure, berry aneurysm, hepatic cysts, mitral valve prolapse
Autosomal Dominant Polycystic Kidney Disease
Cysts in collecting ducts, shrunken kidneys
Medullary Cystic Kidney Disease
Inflammatory infiltrate in interstitium, caused by NSAIDS, penicillin, and diuretics
Acute Interstitial Nephritis
Caused by chronic NSAID use, DM, sickle cell, severe acute pyelonephritis
Renal Papillary Necrosis
Normal glomeruli with effacement of foot processes responds to steroids, common in kids
Minimal Change Disease (nephrotic syndrome)
Associated with HIV, heroin use, and sickle cell disease, common in Hispanics and African Americans, effacement of foot processes, no response to steroids
Focal Segmental Glomerulosclerosis (nephrotic syndrome)
Associated with Hep B, solid tumors, SLE, or drugs, common in Caucasian adults, thick BM due to immune complex deposition (granular appearance on IF, spike and dome on EM)
Membranous Nephropathy
Can be Type 1 (associated with HBV and HCV) or Type 2 (associated with C3 nephritic factor), thick BM due to immune complex deposition (granular IF, tram track appearance on H&E)
Membranoproliferative Glomerulonephritis (nephritic AND/OR nephrotic syndrome)
Sclerosis of mesangium, nonenzymatic glycosylation of vascular BM leading to hyalinr arteriolosclerosis, efferent arteriole more affected
Diabetes Mellitus (nephrotic syndrome)
Congo red stain with apple-green birefringence under polarized light
Systemic Amyloidosis (nephrotic syndrome)
Hypoalbuminemia, hypogammaglobulinemia, hypercoagulable state, hyperlipidemia and hypercholesterolemia
Nephrotic Syndrome
Oliguria and azotemia, salt retention, periorbital edema, hypertension, RBC casts and dysmorphic RBCs in urine
Nephritic Syndrome
Cola-colored urine, oliguria, HTN, mediated by immune complexes (granular IF and subepithelial humps on EM)
Poststreptococcal Glomerulonephritis (nephritic syndrome)
Crescents in Bowman space made of fibrin and macrophages, renal failure within weeks to months, can be linear (Goodpastures), granular (PSGN, SLE), or negative IF (GPA, Churg-Strauss)
Rapidly Progressive Glomerulonephritis (nephritic syndrome)
Immune complex in mesangium of glomeruli, hematuria with RBC casts
IgA Nephropathy (Berger Disease, nephritic syndrome)
Infection of the bladder, most commonly E.coli, pyuria and positive culture
Cystitis
Infection of the kidney, WBC casts, increased risk with vesicoureteral reflux, E. coli most common
Pyelonephritis
Interstitial fibrosis, due to vesicoureteral reflux or obstruction, cortical scarring with blunted calyces, thyroidization of the kidney
Chronic Pyelonephritis
Common causes are DM, HTN, and glomerular disease, presents with uremia, salt and water retention, hyperkalemia, metabolic acidosis, anemia, hypocalcemia, and renal osteodystrophy
Chronic Renal Failure
Vessel, smooth muscle, and fat hamartoma
Angiomyolipoma
Classic triad of hematuria, palpable mass, and flank pain, can have paraneoplastic syndrome, can involve renal vein, loss of VHL tumor suppressor gene (increased IGF-1 and HIF-alpha), sporadic or hereditary, most common cell type is clear cell
Renal Cell Carcinoma
Most common tumor in children, large unilateral flank mass, comprised of blastema, can be seen with WAGR or Beckwith-Wiedemann syndrome
Wilms Tumor
Horseshoe Kidney
Most common congenital renal anomaly, kidney gets caught on inferior mesenteric artery
Renal Agenesis
Absent kidney formation - bilateral = oligohydramnios with lung hypoplasia, flat face with low set ears, defects of the extremities (Potter sequence)
Dysplastic Kidney
Noninherited congenital malformation of the renal parenchyma, cysts
Autosomal Recessive Polycystic Kidney Disease
Inherited defect, cysts in cortex and medulla, appears in infants, congenital hepatic fibrosis and hepatic cysts
Autosomal Dominant Polycystic Kidney Disease
Inherited defect, cysts in cortex and medulla, appears in young adults with HTN, hematuria, and worsening renal failure, berry aneurysm, hepatic cysts, mitral valve prolapse
Medullary Cystic Kidney Disease
Cysts in collecting ducts, shrunken kidneys
Prerenal Azotemia
Serum BUN:Cr ratio >15, decreased blood flow means decreased GFR, FENa
Postrenal Azotemia
Early stages serum BUN:Cr ratio>15 and FENa 2%
Acute Tubular Necrosis
Necrotic cells plug tubules, brown granular casts in urine, serum BUN:Cr 2%, ischemic or nephrotixic
Acute Interstitial Nephritis
Inflammatory infiltrate in interstitium, caused by NSAIDS, penicillin, and diuretics
Renal Papillary Necrosis
Caused by chronic NSAID use, DM, sickle cell, severe acute pyelonephritis
Minimal Change Disease (nephrotic syndrome)
Normal glomeruli with effacement of foot processes responds to steroids, common in kids
Focal Segmental Glomerulosclerosis (nephrotic syndrome)
Associated with HIV, heroin use, and sickle cell disease, common in Hispanics and African Americans, effacement of foot processes, no response to steroids
Membranous Nephropathy
Associated with Hep B, solid tumors, SLE, or drugs, common in Caucasian adults, thick BM due to immune complex deposition (granular appearance on IF, spike and dome on EM)
Membranoproliferative Glomerulonephritis (nephritic AND/OR nephrotic syndrome)
Can be Type 1 (associated with HBV and HCV) or Type 2 (associated with C3 nephritic factor), thick BM due to immune complex deposition (granular IF, tram track appearance on H&E)
Diabetes Mellitus (nephrotic syndrome)
Sclerosis of mesangium, nonenzymatic glycosylation of vascular BM leading to hyalinr arteriolosclerosis, efferent arteriole more affected
Systemic Amyloidosis (nephrotic syndrome)
Congo red stain with apple-green birefringence under polarized light
Nephrotic Syndrome
Hypoalbuminemia, hypogammaglobulinemia, hypercoagulable state, hyperlipidemia and hypercholesterolemia
Nephritic Syndrome
Oliguria and azotemia, salt retention, periorbital edema, hypertension, RBC casts and dysmorphic RBCs in urine
Poststreptococcal Glomerulonephritis (nephritic syndrome)
Cola-colored urine, oliguria, HTN, mediated by immune complexes (granular IF and subepithelial humps on EM)
Rapidly Progressive Glomerulonephritis (nephritic syndrome)
Crescents in Bowman space made of fibrin and macrophages, renal failure within weeks to months, can be linear (Goodpastures), granular (PSGN, SLE), or negative IF (GPA, Churg-Strauss)
IgA Nephropathy (Berger Disease, nephritic syndrome)
Immune complex in mesangium of glomeruli, hematuria with RBC casts
Cystitis
Infection of the bladder, most commonly E.coli, pyuria and positive culture
Pyelonephritis
Infection of the kidney, WBC casts, increased risk with vesicoureteral reflux, E. coli most common
Chronic Pyelonephritis
Interstitial fibrosis, due to vesicoureteral reflux or obstruction, cortical scarring with blunted calyces, thyroidization of the kidney
Chronic Renal Failure
Common causes are DM, HTN, and glomerular disease, presents with uremia, salt and water retention, hyperkalemia, metabolic acidosis, anemia, hypocalcemia, and renal osteodystrophy
Angiomyolipoma
Vessel, smooth muscle, and fat hamartoma
Renal Cell Carcinoma
Classic triad of hematuria, palpable mass, and flank pain, can have paraneoplastic syndrome, can involve renal vein, loss of VHL tumor suppressor gene (increased IGF-1 and HIF-alpha), sporadic or hereditary, most common cell type is clear cell
Wilms Tumor
Most common tumor in children, large unilateral flank mass, comprised of blastema, can be seen with WAGR or Beckwith-Wiedemann syndrome
Decreased blood flow means decreased GFR, BUN:Cr ratio > 15, FENa
Prerenal Azotemia
Early stages has BUN:Cr > 15% and FENa 2%
Postrenal Azotemia
Necrotic cells plug tubules, brown granular casts, can be due to ischemic or nephrotic causes, BUN:Cr 2%
Acute Tubular Necrosis
