Renal pathology & Disease Condition.

1. Renal Pathology & Disease
Condition
Dr. Deepika R. Kenjale

2. Renal diseases: The kidneys tend to be damaged & are
not able to filtrate or do its function as it should  waste material
builds up in the body that can harm our well being.
• It can be attributed to a variety of causes which, include genetics,
injuries and medicine.
Renal failure Significant loss of renal function in both
kidneys to the point where less than 10-20% of normal GFR
remains.
•Either there is glomerular dysfunction or tubular dysfunction.

4. Common Presentation
1.Dysuria
2.Loin pain
3.Oliguria/anuria
4.Polyuria
5.Nocturia
6. Haematuria
7.Proteinuria & nephrotic syndrome
8.Oedema
9.Increased frequency & urinary incontinence
10.Hypertension…….

5. Classification
1. Inherited:
a) Autosomal Dominant Polycystic Kidney Disease
b) Tuberous Sclerosis
c) Alport Syndrome
d) Von-Hippel Lindau Syndrome
2. Congenital:
a) Renal agenesis (unilateral or bilateral)
b) Supernumerary kidneys
c) Renal ectopia, renal fusion
d) Cystic diseases of kidney
3. Acquired:
a) Glomerular diseases.
b) ARF/CRF
c) Nephrolithiasis
d

6. Disorders of the renal system
Nephrotic
Syndrome
Nephritic
Syndrome
Glomerular
Diseases
Tubulo-interstitial
Diseases
Renal vascular
Diseases Others
•Renal artery
stenosis
•Renal infarcts
•Hypertensive
vascular
diseases
•Renal stone
•Neoplasms
•Acute Tubular
Necrosis
•Acute &
Chronic
Pyelonephritis-
infective.
•Gout
nephropathy-
noninfective

7. Glomerular Diseases
• Glomerulonephritis is inflammation of the tiny
filters in your kidneys (glomeruli).
• Glomeruli are filtration unit of kidneythey
remove excess fluid, electrolytes and waste
from your bloodstream and pass them into
your urine.

9. Nephrotic Syndrome
• Definition: It is a clinicopathological condition
characterized by heavy proteinuria (>3.5 gm/day),
hypoalbuminaemia, edema, hyperlipidaemia,
lipiduria, hypercoagulability.

10. Pathophysiology:

13. Signs & Symptoms:

14. Nephritic Syndrome
• Definition: It is a condition characterized by
acute onset of haematuria, proteinuria,
hypertension, edema & oliguria following an
infective illness about 10-12 days earlier

15. Causes:

17. Signs & Symptoms:

18. Acute Renal Failure
• Definition: Syndrome characterized by rapid onset of
renal dysfunction, chiefly oliguria or uremia.
• Sudden decrease in renal function & sudden increase in
metabolic waste products (urea & creatinine) in blood with
consequent development of uraemia.
• Manifestation:
- Oliguria
- Possible edema & fluid retension
- Elevated BUN & serum creatinine
- Alteration in serum electrolytes

19. Causes:

20. Clinical Features:

21. Treatment:
• Prevention of acute renal failure through
support of blood pressure and blood volume.
• Correction of fluid & electrolyte imbalance.
• Dialysis, which may be employed while the
kidneys are in recovery phase.
• Low protein, high carbohydrate diet to minimize
the formation of nitrogenous wastes.

22. Chronic Renal Failure
• Definition: It is a syndrome characterized by
progressive & irreversible deterioration of
renal function due to slow destruction of renal
parenchyma, eventually terminating in death
when sufficient number of nephrons have
been damaged.

25. Manifestation
Loss of tubular reabsorption

26. Treatment
• Careful management of fluids & electrolytes.
• Prudent use of diuretics.
• Careful dietary management, restriction of
dietary protein inatke.
• Recombinant erythropoietin to treat anemia.
• Renal dialysis.
• Renal Transplantation.

28. Renal Function Test
1. Clearance test:
- Clearance test- Gives estimation of GFR.
- Insulin clearance- Gives very close estimate of GFR.
2. Urine Test:
-Dipstick
- Protein creatinine ratio,
- Microalbumin
3. Blood Test:
A. Electrolytes- Na (137-145 mmol/L), K (3.5-5.1mmol/L), Cl (98-107 mmol/L).
B. Creatinine (0.7-1.2 mg/dl), Uric acid (2.5-6.2 mg/dl), BUN (9-20 mg/dl)
C .Calcium (8.4-10.2 mg/dl), Phosphorus (2.5-4.5 mg/dl)
D. Total Protein6.3-8.2 gm/dl
E . Cystin C eGFR , it tells the condition of the kidney quiet before the creatine (6-8 weeks before).
4. Tubular Function test:
- Dilution test
- Concentration test