Renal pathology
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Transcript of Renal pathology
FUNDAMENTALS OF RENAL PATHOLOGY
Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis and characterization of medical diseases (non-tumor) of the kidneys.
In the academic setting, renal pathologists work closely with nephrologists and transplant surgeons, who typically obtain diagnostic specimens via percutaneous renal biopsy.
The renal pathologist must synthesize findings from light microscopy, electron microscopy, and immunofluorescence to obtain a definitive diagnosis.
Medical renal diseases may affect the glomerulus, the tubules and interstitium, the vessels, or a combination of these compartments.
NORMAL HISTOLOGY
THE GLOMERULUS
Typical stains used in renal evaluating renal biopsy
ELECTRON MICROGRAM
Clinical Presentations of Glomerular Diseases
symptomatic proteinuria
•nephrotic syndrome
(proteinuria, hypoproteinemia, lyperlipidemia, edema)
•asymptomatic hematuria
•glomerulonephritis
(hematuria, proteinuria, hypertension, renal failure)
•acute glomerulonephritis
(neprhitis with short term renal failure)
•crescentic glomerulonephritis
(nephritis with rapidly progressive renal failure)
•chronic glomerulonephritis
(chronic progression of renal failure)
•End Stage Renal Disease
(irreversible renal failure)
The Nephrotic Syndrome
The nephrotic syndrome is characterized by massive proteinuria, which leads to hypoproteinemia/hypoalbunemia, hyperlipidemia with elevated cholesterols, triglicerides and other lipids, and edema.
The edema results not only from the hypoosmolar state caused by the loss of plasma proteins, but also from abnormal salt and water retention.
Histologic feature that is found in any patient with nephrotic range proteinuria no matter what the cause
OVAL FAT BODIES
Minimal Change Glomerulopathy
IF
ULTRA STRUCTURE
Membranous Glomerulopathy
H&E
SPECIAL STAINS
IA
L STAINS
ELECTRON MICROGRAM
IF
Focal Segmental Glomerulosclerosis
H&E
IF
Type I Membranoproliferative (Mesangiocapillary) Glomerulonephritis
IF
ELECRON MICRGRAM
IF
ELECTRON MICROGRAM
Type II Membranoproliferative Glomerulonephritis, (Dense Deposit Disease)
ELECTRON MICROGRAM
IF
REFFERENCE
www.uncnephropathology.org/jennette/tutorial.htm