Guided Lecture Notes, Chapter 25, Disorders of Renal Function
Learning Objective 1. Differentiate disorders of kidney development.

Differentiate renal agenesis, renal hypoplasia, and renal dysplasia. (Refer to
PowerPoint side 2.)

Describe abnormalities in location of form of the kidneys, including horseshoe
kidney. (Refer to Figure 25-1.)
Learning Objective 2. Describe the genetic basis for renal cystic disease, the pathology
of the disorder, and its signs and symptoms.

Describe renal cystic disease.

Differentiate autosomal dominant polycystic kidney disease, autosomal recessive
polycystic kidney disease, nephronophthisis, and medullary cystic diseases with
regard to cause, pathology, and clinical manifestations. (Refer to PowerPoint
slide 3 and Figures 25-2 and 25-3.)

Differentiate simple cysts and acquired renal cystic disease. (Refer to PowerPoint
slide 3.)
Learning Objective 3. Differentiate mechanism involved in glomerular injury.

Review the anatomy and physiology of the glomerulus. (Refer to PowerPoint
slide 4 and Figure 25-4A.)

Differentiate the two immune mechanisms implicated in the development of
glomerular injury. (Refer to PowerPoint slide 5 and Figure 25-5.)

Differentiate the terms proliferative, membranous, sclerotic, diffuse, focal,
segmental, and mesangial to explain changes in glomerular structure that occur
with glomerulonephritis. (Refer to PowerPoint slide 6 and Figure 25-4B.)

Differentiate nephritic syndrome and nephrotic syndrome. (Refer to PowerPoint
slides 7 and 8.)
Learning Objective 4. Differentiate glomerular diseases.

Relate the proteinuria, hematuria, pyuria, oliguria, edema, hypertension, and
azotemia that occur with glomerular diseases to changes in glomerular structure.

Differentiate acute nephritic syndrome, acute postinfectious glomerulonephritis,
rapidly progressive glomerulonephritis, Goodpasture syndrome, nephrotic
syndrome, minimal-change disease/lipoid nephritis, membranous
glomerulonephritis, focal segmental glomerulosclerosis, IgA nephropathy,
hereditary nephritis/Alport syndrome, and chronic glomerulonephritis with regard
to cause, pathology, and clinical manifestations. (Refer to PowerPoint slides 9 to
12 and Figures 25-6, 25-7, 25-8, 25-9, and 25-10.)

Differentiate how diseases such as systemic lupus erythematosus, diabetes
mellitus, and hypertension result in glomerular disease. (Refer to PowerPoint
slides 13 to 15.)
Learning Objective 5. Differentiate tubular and interstitial kidney disorders.

Define tubulointerstitial kidney disease, and identify the tissue affected in
tubulointerstitial disorders.

Differentiate acute acute tubular necrosis, tubulointerstitial nephritis, acute
pyelonephritis, chronic pyelonephritis, reflux nephropathy, and nephropathy
induced by drugs and toxins with regard to cause, pathology, and clinical
manifestations. (Refer to PowerPoint slides 16 and 17 and Figures 25-11 and
25-12.)

Explain why the kidneys’ high blood flow and filtration pressure and metabolic
function predispose them to injury due to drugs and toxins.

Describe how drugs and toxins damage the kidneys.

Differentiate between acute drug-related hypersensitivity reactions and chronic
analgesic nephritis with regard to cause, clinical manifestations, and treatment.
Learning Objective 6. Differentiate obstructive kidney disorders.

Describe the effects of urinary tract obstruction on renal structure and function.

Identify common causes and locations of urinary tract obstruction. (Refer to
Figure 25-13 and Table 25-1.)

Classify obstructive disorders a sudden or insidious, partial or complete, unilateral
or bilateral.

Describe effects of urine stasis and progressive dilation of collecting ducts and
tubular structures and the causes, pathology, clinical manifestations, and treatment
associated with hydronephrosis. (Refer to PowerPoint slides 18 to 21 and Figure
25-14.)
Learning Objective 7. Differentiate kidney stones.

Discuss the merits of the saturation, matrix, and inhibitor theories as they relate to
the formation of calculi. (Refer to PowerPoint slide 22.)

Differentiate the anatomy and pathology of the four types of kidney
stones/calculi. (Refer to PowerPoint slides 23 and 24 and Figure 25-15 and
Table 25-2.)

Explain the common clinical manifestations and the mechanisms of pain and
infection that occur with kidney stones.

Describe the methods used in the diagnosis and treatment of kidney stones.
Learning Objective 8. Differentiate two major groups of malignant kidney tumors.
(Refer to PowerPoint slide 25.)

Characterize Wilms tumor in terms of age of onset, possible oncogenic origin,
manifestations, and treatment.

Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment
of the embryonic kidney cancer (Wilms tumor or nephroblastoma). (Refer to
PowerPoint slide 26 and Figure 25-16.)

Identify risk factors for adult kidney cancer, and discuss its incidence, pathology,
clinical manifestations, diagnosis, and treatment. (Refer to PowerPoint slide 27
and Figure 25-17.)