Pathology of Kidney and the Urinary tract

1
Pathology of Kidney and the Urinary tract

• Dr. Amar C. Al-Rikabi
• Dr. Hala Kassouf Kfoury

2
Normal Kidney, Congenital and Cystic Renal
Diseases and Acute Renal Failure

• Lecture -1

3
(No Transcript)
4
(No Transcript)
5
This paraffin embedded 2µm section illustrates a
normal glomerulus with normal vascular pole with
minimal periglomerular interstitial fibrosis and
surrounding intact tubules
6
This glomerulus shows only minimal abnormalities
by electron microscopy, with rare Vacuoles and
blebs in the podocytes.
7
Bisected kidney shows a less severe form of CRD
with multiple cysts and focally a significant
degree of disorganization of parenchymal
architecture.
8
Autosomal recessive (infantile) polycystic
disease (ARPKD). Elongated streaks represent
dilated tubules.
9
Cut surface of ADPKD showing variable-size,
irregular cysts with no recognizable intervening
normal parenchyma. Most cysts contain clear fluid
and the pelvis is distorted.
Histology of ADPKD shows a single glomerulus
alongside several cysts
10
Late stage of ADPKD showing greatly enlarged
renal profiles due to innumerable cysts of
varying size replacing the renal parenchyma.
11
Acute renal failure is a syndrome defined by a
sudden loss of renal function over several hours
to several days.
Mayo Clin Proc. 20017667-74
12
RPGN (Rapidly Progressive Glomerulonephritis) is
a syndrome defined by the rapid loss of renal
function over days to weeks due to acute
glomerulonephritis.
13
Etiology of ARF
14
The Pathophysiology of ARF
JASN 19989(4)710-718
15

• ACUTE RENAL FAILURE
• Acute tubular necrosis (ATN)
• Clinically, rapid deterioration in renal function
  usually, but not always associated with oliguria.
• B. Many different kidney diseases may present
  with acute renal failure although ATN is the most
  common cause by far.
• C. Conditions associated with ATN
• 1. Shock2. Sepsis3. Incompatible blood
  transfusions4. Burns5. Crush injury6. Drugs

16
ATN Acute tubular necrosis
17
(No Transcript)
18
(No Transcript)
19
Kidney in acute tubular necrosis (ATN) showing
pale, swollen cortex and congested medulla.
Elongated, stretched out, regenerating proximal
tubular lining cells encompass the necrotic
epithelium.
20
Acute Kidney Injury

• Conclusion
• 1- Specify the cause of the acute kidney injury