Renal pathology deals with diagnosing and characterizing kidney diseases through examination of renal biopsy specimens using light microscopy, electron microscopy, and immunofluorescence. The renal pathologist must synthesize findings across these diagnostic tools to reach a definitive diagnosis. Medical kidney diseases can affect the glomerulus, tubules and interstitium, blood vessels, or a combination of these renal compartments.

1. FUNDAMENTALS OF
RENAL PATHOLOGY

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. NORMAL HISTOLOGY

4. THE GLOMERULUS

5. Typical stains used in renal
evaluating renal biopsy

7. ELECTRON MICROGRAM

8. 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)

9. 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.

11. Histologic feature that is found in any
patient with nephrotic range
proteinuria no matter what the cause

12. OVAL FAT BODIES

13. Minimal Change Glomerulopathy

14. IF

15. ULTRA STRUCTURE

16. Membranous Glomerulopathy

17. H&E

18. SPECIAL STAINS
IA
L STAINS

19. ELECTRON MICROGRAM

20. IF

21. Focal Segmental Glomerulosclerosis

23. H&E

24. IF

25. Type I Membranoproliferative
(Mesangiocapillary)
Glomerulonephritis

27. IF

28. ELECRON MICRGRAM

29. IF

30. ELECTRON MICROGRAM

32. Type II Membranoproliferative
Glomerulonephritis, (Dense Deposit
Disease)

34. ELECTRON MICROGRAM

35. IF

36. REFFERENCE

www.uncnephropathology.org/jennette/tutorial.htm