Principles and practice of Human Pathology – Lecture 14 + 15 (15-6-2018):
Nephropathology 1
Kidney function:
The kidneys have many crucial functions, including:
- Maintaining overall fluid balance
- Regulating and filtering minerals from blood
- Filtering waste materials from food, medications and toxic substances
- Creating hormones (e.g. EPO) that help producing red blood cells, promote
bone health and regulate blood pressure.
Acute vs. chronic kidney failure:
- Kidney failure/kidney insufficiency
*When there is a kidney disease, it will in many cases express itself as a kidney
insufficiency
A distinction is made between acute and chronic renal insufficiency
Acute renal insufficiency:
- Life-threatening complications (overfilling, hyperkalemia = elevated level of
potassium in the blood serum, acidosis)
Causes of acute renal insufficiency may be prerenal, renal or postrenal.
Chronic kidney insufficiency:
Prolonged loss of kidney function due to chronic kidney disease
Chronic renal failure will result in systemic disorders
Diseases of the different segments of the kidney:
- Vascular
- Glomerular
- Tubulo-interstitial
o Interstitium is the area in between the tubuli, every white space inside
the tubuli is vasculature
- Ureters
This lecture: only glomerular diseases
The glomerulus contains the ‘filter system’ of the kidney.
Visceral epithelial cells + podocytes are the main cells that are injured, causing the
filtration barrier to become leaky.
Endothelial cells: inner lining of blood vessels. Important for maintaining the selective
filtration barrier
Glomerular injury:
- Molecules that are normally retained in the blood enter the urine
proteinuria/hematuria
Nephropathology 1
Kidney function:
The kidneys have many crucial functions, including:
- Maintaining overall fluid balance
- Regulating and filtering minerals from blood
- Filtering waste materials from food, medications and toxic substances
- Creating hormones (e.g. EPO) that help producing red blood cells, promote
bone health and regulate blood pressure.
Acute vs. chronic kidney failure:
- Kidney failure/kidney insufficiency
*When there is a kidney disease, it will in many cases express itself as a kidney
insufficiency
A distinction is made between acute and chronic renal insufficiency
Acute renal insufficiency:
- Life-threatening complications (overfilling, hyperkalemia = elevated level of
potassium in the blood serum, acidosis)
Causes of acute renal insufficiency may be prerenal, renal or postrenal.
Chronic kidney insufficiency:
Prolonged loss of kidney function due to chronic kidney disease
Chronic renal failure will result in systemic disorders
Diseases of the different segments of the kidney:
- Vascular
- Glomerular
- Tubulo-interstitial
o Interstitium is the area in between the tubuli, every white space inside
the tubuli is vasculature
- Ureters
This lecture: only glomerular diseases
The glomerulus contains the ‘filter system’ of the kidney.
Visceral epithelial cells + podocytes are the main cells that are injured, causing the
filtration barrier to become leaky.
Endothelial cells: inner lining of blood vessels. Important for maintaining the selective
filtration barrier
Glomerular injury:
- Molecules that are normally retained in the blood enter the urine
proteinuria/hematuria
