Difference between revisions of "End-stage kidney"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = End-stage kidney - a -- intermed mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = End-stage kidney with thyroidization. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      =
| Micro      = global sclerosis of the glomeruli, interstitial fibrosis, +/-thyroidization (colloid-like hyaline cast formation that impart an appearance that mimics the [[thyroid gland]])
| Subtypes  =
| Subtypes  =
| LMDDx      =
| LMDDx      =
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| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      =
| Gross      = small kidneys, thinned renal cortex, +/-dilated renal calyces, +/-cysts
| Grossing  =
| Grossing  =
| Site      = [[kidney]] - see ''[[medical kidney diseases]]''
| Site      = [[kidney]] - see ''[[medical kidney diseases]]''
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| Tx        =
| Tx        =
}}
}}
'''End-stage kidney''' is a non-functional [[kidney]]. '''End-stage renal disease''', abbreviated '''ESRD''', redirect here.
'''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==
==General==
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*+/-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>
*+/-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.
**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.
   
   
Image:
===Images===
www:
*[http://library.med.utah.edu/WebPath/RENAHTML/RENAL108.html Thyroidization of the kidney (utah.edu)].
*[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==
==See also==
*[[Medical kidney diseases]].
*[[Medical kidney diseases]].
*[[Kidney]].
*[[Acquired cystic disease-associated renal cell carcinoma]].


==References==
==References==

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:

Note:

  • The end-stage kidney, much like the end-stage liver, often does not have apparent disease specific findings.

DDx:

Images

www:

Case 1

  • ESK - low mag. (WC)

  • ESK - intermed. mag. (WC)

  • ESK - low mag. (WC)

  • ESK - intermed. mag. (WC)

  • ESK - intermed. mag. (WC)

  • ESK - high mag. (WC)

Case 2

  • TK - low mag.

  • TK - intermed. mag.

  • TK - high mag.

  • TK - very high mag.

  • TK - very high mag.

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

  1. ↑ 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.
  2. ↑ 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.
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