Difference between revisions of "Medical kidney diseases"

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*'''A'''ging, '''D'''iabetes, '''H'''ypertension, '''D'''rugs.
*'''A'''ging, '''D'''iabetes, '''H'''ypertension, '''D'''rugs.


Image:
=====Image=====
*[http://commons.wikimedia.org/wiki/File:Renal_arterial_hyalinosis_-_he_-_very_high_mag.jpg Arterial hyaline - HE - very high mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg Arterial hyaline - PAS - very high mag. (WC)].
Image:Renal_arterial_hyalinosis_-_he_-_very_high_mag.jpg | Arterial hyaline - HE - very high mag. (WC/Nephron)
*[http://commons.wikimedia.org/wiki/File:Renal_arterial_hyalinosis_-_hps_-_very_high_mag.jpg Arterial hyaline - HPS - very high mag. (WC)].
Image:Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg | Arterial hyaline - PAS - very high mag. (WC/Nephron)
Image:Renal_arterial_hyalinosis_-_hps_-_very_high_mag.jpg | Arterial hyaline - HPS - very high mag. (WC/Nephron)
</gallery>


====Atherosclerosis====
====Atherosclerosis====
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| diffuse proliferative GN, membranous nephropathy
| diffuse proliferative GN, membranous nephropathy
| [[diabetic nephropathy]], [[idiopathic nodular glomerulosclerosis]], [[renal amyloidosis]], light chain deposition disease, [[fibrillary glomerulopathy]], [[immunotactoid glomerulopathy]]
| [[diabetic nephropathy]], [[idiopathic nodular glomerulosclerosis]], [[renal amyloidosis]], light chain deposition disease, [[fibrillary glomerulopathy]], [[immunotactoid glomerulopathy]]
| [http://commons.wikimedia.org/wiki/File:Nodular_glomerulosclerosis.jpeg (WC)]
| [[Image:Nodular_glomerulosclerosis.jpeg|thumb|center|150px|Nodular GS (WC)]]
|-
|-
|[[Membranous nephropathy]] (MN)
|[[Membranous nephropathy]] (MN)
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| normal light microscopy, light chain deposition disease
| normal light microscopy, light chain deposition disease
| [[hepatitis B]], [[hepatitis C]], carcinoma, NSAID toxicity, SLE, idiopathic (MN); light chain deposition disease ([[plasma cell neoplasm]])
| [[hepatitis B]], [[hepatitis C]], carcinoma, NSAID toxicity, SLE, idiopathic (MN); light chain deposition disease ([[plasma cell neoplasm]])
| [http://commons.wikimedia.org/wiki/File:Membranous_nephropathy_-_mpas_-_very_high_mag.jpg (WC)]  
| [[Image:Membranous_nephropathy_-_mpas_-_very_high_mag.jpg|thumb|center|150px|MN (WC)]]  
|-
|-
|[[Focal segmental glomerulosclerosis]]
|[[Focal segmental glomerulosclerosis]]
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| [[rapidly progressive glomerulonephritis]], nodular mesangial expansion
| [[rapidly progressive glomerulonephritis]], nodular mesangial expansion
| primary FSGS, secondary FSGS ([[HIV]], [[IVDU]], [[obesity]], [[parvovirus B19]], [[Alport syndrome]]
| primary FSGS, secondary FSGS ([[HIV]], [[IVDU]], [[obesity]], [[parvovirus B19]], [[Alport syndrome]]
| [http://commons.wikimedia.org/wiki/File:Focal_segmental_glomerulosclerosis_-_high_mag.jpg (WC)]
| [[Image:Focal_segmental_glomerulosclerosis_-_high_mag.jpg|thumb|center|150px|FSGS (WC)]]
|-
|-
|Diffuse proliferative glomerulonephritis
|Diffuse proliferative glomerulonephritis
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| nodular glomerulosclerosis
| nodular glomerulosclerosis
| [[post-infectious glomerulonephritis]], [[MPGN]], [[dense deposit disease]], diffuse proliferative [[lupus nephritis]] (class IV), cryoglobulinemic GN
| [[post-infectious glomerulonephritis]], [[MPGN]], [[dense deposit disease]], diffuse proliferative [[lupus nephritis]] (class IV), cryoglobulinemic GN
| [http://commons.wikimedia.org/wiki/File:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg (WC)]
| [[Image:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg|thumb|center|150px|MPGN (WC)]]
|-  
|-  
|[[Rapidly progressive glomerulonephritis]]
|[[Rapidly progressive glomerulonephritis]]
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| [[FSGS]], diffuse proliferative glomerulonephritis
| [[FSGS]], diffuse proliferative glomerulonephritis
| [[AGBM]], [[post-infectious glomerulonephritis]], pauci-immune GN, immune complex diseases ([[lupus nephritis]], [[IgA nephropathy]], others)
| [[AGBM]], [[post-infectious glomerulonephritis]], pauci-immune GN, immune complex diseases ([[lupus nephritis]], [[IgA nephropathy]], others)
| [http://en.wikipedia.org/wiki/File:Crescentic_glomerulonephritis_%282%29.jpg (WC)]
| [[Image:Crescentic_glomerulonephritis_%282%29.jpg|thumb|center|150px|Crescentic GN (WC)]]
|-
|-
|Tubular injury
|Tubular injury
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| normal light microscopy
| normal light microscopy
| [[acute tubular necrosis]], [[chronic allograft nephropathy]]
| [[acute tubular necrosis]], [[chronic allograft nephropathy]]
| [http://commons.wikimedia.org/wiki/File:Chronic_allograft_nephropathy_-_intermed_mag.jpg (WC)]
| [[Image:Chronic_allograft_nephropathy_-_intermed_mag.jpg|thumb|center|150px|CAN (WC)]]
|-
|-
|Small vessel pathology
|Small vessel pathology
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| none
| none
| [[thrombotic microangiopathy]] (malignant hypertension, [[scleroderma]] renal crisis, DIC, HUS, TTP,
| [[thrombotic microangiopathy]] (malignant hypertension, [[scleroderma]] renal crisis, DIC, HUS, TTP,
| [http://commons.wikimedia.org/wiki/File:Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg hyalinosis (WC)], [http://commons.wikimedia.org/wiki/File:Thrombotic_microangiopathy_-_very_high_mag.jpg TMA (WC)]
| [[Image:Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg |thumb|center|100px| Hyalinosis (WC)]] [[Image:Thrombotic_microangiopathy_-_very_high_mag.jpg|thumb|center|150px| TMA (WC)]]
|-
|-
|Large vessel pathology
|Large vessel pathology
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| none
| none
| [[atherosclerosis]], [[cholesterol embolism]], other types of embolism, [[thrombosis]]
| [[atherosclerosis]], [[cholesterol embolism]], other types of embolism, [[thrombosis]]
| [http://commons.wikimedia.org/wiki/File:Cholesterol_embolus_-_intermed_mag.jpg (WC)]
| [[Image:Cholesterol_embolus_-_intermed_mag.jpg |thumb|center|150px| Cholesterol embolus (WC)]]
|- <!--
|- <!--
| Pattern
| Pattern
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| [[diabetes mellitus]] (DM)
| [[diabetes mellitus]] (DM)
| [[amyloidosis]], [[idiopathic nodular glomerulosclerosis]] (nodular GS without DM)
| [[amyloidosis]], [[idiopathic nodular glomerulosclerosis]] (nodular GS without DM)
| [http://commons.wikimedia.org/wiki/File:Nodular_glomerulosclerosis.jpeg (WC)]
| [[Image:Nodular_glomerulosclerosis.jpeg|thumb|center|150px|Nodular GS (WC)]]
|-
|-
|[[Focal segmental glomerulosclerosis]] (FSGS)
|[[Focal segmental glomerulosclerosis]] (FSGS)
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| primary FSGS, secondary FSGS ([[HIV]], [[IVDU]], obesity, [[parvovirus B19]], [[Alport syndrome]]); unresponsive to steroids, worse prognosis than MCD
| primary FSGS, secondary FSGS ([[HIV]], [[IVDU]], obesity, [[parvovirus B19]], [[Alport syndrome]]); unresponsive to steroids, worse prognosis than MCD
| [[minimal change disease]]
| [[minimal change disease]]
| [http://commons.wikimedia.org/wiki/File:Focal_segmental_glomerulosclerosis_-_high_mag.jpg (WC)]
| [[Image:Focal_segmental_glomerulosclerosis_-_high_mag.jpg|thumb|center|150px|FSGS (WC)]]
|-
|-
|[[Membranous nephropathy]]<br>(AKA membranous GN)
|[[Membranous nephropathy]]<br>(AKA membranous GN)
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| primary vs. secondary (Henoch-Schoenlein purpura)
| primary vs. secondary (Henoch-Schoenlein purpura)
| [[RPGN]]
| [[RPGN]]
| [http://commons.wikimedia.org/wiki/File:Henoch-Sch%C3%B6nlein_nephritis_IgA_immunostaining.jpg (WC)]
| [[Image:Henoch-Sch%C3%B6nlein_nephritis_IgA_immunostaining.jpg|thumb|center|150px|HSN - IgA IHC (WC)]]
|-
|-
|[[Membranoproliferative glomerulonephritis]] (MPGN)
|[[Membranoproliferative glomerulonephritis]] (MPGN)
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| [[SLE]], [[cryoglobulinemia]], [[hepatitis B]], [[hepatitis C]]
| [[SLE]], [[cryoglobulinemia]], [[hepatitis B]], [[hepatitis C]]
| Pathol. DDx?
| Pathol. DDx?
| [http://commons.wikimedia.org/wiki/File:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg (WC)]
| [[Image:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg|thumb|center|MPGN (WC)]]
|-
|-
|[[Focal proliferative glomerosclerosis|Focal proliferative<br> glomerosclerosis]] (FPGS)
|[[Focal proliferative glomerosclerosis|Focal proliferative<br> glomerosclerosis]] (FPGS)
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*GBM = ''thick '''G'''BM'', '''''b'''oth afferent & efferent artiole thickened'', '''''m'''esangial matrix expansion''.
*GBM = ''thick '''G'''BM'', '''''b'''oth afferent & efferent artiole thickened'', '''''m'''esangial matrix expansion''.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Nodular_glomerulosclerosis.jpeg Nodular glomerulosclerosis (WC)].
<gallery>
Image:Nodular_glomerulosclerosis.jpeg | Nodular glomerulosclerosis. (WC)
</gallery>
www:
*[http://library.med.utah.edu/WebPath/jpeg1/RENAL027.jpg Nodular GS (med.utah.edu)].
*[http://library.med.utah.edu/WebPath/jpeg1/RENAL027.jpg Nodular GS (med.utah.edu)].
*[http://www.markwickmd.com/images/pages/armani_ebstein_lesion.jpg Armanni-Ebstein lesion (markwickmd.com)].
*[http://www.markwickmd.com/images/pages/armani_ebstein_lesion.jpg Armanni-Ebstein lesion (markwickmd.com)].
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**Class IV is essentially a dead kidney - doesn't get biopsied.
**Class IV is essentially a dead kidney - doesn't get biopsied.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:SLE_Nephritis_Pathology_Diagram.svg SLE nephritis - schematic (WC)].
<gallery>
Image:SLE_Nephritis_Pathology_Diagram.svg| SLE nephritis - schematic. (WC)
</gallery>
*Membranous lupus:
*Membranous lupus:
**[http://www.flickr.com/photos/jian-hua_qiao_md/3989875425/in/set-72157622411941607 H&E (flickr.com)].
**[http://www.flickr.com/photos/jian-hua_qiao_md/3989875425/in/set-72157622411941607 H&E (flickr.com)].
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*Diagnosis based on immunofluorescence (IgA+).
*Diagnosis based on immunofluorescence (IgA+).


Images:
====Images====
*[http://library.med.utah.edu/WebPath/jpeg2/RENAL096.jpg IgA nephropathy (med.utah.edu)].
*[http://library.med.utah.edu/WebPath/jpeg2/RENAL096.jpg IgA nephropathy (med.utah.edu)].
*[http://path.upmc.edu/cases/case96.html HSP (upmc.edu)].
*[http://path.upmc.edu/cases/case96.html HSP (upmc.edu)].
*[http://commons.wikimedia.org/wiki/File:Henoch-Sch%C3%B6nlein_nephritis_IgA_immunostaining.jpg HSP - IgA IHC (WC)].
<gallery>
 
Image:Henoch-Sch%C3%B6nlein_nephritis_IgA_immunostaining.jpg | HSP - IgA IHC (WC)
</gallery>
====Scoring====
====Scoring====
IgA nephropathy can be scored using an assessment of '''m'''esangial proliferation, '''e'''ndocapillary proliferation, glomerulo'''s'''clerosis and '''t'''ubular atrophy and interstitial fibrosis (abbreviated ''MEST'').<ref>{{Cite journal  | last1 = Coppo | first1 = R. | last2 = Cattran | first2 = D. | last3 = Roberts Ian | first3 = SD. | last4 = Troyanov | first4 = S. | last5 = Camilla | first5 = R. | last6 = Cook | first6 = T. | last7 = Feehally | first7 = J. | title = The new Oxford Clinico-Pathological Classification of IgA nephropathy. | journal = Prilozi | volume = 31 | issue = 1 | pages = 241-8 | month = Jul | year = 2010 | doi =  | PMID = 20693944 }}</ref>
IgA nephropathy can be scored using an assessment of '''m'''esangial proliferation, '''e'''ndocapillary proliferation, glomerulo'''s'''clerosis and '''t'''ubular atrophy and interstitial fibrosis (abbreviated ''MEST'').<ref>{{Cite journal  | last1 = Coppo | first1 = R. | last2 = Cattran | first2 = D. | last3 = Roberts Ian | first3 = SD. | last4 = Troyanov | first4 = S. | last5 = Camilla | first5 = R. | last6 = Cook | first6 = T. | last7 = Feehally | first7 = J. | title = The new Oxford Clinico-Pathological Classification of IgA nephropathy. | journal = Prilozi | volume = 31 | issue = 1 | pages = 241-8 | month = Jul | year = 2010 | doi =  | PMID = 20693944 }}</ref>
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*[[Nodular glomerulosclerosis]].
*[[Nodular glomerulosclerosis]].


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Membranoproliferative_glomerulonephritis_-_intermed_mag.jpg MPGN - intermed. mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg MPGN - very high mag. (WC)].
Image:Membranoproliferative_glomerulonephritis_-_intermed_mag.jpg | MPGN - intermed. mag. (WC/Nephron)
Image:Membranoproliferative_glomerulonephritis_-_very_high_mag.jpg | MPGN - very high mag. (WC/Nephron)
</gallery>
*[http://path.upmc.edu/cases/case593.html MPGN - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case593.html MPGN - several images (upmc.edu)].


Line 886: Line 896:
*+/-[[Vasculitis]].
*+/-[[Vasculitis]].


Images:
====Images====
*WC - KGH:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_%282%29.jpg RPGN (WC)].
Image:Crescentic_glomerulonephritis_%282%29.jpg | RPGN (WC/KGH)  
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_%281%29.jpg RPGN (WC)].
Image:Crescentic_glomerulonephritis_%281%29.jpg | RPGN (WC/KGH)
*WC:
Image:Crescentic_glomerulonephritis_-_intermed_mag.jpg | RPGN - intermed. mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_-_intermed_mag.jpg RPGN - intermed. mag. (WC)].
Image:Crescentic_glomerulonephritis_-_high_mag.jpg | RPGN - high mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_-_high_mag.jpg RPGN - high mag. (WC)].
</gallery>
 
==Post-infectious glomerulonephritis==
==Post-infectious glomerulonephritis==
*Abbreviated ''PIGN''.
*Abbreviated ''PIGN''.
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*[[Glomerular crescents]].
*[[Glomerular crescents]].


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Post-infectious_glomerulonephritis_-_high_mag.jpg Post-infectious GN - high mag. (WC)].
Image:Post-infectious_glomerulonephritis_-_high_mag.jpg | Post-infectious GN - high mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Post-infectious_glomerulonephritis_-_very_high_mag.jpg Post-infectious GN - very high mag. (WC)].
Image:Post-infectious_glomerulonephritis_-_very_high_mag.jpg | Post-infectious GN - very high mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Acute_Glomerulonephritis_Pathology_Diagram.svg Post-infectious GN - schematic (WC)].
Image:Acute_Glomerulonephritis_Pathology_Diagram.svg | Post-infectious GN - schematic (WC/Nephron)
*www:
</gallery>
**[http://path.upmc.edu/cases/case671.html Post-infectious glomerulonephritis - several images (upmc.edu)].
www:
*[http://path.upmc.edu/cases/case671.html Post-infectious glomerulonephritis - several images (upmc.edu)].


===IF===
===IF===
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**Crescentic glomerulonephritis.
**Crescentic glomerulonephritis.


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_-_intermed_mag.jpg RPGN - intermed. mag. (WC)].
Image:Crescentic_glomerulonephritis_-_intermed_mag.jpg | RPGN - intermed. mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Crescentic_glomerulonephritis_-_high_mag.jpg RPGN - high mag. (WC)].
Image:Crescentic_glomerulonephritis_-_high_mag.jpg | RPGN - high mag. (WC/Nephron)
*www:
</gallery>
**[http://path.upmc.edu/cases/case541.html AGBM disease - several images (upmc.edu)].
www:
*[http://path.upmc.edu/cases/case541.html AGBM disease - several images (upmc.edu)].


===IF===
===IF===
Line 1,083: Line 1,094:
**Macrophages (CD68 +ve).
**Macrophages (CD68 +ve).


Images:
=====Images=====
*www:  
www:  
**[http://www.kidneypathology.com/Imagenes/Amiloidosis%20y/MM.3.w.jpg Cast nephropathy in myeloma (kidneypathology.com)].
*[http://www.kidneypathology.com/Imagenes/Amiloidosis%20y/MM.3.w.jpg Cast nephropathy in myeloma (kidneypathology.com)].
**[http://www.kidneypathology.com/Imagenes/Amiloidosis%20y/MM.5.w.jpg Cast nephropathy in myeloma - refractile crap (kidneypathology.com)].
*[http://www.kidneypathology.com/Imagenes/Amiloidosis%20y/MM.5.w.jpg Cast nephropathy in myeloma - refractile crap (kidneypathology.com)].
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Cast_nephropathy_-_high_mag.jpg Myeloma cast nephropathy - high mag. (WC)].
Image:Cast_nephropathy_-_high_mag.jpg | Myeloma cast nephropathy - high mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Cast_nephropathy_-_2_cropped_-_very_high_mag.jpg Myeloma cast nephropathy - cropped - very high mag. (WC)].
Image:Cast_nephropathy_-_2_cropped_-_very_high_mag.jpg | Myeloma cast nephropathy - cropped - very high mag. (WC/Nephron)
 
</gallery>
====Stains====
====Stains====
*Myeloma casts = PAS -ve.
*Myeloma casts = PAS -ve.
Line 1,217: Line 1,228:
*[[Neutrophil]]s within the renal tubules and interstitium.<ref name=Ref_Sternberg5_1726>{{Ref Sternberg5|1726}}</ref>
*[[Neutrophil]]s within the renal tubules and interstitium.<ref name=Ref_Sternberg5_1726>{{Ref Sternberg5|1726}}</ref>


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Acute_pyelonephritis_-_intermed_mag.jpg Acute pyelonephritis - intermed. mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Acute_pyelonephritis_-_2_-_high_mag.jpg Acute pyelonephritis - high mag. (WC)].
Image:Acute_pyelonephritis_-_intermed_mag.jpg | Acute pyelonephritis - intermed. mag. (WC/Nephron)
*[http://commons.wikimedia.org/wiki/File:Acute_pyelonephritis_-_2_-_very_high_mag.jpg Acute pyelonephritis - very high mag. (WC)].
Image:Acute_pyelonephritis_-_2_-_high_mag.jpg | Acute pyelonephritis - high mag. (WC/Nephron)
 
Image:Acute_pyelonephritis_-_2_-_very_high_mag.jpg | Acute pyelonephritis - very high mag. (WC/Nephron)
</gallery>
==Chronic pyelonephritis==
==Chronic pyelonephritis==
*''Reflux nephropathy'' is considered synonym in some sources.<ref name=Ref_Sternberg5_1728>{{Ref Sternberg5|1728}}</ref>
*''Reflux nephropathy'' is considered synonym in some sources.<ref name=Ref_Sternberg5_1728>{{Ref Sternberg5|1728}}</ref>
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