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Difference between revisions of "Medical kidney diseases"
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Medical kidney diseases (view source)
Revision as of 04:08, 25 January 2012
, 04:08, 25 January 2012→Disease that does not commonly get biopsied: re-work section
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*Cystic [[renal cell carcinoma]]. | *Cystic [[renal cell carcinoma]]. | ||
= | =Pyelonephritis= | ||
== | ''Pyelonephritis'' is a misnomer; it is ''not'' an inflammatory process affecting the renal pelvis, as the name suggests. ''Pyelonephritis'' actually refers to a ''nephritis'' or ''tubulointerstitial nephritis''.<ref name=Ref_Sternberg5_1725>{{Ref Sternberg5|1725}}</ref> | ||
It can be subdivided into: | |||
* | *[[Acute pyelonephritis]]. | ||
*[[Chronic pyelonephritis]]. | |||
**[[Xanthogranulomatous pyelonephritis]]. | |||
==Acute pyelonephritis== | |||
*[[AKA]] ''acute infectious tubulointerstitial nephritis''. | |||
*[[AKA]] ''diffuse suppurative nephritis''. | |||
===General=== | |||
*Typically preceeded by a (lower) urinary tract infection (UTI). | |||
*Usually diagnosed clinically: | |||
**Urine C&S, urine R&M, +/-CT abdomen. | |||
**Fever, costovertebral tenderness. | |||
===Gross=== | |||
Features: | |||
*+/-[[Necrosis]] of renal papillae.<ref name=Ref_Klatt251>{{Ref Klatt|251}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Neutrophils within the renal tubules and interstitum.<ref name=Ref_Sternberg5_1726>{{Ref Sternberg5|1726}}</ref> | |||
== | ==Chronic pyelonephritis== | ||
*''Reflux nephropathy'' is considered synonym in some sources.<ref name=Ref_Sternberg5_1728>{{Ref Sternberg5|1728}}</ref> | |||
===General=== | ===General=== | ||
*May be associated with vesicoureteral reflux. | *May be associated with vesicoureteral reflux. | ||
*Chronic pyelonephritis may be a reason for nephrectomy.<ref>URL: [https://secure.health.utas.edu.au/intranet/cds/pathprac/Files/Cases/Renal/Case44/Case44.htm https://secure.health.utas.edu.au/intranet/cds/pathprac/Files/Cases/Renal/Case44/Case44.htm]. Accessed on: 26 July 2011.</ref> | *Chronic pyelonephritis may be a reason for nephrectomy.<ref>URL: [https://secure.health.utas.edu.au/intranet/cds/pathprac/Files/Cases/Renal/Case44/Case44.htm https://secure.health.utas.edu.au/intranet/cds/pathprac/Files/Cases/Renal/Case44/Case44.htm]. Accessed on: 26 July 2011.</ref> | ||
===Gross=== | ===Gross=== | ||
*Dilated and distorted renal pelvis.<ref name=Ref_Sternberg5_1729>{{Ref Sternberg5|1729}}</ref> | |||
*+/-[[Necrosis]] of renal papillae. | *+/-[[Necrosis]] of renal papillae.<ref name=Ref_Klatt251>{{Ref Klatt|251}}</ref> | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref name=Ref_Sternberg5_1729>{{Ref Sternberg5|1729}}</ref> | ||
*Interstitial | *Mononuclear tubulointerstitial infiltrate. | ||
**Usu. more dense at the pelvis. | |||
*Interstitial fibrosis. | |||
*+/-Renal casts (PAS positive); may result in a thyroid-like apparance. | |||
===Stains=== | |||
*PAS +ve -- renal tubular casts. | |||
=Disease that does not commonly get biopsied= | |||
==Malignant hypertension== | |||
:''See: [[hyperplastic arteriolosclerosis]]''. | |||
:''See: [[thrombotic microangiopathy]]''. | |||
*May be seen in [[scleroderma]]. | |||
==Acute tubular necrosis== | ==Acute tubular necrosis== | ||