Basic Pathology for Health Science Diploma Programs
Fiji School of Medicine
Module: Systemicl Pathology
Chapter: Renal system
Disorders of Kidney, Glomerulonephritis, kidney Failure, nephrolithiasis,
Self Study Guide
Resource Person:
Dr. Venkatesh M. Shashidhar
Department of Pathology
Keywords:
Polyuria (more urine)
Oliguria (less urine)
Anuria (no urine)
Proteinuria (protein in ur)
Hematuria (blood in ur)
Nephritic syndrome
Nephrotic syndrome
Pyelonephritis
Glomerulonephritis
Endstage kidney disease
Renal failure
Nephrosclerosis
Hydronephrosis
Urolithiasis
Resources:
Pathology Illustrated
4th Edition, Govan et al. pp
Comprehensive Radiographic
Pathology.
Tortora and Grabowski, 8th
Edition
Web:
www.fsm.ac.fj/bulletin board
Share drive:\Pathology
lectures\diploma
www.fsm.ac.fj - pathology
home page
Introduction:
Daily Kidneys filter over 1700 litres of blood to produce a litre of urine. In doing so they
excrete waste products, regulates water, salt and pH and blood pressure balance. Kidney is
also an endocrine gland producing Renin (controls blood pressure) and Erythropoietin
(RBC production) hormones. Initially blood is filtered off water and all small molecules to
produce about 180 liters of glomerular filtrate/day, then complex mechanisms of absorption
and secretion in the tubules produce 1.5L of concentrated urine. Disorders affecting these
mechanisms cause either excess or decreased production of urine, affecting balance in the
body.
Review the following:
Revise Anatomy and physiology of Urinary system. Review the Structure of glomerulus and
its function. How kidney filters out urine. What is pH balance, water and salt balance in body
how is it regulated.
Familiarise yourself to the following:
Renal disorders present with disturbances in Urine formation, water and salt & pH balance,
and affect blood pressure. Renal disorders can be classified into four major groups.
1. Glomerulonephritis Glomerular diseases Destruction of
glomeruli by immune or infections.
2. Acute tubular necrosis Tubular diseases Necrosis of
tubules by toxins or infections.
3. Pyelonephritis Interstitial diseases - Infections
4. Nephrosclerosis Vascular diseases thickening of blood
vessels Hypertension leading to micro infarctions.
Most renal disorders produce one of four clinical syndromes.
Nephritic syndrome. Oliguria, Haematuria, Proteinuria, Oedema.
1. Nephrotic syndrome. Gross proteinuria, hyperlipidemia,
2. Acute renal failure. Loss of Kidney function - within weeks Uremia.
Chronic renal failure. Over months and years - Uremia
Kidney Failure: Or end stage kidney disease is terminal stage of destruction of kidney to
totally affect kidney function. Patient presents with uremia (excess urea in blood), high
blood pressure, and anuria (no urine) or oliguria (little urine). Fatal disease, and requires
continuous dialysis (artificial filtering of blood) What is dialysis? Hemodialysis and
peritoneal dialysis. What is kidney transplantation, when is it done, how is it done.
Nephrolithiasis: Formation of stone in kidney, Urolithiasis (formation of stone in urinary
tract) results in obstruction to flow, and dilatation of urinary tract called hydronephrosis.
Laboratory investigations (routine) for the diagnosis of renal disorders:
1.
2.
3.
4.
Urine chemistry: Sugar, Bilirubin, Ketones.
Microscopy Cells, Casts & Crystals
Serum electrolytes Sodium & Potassium
Blood urea Nitrogen (BUN) & creatinine.
Self Assessment Questions:
1. How are kidney disorders classified? Give an example each?
2. What do you understand by Nephrotic syndrome
3. What are the clinical syndromes seen in kidney disorders?
4. Mention common laboratory tests are done to diagnose kidney disorders?
5. What is Hematuria? Mention two diseases presenting with Hematuria?
6. What is nephrosclerosis?
7. What are urinary casts? What is their importance?
8. What is glomerulonephritis? What are its common causes?
February 9, 2015
