Difference between revisions of "End-stage kidney"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = End-stage kidney - a -- intermed mag.jpg | |||
| Width = | |||
| Caption = End-stage kidney with thyroidization. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = global sclerosis of the glomeruli, interstitial fibrosis, +/-thyroidization (colloid-like hyaline cast formation that impart an appearance that mimics the [[thyroid gland]]) | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = small kidneys, thinned renal cortex, +/-dilated renal calyces, +/-cysts | |||
| Grossing = | |||
| Site = [[kidney]] - see ''[[medical kidney diseases]]'' | |||
| Assdx = [[chronic pyelonephritis]], [[acquired cystic disease-associated renal cell carcinoma]], [[papillary renal cell carcinoma]], [[acquired renal cystic disease]] | |||
| Syndromes = | |||
| Clinicalhx = +/-[[diabetes mellitus]] (most common) | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''End-stage kidney''', abbreviated '''ESK''', is a non-functional (chronically damaged) [[kidney]]. | |||
'''End-stage renal disease''' (abbreviated '''ESRD''') and '''end-stage kidney disease''' (abbreviated '''ESKD''') redirect here. | |||
==General== | |||
*Many end-stage renal disease (ESRD) kidneys have a similar appearance. | |||
**Notable exception: polycystic kidney diseases have distinctive appearance, e.g. [[ADPKD]]. | |||
==Gross== | |||
*Small kidneys. | |||
*Thinned renal cortex. | |||
*+/-Dilated renal calyces. | |||
*+/-Cysts. | |||
Note: | |||
*Normal (adult) kidneys are ~11 cm from pole-to-pole.<ref name=pmid20030823>{{Cite journal | last1 = Glodny | first1 = B. | last2 = Unterholzner | first2 = V. | last3 = Taferner | first3 = B. | last4 = Hofmann | first4 = KJ. | last5 = Rehder | first5 = P. | last6 = Strasak | first6 = A. | last7 = Petersen | first7 = J. | title = Normal kidney size and its influencing factors - a 64-slice MDCT study of 1.040 asymptomatic patients. | journal = BMC Urol | volume = 9 | issue = | pages = 19 | month = | year = 2009 | doi = 10.1186/1471-2490-9-19 | PMID = 20030823 | URL = http://www.biomedcentral.com/1471-2490/9/19 }}</ref> | |||
==Microscopic== | |||
Features: | |||
*Global sclerosis of the glomeruli. | |||
*Interstitial fibrosis. | |||
*+/-Thyroidization - colloid-like hyaline cast formation that impart an appearance that mimics the [[thyroid gland]]:<ref name=pmid19594588>{{Cite journal | last1 = Ito | first1 = S. | last2 = Kobayashi | first2 = A. | last3 = Tsuchiya | first3 = T. | last4 = Moriyama | first4 = Y. | last5 = Kikuchi | first5 = M. | last6 = Deguchi | first6 = T. | last7 = Yamaguchi | first7 = Y. | title = Thyroidization in renal allografts. | journal = Clin Transplant | volume = 23 Suppl 20 | issue = | pages = 6-9 | month = Aug | year = 2009 | doi = 10.1111/j.1399-0012.2009.01001.x | PMID = 19594588 }}</ref> | |||
**Typical of [[chronic pyelonephritis]] and obstructive nephropathy. | |||
*+/-[[Interstitial nephritis]]. | |||
*+/-[[Pyelonephritis]]. | |||
Note: | |||
*The end-stage kidney, much like the end-stage liver, often does not have apparent disease specific findings. | |||
DDx: | |||
*[[Diabetic nephropathy]] - most common cause of ESRD in North America, may have vague nodularity. | |||
*[[Chronic pyelonephritis]] - commonly associated with ESRD. | |||
*[[Renal papillary adenoma]] - common incidental finding. | |||
*[[Acquired cystic disease of the kidney]] - seen in ESRD, may be an concurrent pathology. | |||
*Other causes of end-stage renal disease. | |||
===Images=== | |||
www: | |||
*[http://library.med.utah.edu/WebPath/RENAHTML/RENAL108.html Thyroidization of the kidney (utah.edu)]. | |||
====Case 1==== | |||
<gallery> | |||
Image: End-stage kidney - a -- low mag.jpg | ESK - low mag. (WC) | |||
Image: End-stage kidney - a -- intermed mag.jpg | ESK - intermed. mag. (WC) | |||
Image: End-stage kidney - b -- low mag.jpg | ESK - low mag. (WC) | |||
Image: End-stage kidney - b -- intermed mag.jpg | ESK - intermed. mag. (WC) | |||
Image: End-stage kidney - c -- intermed mag.jpg | ESK - intermed. mag. (WC) | |||
Image: End-stage kidney - c -- high mag.jpg | ESK - high mag. (WC) | |||
</gallery> | |||
====Case 2==== | |||
<gallery> | |||
Image: Thyroidization of the kidney -- low mag.jpg | TK - low mag. | |||
Image: Thyroidization of the kidney -- intermed mag.jpg | TK - intermed. mag. | |||
Image: Thyroidization of the kidney -- high mag.jpg | TK - high mag. | |||
Image: Thyroidization of the kidney -- very high mag.jpg | TK - very high mag. | |||
Image: Thyroidization of the kidney - alt -- very high mag.jpg | TK - very high mag. | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
Right Kidney, Nephrectomy: | |||
- End-stage kidney with predominantly obsolete glomeruli, thyroidization and | |||
chronic interstitial inflammation. | |||
- Minimal chronic inflammation of renal pelvis and ureter. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
KIDNEY, LEFT, NEPHRECTOMY: | |||
- END-STAGE KIDNEY WITH MULTIPLE ABSCESSES ASSOCIATED WITH GIANT CELLS | |||
AND HISTIOCYTIC RESPONSE. | |||
- CHRONIC PYELONEPHRITIS AND INTERSTITIAL NEPHRITIS. | |||
- ATHEROSCLEROSIS, MILD-TO-MODERATE. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
==See also== | |||
*[[Medical kidney diseases]]. | |||
*[[Kidney]]. | |||
*[[Acquired cystic disease-associated renal cell carcinoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] |
Latest revision as of 14:26, 15 July 2017
End-stage kidney | |
---|---|
Diagnosis in short | |
End-stage kidney with thyroidization. H&E stain. | |
| |
LM | global sclerosis of the glomeruli, interstitial fibrosis, +/-thyroidization (colloid-like hyaline cast formation that impart an appearance that mimics the thyroid gland) |
Gross | small kidneys, thinned renal cortex, +/-dilated renal calyces, +/-cysts |
Site | kidney - see medical kidney diseases |
| |
Associated Dx | chronic pyelonephritis, acquired cystic disease-associated renal cell carcinoma, papillary renal cell carcinoma, acquired renal cystic disease |
Clinical history | +/-diabetes mellitus (most common) |
End-stage kidney, abbreviated ESK, is a non-functional (chronically damaged) kidney.
End-stage renal disease (abbreviated ESRD) and end-stage kidney disease (abbreviated ESKD) redirect here.
General
- Many end-stage renal disease (ESRD) kidneys have a similar appearance.
- Notable exception: polycystic kidney diseases have distinctive appearance, e.g. ADPKD.
Gross
- Small kidneys.
- Thinned renal cortex.
- +/-Dilated renal calyces.
- +/-Cysts.
Note:
- Normal (adult) kidneys are ~11 cm from pole-to-pole.[1]
Microscopic
Features:
- Global sclerosis of the glomeruli.
- Interstitial fibrosis.
- +/-Thyroidization - colloid-like hyaline cast formation that impart an appearance that mimics the thyroid gland:[2]
- Typical of chronic pyelonephritis and obstructive nephropathy.
- +/-Interstitial nephritis.
- +/-Pyelonephritis.
Note:
- The end-stage kidney, much like the end-stage liver, often does not have apparent disease specific findings.
DDx:
- Diabetic nephropathy - most common cause of ESRD in North America, may have vague nodularity.
- Chronic pyelonephritis - commonly associated with ESRD.
- Renal papillary adenoma - common incidental finding.
- Acquired cystic disease of the kidney - seen in ESRD, may be an concurrent pathology.
- Other causes of end-stage renal disease.
Images
www:
Case 1
Case 2
Sign out
Right Kidney, Nephrectomy: - End-stage kidney with predominantly obsolete glomeruli, thyroidization and chronic interstitial inflammation. - Minimal chronic inflammation of renal pelvis and ureter. - NEGATIVE for malignancy.
Block letters
KIDNEY, LEFT, NEPHRECTOMY: - END-STAGE KIDNEY WITH MULTIPLE ABSCESSES ASSOCIATED WITH GIANT CELLS AND HISTIOCYTIC RESPONSE. - CHRONIC PYELONEPHRITIS AND INTERSTITIAL NEPHRITIS. - ATHEROSCLEROSIS, MILD-TO-MODERATE. - NEGATIVE FOR MALIGNANCY.
See also
References
- ↑ Glodny, B.; Unterholzner, V.; Taferner, B.; Hofmann, KJ.; Rehder, P.; Strasak, A.; Petersen, J. (2009). "Normal kidney size and its influencing factors - a 64-slice MDCT study of 1.040 asymptomatic patients.". BMC Urol 9: 19. doi:10.1186/1471-2490-9-19. PMID 20030823.
- ↑ Ito, S.; Kobayashi, A.; Tsuchiya, T.; Moriyama, Y.; Kikuchi, M.; Deguchi, T.; Yamaguchi, Y. (Aug 2009). "Thyroidization in renal allografts.". Clin Transplant 23 Suppl 20: 6-9. doi:10.1111/j.1399-0012.2009.01001.x. PMID 19594588.