Flashcards in Renal Deck (57)
What characterizes Renal dysplasia?
Undifferentiated Tubular Structures surrounded by primitive mesenchyme, sometimes with heterotropic tissue such as smooth muscle and cartilage
What does renal dysplasia result from?
What are the subtypes of RENAL DYSPLASIA?
What is the most common cause of an abdominal mass in newborns? What otheer mass can be palpated in newborns with this disease?
Unilateral multicystic renal dysplasia
What characterizes Medullary sponge kidney?
Multiple small cysts in the renal papillae
What are the symptoms of AD PKD?
Heaviness in the loins
B/L Flank Mass
Passage of Blood Clot in the Urine
1/2 progress to uremia (clinical renal failure)
Morphological changes in what part of the kidney do the following syndromes share in common (Amyloid nephropathy, FSGS, Hereditary Nephritis, Membranous glomerulopoathy)?
What causes Amyloid Nephropathy?
Deposition of secreted lambda or kappa light chains in the glomerular basement membranes and mesangial matrix. Amorphous acellular material expands the mesangium and obstructs the glomerular capillaries.
The immunoglobulin chains are secreted by neoplastic plasma cells.
Where else other than GBM can deposits of AL amyloid appear?
Tubular Basement membranes
Walls of Renal Vessels
Amyloid deposits are identified by? not identified by?
Congo Red apple-green
Not PAS - it is not PAS positive
What does Renal amyloidosis lead to ?
What characterizes MCD?
Fusion (effacement) of visceral epithelial foot processes on EM (from cell selling as seen in all cases in nephrotic range proteinuria)
Normal glomeruli in light microscopy
Where are granular deposits found in the glomeruli of patients affected by Membranous proliferative glomerulonephritis?
Glomerular capillary Loops and Mesangium
What are the range of possible prognosis of membranous glomerulonephropathy?
Spontaneous Remission (25%)
Persistent proteinuria and stable/partial loss of renal function (50%)
Renal Failure (25%)
Subendothelial deposits of immune complexes are found in what diseases?
What might distinguish membranous nephropathy due to lupus from idiopathic membranous nephropathy?
Membranous nephropathy of lupus also features mesangial and subendothelial deposits of immunogloobulins. (not just along BM)
Granulomatous lesions resulting from Wgener granulomatosis can be found where in the body?
The nose, sinuses, lungs, and is associated with renal glomerular disease
Wegner granulomatous necrotic lesions are characterized by?
Granulomatous inflammation (composed of neutrophils, plasma cells, and macrophages)
What characterizes ANCA glomerulonephritis?
It is an aggressive, Neutrophil-mediated disease characterized by glomerular necrosis and crescents.
Neutrophils adhere to endothelial cells, release toxic oxygen metabolites, degranulate, and kill the endothelial cells.
Exudation of inflammatory cells through the disrupted, segmentally necrotic basement membrane leads to the formation of the crescents.
In FSGS, what findings are expected upon light microscopy?
Varying numbers of glomeruli with segmental obliteration of capillary loops
( obliteration caused by increased collagen and the accumulation of lipid or proteinaceous material.)
ON renal biopsy, what is the diagnostic findings of Berger Diseaes?
Intense Mesangial staining for IgA often accompanied by C3 staining (activates complement through the alternative pathway)
(There is a range of nephropathies seen on light microscopy: no changes to chronic sclerosing glomerulonephritis)
What groups of diseases demonstrate Focal proliferative glomerulonephritis pathology?
Nephritis that accompanies several vasculitides, Henoch-Schonlein Purpura, IgA Nephropathy (Berger Disease)
Ultrastructural features of acute postinfectious glomerulonephritis include
Subepithelial dense deposits shaped like 'humps'.
Deposits are accompanied by mesangial and subendothelial deposits which may be more difficult to find but more important in pathogenesis because of their proximity to inflammatory mediator systems in the blood.
What is Diffuse proliferative glomerulonephritis?
Severe form of lupus nephritis, characterized by widespread involvement of glomeruli and diffuse proliferation of mesangial and endothelial cells and even of epithelial cells.
What is most common complication of SLE?
What are microscopic findings of proliferative glomerulonephritis
EM: Deposits of immune complexes on both sides of the basement membrane, in the mesangial areas, and even inside the capillary loops
Thickened BM of the glomeruli are known as "wire loop" lesions.
90% of patients with what glomerular patholgoy have glomerular crescents(crescentic glomerulonephritis)
Patients with anti-GBM glomerulonephritis
What does Anti-GBM glomerulonephritis typically present with?
Rapidly Progressive Renal Failure
Nephritic Signs and Symptoms
Linear immunofluorescence for Ig G is seen along the GBM
Secondary membranous nephropathy causes
Autoimmune Disease (ex SLE)
Infectious Diseases (Hep B)
Therapeutic Agents (ex. Penicillamine)
Malignancy (Paraneoplastic Syndrome is membranous nephropathy)