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Renal pathology

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Renal pathology

  1. 1. FUNDAMENTALS OF RENAL PATHOLOGY
  2. 2.  Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis and characterization of medical diseases (nontumor) 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.
  3. 3. NORMAL HISTOLOGY
  4. 4. THE GLOMERULUS
  5. 5. Typical stains used in renal evaluating renal biopsy
  6. 6. ELECTRON MICROGRAM
  7. 7. 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)
  8. 8. 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.
  9. 9. Histologic feature that is found in any patient with nephrotic range proteinuria no matter what the cause
  10. 10. OVAL FAT BODIES
  11. 11. Minimal Change Glomerulopathy
  12. 12. IF
  13. 13. ULTRA STRUCTURE
  14. 14. Membranous Glomerulopathy
  15. 15. H&E
  16. 16. SPECIAL STAINS IA L STAINS
  17. 17. ELECTRON MICROGRAM
  18. 18. IF
  19. 19. Focal Segmental Glomerulosclerosis
  20. 20. H&E
  21. 21. IF
  22. 22. Type I Membranoproliferative (Mesangiocapillary) Glomerulonephritis
  23. 23. IF
  24. 24. ELECRON MICRGRAM
  25. 25. IF
  26. 26. ELECTRON MICROGRAM
  27. 27. Type II Membranoproliferative Glomerulonephritis, (Dense Deposit Disease)
  28. 28. ELECTRON MICROGRAM
  29. 29. IF
  30. 30. REFFERENCE  www.uncnephropathology.org/jennette/tutorial.htm

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