Nephron Loss and Glomerular Injury
38 Questions
3 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the characteristic histological feature of Focal Segmental Glomerulosclerosis?

  • Sclerosis affecting only the cortical glomeruli
  • Sclerosis affecting some but not all glomeruli (correct)
  • Sclerosis affecting only the juxtamedullary glomeruli
  • Sclerosis affecting all glomeruli

    • What is the term used to describe the involvement of only segments of each affected glomerulus?

  • Focal
  • Diffuse
  • Global
  • Segmental (correct)

    • What is often seen in affected glomeruli using immunofluorescence microscopy?

  • Trapping of C3 only
  • Nonspecific trapping of immunoglobulins, usually IgM, and complement (correct)
  • Absence of immunoglobulins
  • Specific trapping of IgG

    • What is deposited in the affected glomeruli?

    <p>Hyaline masses and lipid droplets</p> Signup and view all the answers

    What is the term used to describe the combination of focal and segmental involvement?

    <p>Focal and segmental</p> Signup and view all the answers

    What is expressed by podocytes in Focal Segmental Glomerulosclerosis?

    <p>Complement</p> Signup and view all the answers

    What is the consequence of cell injury or apoptosis in the context of the complement system?

    <p>Activation of the alternative and mannose-binding lectin pathways</p> Signup and view all the answers

    What is the suspected role of antibodies against glomerular cell antigens in certain disorders?

    <p>To directly damage glomerular cells or slit diaphragms</p> Signup and view all the answers

    What is the primary mechanism of tissue injury in poststreptococcal GN?

    <p>Activation of the classical pathway</p> Signup and view all the answers

    What is the characteristic feature of membranous nephropathy?

    <p>Granular subepithelial deposits</p> Signup and view all the answers

    What is the consequence of a 30-50% reduction in GFR due to renal disease?

    <p>Progression to end-stage kidney disease</p> Signup and view all the answers

    What is the underlying cause of dense deposit disease?

    <p>Complement dysregulation</p> Signup and view all the answers

    What is the characteristic of kidneys in end-stage kidney disease?

    <p>Widespread glomerulosclerosis</p> Signup and view all the answers

    What is the prognosis of dense deposit disease?

    <p>Often progresses to end-stage renal disease</p> Signup and view all the answers

    What is the role of adaptive changes in the remaining glomeruli in progressive sclerosis?

    <p>To initiate and perpetuate progressive sclerosis</p> Signup and view all the answers

    What is the consequence of hypertrophy in remaining glomeruli?

    <p>Increased glomerular permeability</p> Signup and view all the answers

    What is the target of the autoimmune response in membranous nephropathy?

    <p>Phospholipase A2 receptor</p> Signup and view all the answers

    What is the role of streptococcal exotoxin B in poststreptococcal GN?

    <p>Activates the alternative complement pathway</p> Signup and view all the answers

    What is the role of sensitized T cells in experimental glomerulonephritis?

    <p>To cause experimental glomerular injury</p> Signup and view all the answers

    What is the characteristic feature of MPGN?

    <p>Granular subendothelial deposits</p> Signup and view all the answers

    What is the final consequence of the alterations that occur in the remaining glomeruli?

    <p>Further endothelial and podocyte injury</p> Signup and view all the answers

    What is the difference between MPGN and dense deposit disease?

    <p>MPGN is caused by immune complex deposition, while dense deposit disease is caused by complement dysregulation</p> Signup and view all the answers

    What is the typical age range for the onset of hereditary nephritis?

    <p>5-20 years</p> Signup and view all the answers

    What is the most common reason for gross hematuria in patients with IgA nephropathy?

    <p>Respiratory tract infection</p> Signup and view all the answers

    What is the estimated proportion of patients with IgA nephropathy who develop chronic renal failure?

    <p>25-50%</p> Signup and view all the answers

    What is the typical duration of hematuria in patients with IgA nephropathy?

    <p>Several days</p> Signup and view all the answers

    What is the characteristic feature of the nephritic syndrome?

    <p>Hematuria with proteinuria and oliguria</p> Signup and view all the answers

    What is the usual outcome for female carriers of X-linked Alport syndrome?

    <p>Benign clinical course with persistent hematuria</p> Signup and view all the answers

    What is the histological feature that may indicate a worse prognosis in IgA nephropathy?

    <p>All of the above</p> Signup and view all the answers

    What is the genetic defect associated with hereditary nephritis?

    <p>Defects in the genes encoding α3 or α4 type IV collagen</p> Signup and view all the answers

    What is the characteristic appearance of glomeruli in advanced cases of membranous nephropathy?

    <p>Diffuse thickening of the capillary wall</p> Signup and view all the answers

    What is the primary cause of membranous nephropathy in approximately 85% of cases?

    <p>Autoantibodies that cross-react with antigens</p> Signup and view all the answers

    What is the characteristic finding on immunofluorescence microscopy in membranous nephropathy?

    <p>Granular deposits of immunoglobulins and complement</p> Signup and view all the answers

    What percentage of cases of idiopathic nephrotic syndrome in children and adults is accounted for by membranoproliferative glomerulonephritis?

    <p>5% to 10%</p> Signup and view all the answers

    What is the characteristic histological feature of membranoproliferative glomerulonephritis?

    <p>Proliferation of glomerular cells</p> Signup and view all the answers

    What is the primary location of immunoglobulins and complement deposits in membranous nephropathy?

    <p>Glomerular basement membrane</p> Signup and view all the answers

    What is the eventual outcome of the glomeruli in advanced cases of membranous nephropathy?

    <p>Sclerosis</p> Signup and view all the answers

    What is the characteristic feature of membranous nephropathy on light microscopy?

    <p>Normal appearance</p> Signup and view all the answers

    Study Notes

    Nephron Loss and Glomerular Injury

    • Renal disease, glomerular or otherwise, can destroy sufficient nephrons to reduce the GFR to 30% to 50% of normal, leading to end-stage kidney disease.
    • Antibodies against glomerular cell antigens can directly damage glomerular cells or slit diaphragms, potentially contributing to certain disorders.
    • Monocytes and macrophages can infiltrate the glomerulus and release diverse mediators, causing glomerular damage.
    • Sensitized T cells can cause experimental glomerular injury.

    Focal Segmental Glomerulosclerosis

    • Focal segmental glomerulosclerosis (FSGS) is characterized by sclerosis affecting some but not all glomeruli (focal involvement) and involving only segments of each affected glomerulus (segmental involvement).
    • FSGS often presents with proteinuria, and the kidneys show widespread glomerulosclerosis.
    • Progression to end-stage kidney disease is driven by adaptive changes in the remaining glomeruli, leading to hypertrophy, hemodynamic changes, and increased glomerular permeability to proteins.

    Membranous Nephropathy

    • Membranous nephropathy is caused by an autoimmune response, often directed against the phospholipase A2 receptor on podocytes.
    • The disease is characterized by granular subepithelial deposits of antibodies with GBM thickening and loss of foot processes, but little or no inflammation.
    • Membranous nephropathy is often resistant to steroid therapy.

    Membranoproliferative Glomerulonephritis and Dense Deposit Disease

    • Membranoproliferative GN (MPGN) is characterized by alterations in the GBM and mesangium, and proliferation of glomerular cells.
    • Dense deposit disease carries a poor prognosis and tends to recur more frequently in renal transplants.
    • MPGN is caused by immune complex deposition, whereas dense deposit disease is a consequence of complement dysregulation.

    Pathogenesis

    • Poststreptococcal GN is an immune complex disease, primarily caused by complement activation by the classical pathway.
    • The relevant antigens are streptococcal proteins, including streptococcal exotoxin B (Spe B) and streptococcal GAPDH.

    Clinical Course

    • IgA nephropathy often affects children and young adults, with more than half presenting with gross hematuria after an infection of the respiratory or urinary tract.
    • The subsequent course is highly variable, with many patients maintaining normal renal function for decades, while slow progression to chronic renal failure occurs in 25% to 50% of cases over a period of 20 years.

    The Nephritic Syndrome

    • The nephritic syndrome is characterized by hematuria, oliguria with azotemia, proteinuria, and hypertension.
    • The disease is often caused by immune complex deposition, complement activation, and inflammation.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Kidney and Its Collecting System Chapter 13 PDF

    Description

    This quiz covers the mechanisms of nephron loss and glomerular injury, including the role of renal disease, antibodies, and immune cells in causing glomerular damage and end-stage kidney disease.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser