Renal Partners
Anti-GBM (non-collagen domain of Type
IV collagen)
Nephrotic Syndrome
Nephritic Syndrome
Azotemia
Chronic renal failure
Slit Diaphragm
Post-streptococcal glomerulonephritis
Lab
Post-streptococcal glomuerulonephritis
Morphology
IgA nephropathy (Berger Disease)
Morphology
Reccurence Allografts
Henoch-Schlonlein Purpura
Henoch-Schonlein Purpura Cinical
Presentation
Goodpasture Syndrome (CP)
Goodpasture Syndrome Morphology
Crescent Gloumerular Nephritis
Wegener Glomerulonephritis (CP)
Goodpasture disease
-Thickening of the basement membrane
-Proteinuria >3g/24 hrs (“frothy urine”)
-Hematuria
-RBC cast
-Hypertension
-Azotemia
Elevated BUN and creatinine
Hyalinzation and sclerosis
-Composed of nephrin and podocin
-Nephrin molecules are joined by
disulfide bridges
-Anti-streptolysin O titers
-Low complement
-LM: mesgial cell proliferation
-IF: lumpy-bumpy; coarse granular
depositis of IgG and C3
-EM: subepithelial electron dense humps
-LM and IF: diffuse mesangial IgA
-IgA nephropathy
-Focal Segmental Glomerulosclerosis
Membranoproliferative
glomerulonephritis Type I
-Increase in serum IgA
-IgA deposit kidney and skin
-Skin: Palpable red rash
-Kidney: Hematuria
-GI: abdominal pain
-Purpura from vasculitis (no bleeding
disorder)
-Hematuria
-Hemoptysis
-LM: necrosis crescents
-IF: Linear peripheral IgG deposits in
glomerular BM and alveolar septae
-Leakage of fibrin in Bowman’s space
-Rapidly progressive glomerular
nephritis
-Sinusitis
-Pneumonitis
-Glomerulonephritis
Renal Partners 1
Polyarteritis Nodosa Lab
Wegener Glomerulonephritis
Morphology
Polyarteritis Nodosa Lab
HUS
SLE Secondary Nephritic Syndrome
Morphology
Scleroderma Secondary Nephritic
Syndrome
Nephritic Syndrome
Nephrotic Syndrome
Lipid Nephrosis
Lipid Nephrosis Morphology
Minimal change disease
-Previous HepB infection
-eosinphilia
-pANCA
-LM: cresents
-Renal
-Skin
-GI
-Microangiopathic hemolytic anemia
-E. coli 0157:H7
-Hematuria
-Uncooked hamburger
-Schistocytes
-IF: IgG and C3 in mesangium and
tubules
-IF: Full house fluorescence
-EM: subendothelial and mesangial
deposits
-Anti-Scl70
-HTN
-Raynaud’s
-Post-streptococcal Glomerulonephritis
-IgA Nephropathy
-Henoch-Schonlein Purpura
-Goodpasture Syndrome
-Cresent glomerulonephritis
-Wegener Granulomatosis
-Polyarteritis Nodosa
-HUS
-Secondary to SLE and Scleroderma
-Lipid Nephrosis
-Minimal Change disease
-Focal-Segmental Glomerulosclerosis
-Membranous glomerulonephritis
-Membranoproliferative
glomerulonephritis
-Secondary Diabetes and Amyloides
-Children
-Recurrent nephrotic syndrome
-Selective proteinuria (albumin)
-T-cells derived factors caused podocyte
damage and effacement
-EM: Podocyte fusion
-Hodgkins lymphoma
Renal Partners 2
-Nephrotic syndrome
Focal Segmental Glomerulosclerosis
-No response to steroids
-Mixed nephritic/nephrotic syndrome
Focal Segmental Glomerulosclerosis
-LM: Juxtamedullary glomeruli focal
Morphology
sclerosis which spreads superficially as
the disease progresses
Focal Segmental Glomerulosclerosis
-C1q deposits
(FSGS) Types
-Collapsing with HIV
Collapsing (FSGS)
-Collpase of the entire glomerulus
-Podocyte hyperplasia associated with
HIV drugs
Membranous Glomerulonephritis
-HepB
Predisposing Factors
-Non-Hodgkins Lymphoma
Membranous Glomerulonephritis
-LM: thickened BM
Morphology
-IF: Fine granular peripheral IgG and C3
-EM: 4 stages
Membranous Glomerulonephritis EM
1. Epimembranous deposits
four stages
2. Intramembranous deposits and spikes
3. Intramembranous deposits
4. Radioluscents areas
Membranoproliferative
-Type 1: Mesangiocapillary
glomerulonephritis Types
-Type 2: Dense deposit disease
Membranoproliferative
-Hypertension, hematuria, hearing
glomerulonephritis Type I
problems
Membranoproliferative
-LM: lobular pattern proliferation
glomerulonephritis Type I Morphology
increased mesangial matrix thickening of
BM
-IF: C3 deposits in a peripheral lobular
distribution
EM: mesangialization
Silver stain: split basement membrane
(tram track)
Membranoproliferative
-LM: lobular pattern proliferation
glomerulonephritis Type II Morphology
increased mesangial matrix thickening of
BM
-IF: discontinuous linear deposit of C3
peripheral
-EM: Ribbon-like deposits in lamina
densa
Diabetes Secondary Nephrotic Syndrome -Kimmelsteil-Wilson disease
-Microangiopathy leading to BM
sclerosis
Diabetes Secondary Nephrotic Syndrome -LM: nodular sclerosis; hyalinization of
Morphology
afferent and efferent arteriles
Renal Partners 3
Amyloidosis Secondary Nephrotic
Syndome Morphology
RBC cast
Oval fat body
WBC cast
Papillary Necrosis (CP)
Papillary Necrosis etiology
Papillary Necrosis Morphology
Acute tubular necrosis types
Acute tubular necrosis urinalysis
Toxic acute tubular necrosis location
Ischemic acute tubular necrosis location
Ischemic tubular necrosis morphology
Toxic tubular necrosis
Interstitial nephritis acute
Interstitial nephritis chronic
Simple cyst
Autosomal Recessive Polycystic Kidney
Disease (ARPKD)
ARPKD mutation
Dysplastic Kidney Disease (Potter II)
Autosomal Dominant Polycystic Kidney
Disease (ADPKD)
Medullary Cyst (Sponge kidney)
Medullary Cyst CP
-LM: nodular lesions
-IF: positive lambda chains
-EM: non-branching fibrils in BM,
mesangium, and vessel walls
Apple green bifringence with congo red
stain
-Nephritic syndrome
-IgA nephropathy
Tubular cells with lipids
Indicative of upper (kidney) UTI
-Severe flank pain radiating to the groin
-Sterile pyuria
-Diabetes
-Sickle cell disease
-Analgesic nephropathy
-Necrosis and sloughing of the Papillae
-Toxic (Ethylene glycol)
-Ischemic
Tubular casts
Mostly proximal convoluted tubules
Segmental proximal and distal
Tubulorhexis: rupture of BM
Intact BM
Type 1 hypersensitivity Rx
Analgesic
-Benign
-Obstruction and impair circulation
-oligohydramios
-Incompatible with life
-Radial cyst thorugh cortex and medulla
PKHD1 gene mutation -> receptor for
fibrocystin
-Presence of mesenchyme (cartilage) in
the kidney
-Not hereditary
-Liver cyst
-Berry Aneurysm
-Papillary cyst
-Hematuria
-UTI
-Renal stones
Renal Partners 4
Adult onset medullary cystic disease
Horseshoe kidney
Benign recurrent hematuria
Alport syndrome morphology
Alport Syndrome X-linked mutation
Alport Syndrome Familial mutation
Alport Syndrome CP
Nitrites in urine
Urine Examination
-RBC
-WBC
-Tubular cells
-Oval bodies
-RBC cast
-WBC cast
-Granular (Broken RBC cast)
-Tubular
Renal Clear Cell Carcinoma
Renal Papillary Cell Carcinoma
WAGR Syndrome
Denys-Drash Syndrome
Beckwith-Wiedman Syndrome
Sporadic Wilms
Extrophy
Hunner’s ulcer
-Autosomal dominant
-Salt loosing polyuria
-corticomedullary cyst and shrunken
kidneys
-Kdney fused at the inferior pole
-obstruction -> stasis -> infection
Thin capillary loops
EM: lamellation of the lamina densa
Type IV α5 chain mutation
Type IV α3 and α4 chain mutation
-Cataracts and lens dislocation
-Neurosensory hearing loss
Infection
-Hematuria
-Pyuria
-Tubular necrosis
-Tubular cells with lipid droplets
(Nephrotic Syndrome)
-Acute Nephritic Syndrome
-Acute pyelonephritis
-Acute Nephritic Syndrome
-Acute tubular necrosis
-von Hippel Lindau gene
-Chromosome 3 deletion
-Trisomy 1 and 17
-Y chromosome deletion
-Mutated MET proto-oncogene
-Wilms tumor
-Aniridis
-Gonadal anomalies
-Retardation
-Gonadal dysgenesis
-Gonadoblastoma
-Diffuse mesangial sclerosis
-Wilms tumor
-Wilms tumor
-Organomegaly
-Macroglossia
-Hemihypertrophy
Β-catenin gene mutation
Incomplete closure of the anterior
abdominal wall and urinary bladder
Chronic interstitial cystitis
Renal Partners 5
Bladder Squamos Cell Carcinoma
Acute bacterial prostatitis
Schistosomes
-E. coli
-Associated with UTI
Renal Partners 6