The Kidneys

Major Topics for Discussion Review of anatomy and physiology Congenital anomalies Glomerular diseases Vascular diseases Kidney stones Neoplasia

Glomerulus

PAS Stain of Normal Glomerulus - Capillary Loops within Bowman’s Capsule

Normal Glomerulus

(Renal Filter Unit)

Congenital Anomalies

Horseshoe Kidney

Cystic Renal Dysplasia

Polycystic Kidney Disease

HorseshoeKidney

Cystic Renal Dysplasia

Autosomal Dominant Polycystic Kidney Disease

Glomerular Diseases

Nephrotic Syndrome (proteinuria, lipidemia, edema)

Nephritic Syndrome (hematuria, oliguria, hypertension)

Electron Micrograph of the Glomerular Filter - from Capillary Lumen, across the Basement Membrane to the Urinary Space

Pathogenesis of Nephrotic Syndrome

“Minimal Change

Nephrotic Syndrome”

Pathogenesis of Inflammatory Glomerulopathy (Glomerulonephritis)

Anti-GBM antibody

Immune complex

Anti-neutrophil

cytoplasmic antibody

Focal Segmental Glomerulosclerosis

Silver Stain….

HIV-Associated Nephropathy

Pathogenesis of Membranous

Glomerulopathy

( immune complex disease)

Immunofluorescence Demonstration of Immune Complex Proteins Deposited in the Glomerular Basement Membrane

Pathogenesis of Diabetic

Glomerulopathy

PAS Stain….

Diabetic Glomerulopathy

Pathogenesis of Amyloid

Nephropathy

Pathogenesis of Amyloid

Nephropathy

Post-Infectious Glomerulonephritis

Post-Strep Nephritis (Immune Complexes)

Anti-Glomerular Basement Membrane Antibody Disease

Crescentic Anti-GBM Glomerulonephritis

Pathogenesis of Crescentic

(Rapidly Progressive)

Glomerulonephritis

Vascular Diseases

Hypertensive (Benign) Nephrosclerosis

Embolism & Infarction

Shock & Renal Cortical Necrosis

Acute Tubular Necrosis

Benign Nephrosclerosis

(Hypertension)

Renal Infarct

(Embolism)

Renal Cortical Necrosis

(Shock)

Pathogenesis of Acute Tubular Necrosis (ATN)

Obstruction Acute Renal Failure

Pathogenesis of Pyelonephritis

Mechanisms of Acute & Chronic Pyelonephritis

Acute Pyelonephritis

Neutrophils are present in the collecting tubules and interstitial tissue.

Chronic Pyelonephritis

Bisected Kidney Shows Papillary Necrosis

Renal Stones and Urinary Tract Obstruction

Staghorn Calculi

Calcium

Infection

Uric acid

Nephrolithiasis

Hydronephrosis

Complication of Urinary Tract Obstruction

Neoplasia

Wilms Tumor (most common abdominal solid tumor in children)

Renal Cell Carcinoma(most common kidney cancer - 90%)

Wilms Tumor

Renal Cell Carcinoma

Path Key Words Acute

glomerulonephritis Acute renal failure Acute tubular necrosis Adult polycystic kidney

disease Cystic renal dysplasia Hematuria Hydronephrosis

Minimal change nephrotic syndrome

Nephrotic syndrome Oliguria Pyelonephritis Renal cell carcinoma Urolithiasis Wilms tumor