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Pathology of Kidney Disease - Coggle Diagram
Pathology of Kidney Disease
Chronic Kidney Disease
Progressive loss of renal function
Compensatory hyperfiltration
Leads to Further Damage
Original Etiology can be obscured by non specific scarring
Etiology
Pre-Renal: Chronic hypoperfusion, ischemia
Post-Renal: Obstruction, back pressure
Renal: Hereditary, chronic glomerulonephritis, metabolic abnormalities, tubulointerstitial disease
Causes
Congenital/Hereditary (10%)
Obstructive/Chronic pyelonephritis/other tubulointerstitial diseases (10-15%)
Diabetes (30%)
Hypertension/Vascular (25%)
Glomerulonephritis (15-20%)
Adult Polycystic Disease
Pathogenic mechanisms related to primary cilium: Abnormal cell proliferation, Dysregulated apoptosis, defectivw cellular polarity, increased secretion into tubular lumen
Cystic Liver
Histology of Kidney with PCKD
Segmental Glomerulosclerosis
Hyperfiltration -> Progressive Damage
FSGS
Global Glomerulosclerosis
Screening
Need to be big enough to detect on ultrasound
CT Scan
Hydronephrosis due to Obstruction
With Hydroureter
End Stage Hydronephrosis
Thinned Cortex, Dilated pelvis, Glomerular ischemia tubular atrophy and interstitial fibrosis
Glomerulosclerosis (White), Tubular Atrophy (Black)
Interstitial Fibrosis, Atrophic and Dilated Tubules
Other Causes of Obstruction
Renal Calculi
Obstructive Ureteric Tumor
Dilated renal Pelvis and Calyces
Uretero Pelvic Junction Obstruction
Retroperitoneal Fibrosis
IV Urography
CT Scan
Chronic Pyelonephritis
Infections resulting from Obstruction
Abscess Formation
Acute Inflammation Episodes
Leads to Fibrosis, and loss of function
Chronic Pyeloneprhitis
U Shaped scars involving cortex and Medulla
Scarred glomeruli and atrophic tubules follow "thyroidization pattern"
Vascular Causes of Chronic Renal Failure
Consequences of decrease flow to kidneys
Glomeruli: Ishcemic change with wrinkling, retraction of glomerular tuft, and periglomerular and fibrosis
Tubular atrophy
Interstitum: Fibrosis and non-specific chronic inflammation
Aorta with Atherosclerosis
Renal Artery with Obstruction
Gross Examination of Kidney
Small Kidney, diffuse and regular cortical scars that are more superficial than those in pyelonephritis
Scarred Kidney
Interstitial fibrosis containing globally sclerosed glomeruli
Artery with thickened intima
Glomerular Tuft Retraction
Periglomerular Fibrosis
Global Golmerulosclerossi
Hyaline arteriosclerosis
Fibrinoid Necrosis
Afferent arteriole with fibrinoid eosinophilic material and ischemic glomerulus
"Onion skin" change due to lamellation with mucoid change with swelling of intimal layer
Chronic Changes with increased fibrosis
Cholesterol Emboli
Embolic atherosclerotic plaque dislodged from aorta
Glomerulonephritis
Endocapillary hypercellularity ude to increased cellular proliferation, and inflammation related to immune complex deposition resulting in narrowing and obstruction of glomerular capillary blood flow
Wire Loops
Glomerular Crescent
IgA, IgM, IgG, C3, C1q Immunoglobulins
Deposition of large immune complexes (largely subendothelial)
Scars develop (fibrosis/fibrous cescent)
Interstitial Fibrosis and tubular atrophy with non-specific chornic inflammation
Gross Image
