Renal pathology for web

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By: picca (110 month(s) ago)

please email me at stefano.picca@opbg.net

By: picca (110 month(s) ago)

excellent presentation. it would be of much help for my students. stefano picca, md; pediatric nephrologist

By: kimphjones (114 month(s) ago)

Phenomenal presentation. Please e mail it to me on kimphjones@yahoo.com i'll be obliged sir

By: kimphjones (114 month(s) ago)

Brilliant presentation for students. Please Let me download it thanks

By: saxkey (114 month(s) ago)

Excellent slides! Could you kindly share them with me? Thank you so much! My email is saxkey@yahoo.com.

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Presentation Transcript

Slide1: 

Renal Pathology Kristine Krafts, M.D. October 16, 2007

Slide3: 

$2,500,000

Slide4: 

“Like blood, urine is rich in DNA. The Oxidations are portraits of Victor. They're also self-portraits and portraits of assistant Ronnie Cutrone. Doggedly marked territories, they trace signs of identity, even if that identity is unknown (or unknowable).” - Bruce Haines (Art Critic)

Slide5: 

“Art is what you can get away with.” - Andy Warhol

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Diseases involving blood vessels Cystic diseases Tumors

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff

Introductory Stuff: 

Introductory Stuff Functions of the kidney: excretion of waste products regulation of water/salt maintenance of acid/base balance secretion of hormones Diseases of the kidney glomeruli tubules interstitium vessels

Slide10: 

Azotemia:  BUN, creatinine Uremia: azotemia + more problems Acute renal failure: oliguria Chronic renal failure: prolonged uremia Introductory Stuff

Slide11: 

Introductory Stuff

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis Membranous nephropathy Nephritic syndrome Postinfectious GN IgA nephropathy

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome

Nephrotic Syndrome: 

Nephrotic Syndrome Massive proteinuria Hypoalbuminemia Edema Hyperlipidemia, lipiduria

Nephrotic Syndrome: 

Nephrotic Syndrome Adults: systemic disease (diabetes) Children: minimal change disease Characterized by loss of foot processes Causes

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease

Minimal Change Disease: 

Minimal Change Disease #1 cause of nephrotic syndrome in children Loss of foot processes Pathogenesis unknown Good prognosis Things you must know

Slide24: 

Minimal change disease

Slide25: 

Normal glomerulus

Slide26: 

Minimal change disease

Slide27: 

Minimal change disease

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis

Focal Segmental Glomerulosclerosis: 

Focal Segmental Glomerulosclerosis Primary or secondary Some (focal) glomeruli show partial (segmental) hyalinization Unknown pathogenesis Poor prognosis Things you must know

Slide30: 

Focal segmental glomerulosclerosis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis Membranous glomerulonephritis

Membranous Glomerulonephritis: 

Membranous Glomerulonephritis Autoimmune reaction against unknown renal antigen Immune complexes Thickened GBM Subepithelial deposits/spikes Things you must know

Slide33: 

Membranous glomerulonephritis

Slide34: 

Membranous glomerulonephritis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis Membranous glomerulonephritis Nephritic syndrome

Nephritic Syndrome: 

Nephritic Syndrome Hematuria Oliguria, azotemia Hypertension

Nephritic Syndrome: 

Nephritic Syndrome Post-infectious GN, IgA nephropathy Immunologically-mediated Characterized by proliferative changes and inflammation Causes

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis Membranous glomerulonephritis Nephritic syndrome Postinfectious GN

Post-Infectious Glomerulonephritis: 

Post-Infectious Glomerulonephritis Child after strep throat Immune complexes Hypercellular glomeruli Subepithelial humps Things you must know

Post-Infectious Glomerulonephritis: 

Post-Infectious Glomerulonephritis “Sore throat, face bloat, pee coke” Mnemonic

Slide41: 

Post-infectious glomerulonephritis

Slide42: 

Post-infectious glomerulonephritis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis Membranous glomerulonephritis Nephritic syndrome Postinfectious GN IgA nephropathy

IgA Nephropathy: 

IgA Nephropathy Common! Child with hematuria after URI IgA in mesangium Variable prognosis Things you must know

Slide45: 

IgA nephropathy

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Inflammatory lesions pyelonephritis drug-induced interstitial nephritis Toxic/ischemic lesions Acute tubular necrosis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Inflammatory lesions pyelonephritis

Pyelonephritis: 

Pyelonephritis Invasive kidney infection Usually ascends from UTI Fever, flank pain Organisms: E. coli, Proteus Things you must know

Slide49: 

Acute pyelonephritis with abscesses

Slide50: 

Pyelonephritis

Slide51: 

Pyelonephritis

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Cellular cast

Pyelonephritis: 

Pyelonephritis Women, elderly Patients with catheters or malformations Dysuria, frequency Organisms: E. coli, Proteus Urinary Tract Infection

Pyelonephritis: 

E. coli uncomplicated complicated Pyelonephritis UTI: Causative Organisms

Slide56: 

Urinary catheter colonized by Proteus

Slide57: 

Chronic pyelonephritis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Inflammatory lesions pyelonephritis drug-induced interstitial nephritis

Drug-Induced Interstitial Nephritis: 

Drug-Induced Interstitial Nephritis Antibiotics, NSAIDS IgE and T-cell-mediated immune reaction Fever, eosinophilia, hematuria Patient usually recovers Analgesic nephritis is different (bad) Things you must know

Slide60: 

Drug-induced interstitial nephritis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Inflammatory lesions pyelonephritis drug-induced interstitial nephritis Toxic/ischemic lesions Acute tubular necrosis

Acute Tubular Necrosis: 

Acute Tubular Necrosis The most common cause of ARF! Reversible tubular injury Many causes: ischemic (shock), toxic (drugs) Most patients recover Things you must know

Slide63: 

Acute tubular necrosis

Slide64: 

Acute tubular necrosis

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Diseases involving blood vessels Benign nephrosclerosis Malignant nephrosclerosis

Benign Nephrosclerosis: 

Benign Nephrosclerosis Found in patients with benign hypertension Hyaline thickening of arterial walls Leads to mild functional impairment Rarely fatal Things you must know

Slide67: 

Benign nephrosclerosis

Malignant nephrosclerosis: 

Malignant nephrosclerosis Arises in malignant hypertension Hyperplastic vessels Ischemia of kidney Medical emergency Things you must know

Malignant nephrosclerosis: 

Malignant nephrosclerosis 5% of cases of hypertension Super-high blood pressure, encephalopathy, heart abnormalities First sign often headache, scotomas Decreased blood flow to kidney leads to increased renin, which leads to increased BP! 5y survival: 50% Malignant Hypertension

Slide70: 

Malignant hypertension

Slide71: 

Malignant hypertension

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Diseases involving blood vessels Cystic diseases Adult polycystic kidney disease Childhood polycystic kidney disease Medullary cystic disease

Adult Polycystic Kidney Disease: 

Adult Polycystic Kidney Disease Autosomal dominant Huge kidneys full of cysts Usually no symptoms until 30s Associated with brain aneurysms Things you must know

Slide74: 

Adult polycystic kidney disease

Childhood Polycystic Kidney Disease: 

Childhood Polycystic Kidney Disease Autosomal recessive Numerous small cortical cysts Associated with liver cysts Patients often die in infancy Things you must know

Slide76: 

Childhood polycystic kidney disease

Medullary Cystic Kidney Disease: 

Medullary Cystic Kidney Disease Chronic renal failure in children Complex inheritance Kidneys contracted, with many cysts Progresses to end-stage renal disease Things you must know

Renal Pathology Outline: 

Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and interstitial diseases Diseases involving blood vessels Cystic diseases Tumors Renal cell carcinoma Bladder carcinoma

Renal Cell Carcinoma: 

Renal Cell Carcinoma Derived from tubular epithelium Smoking, hypertension, cadmium exposure Hematuria, abdominal mass, flank pain If metastatic, 5y survival = 5% Things you must know

Slide80: 

Renal cell carcinoma

Slide81: 

Renal cell carcinoma

Slide82: 

Renal cell carcinoma

Bladder Carcinoma: 

Bladder Carcinoma Derived from transitional epithelium Present with painless hematuria Prognosis depends on grade and depth of invasion Overall 5y survival = 50% Things you must know

Slide85: 

Bladder carcinoma

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