Renal Pathology

Glomerulonephritis:

• Membranous Glomerulonephritis:

• The glomerular basement membrane is diffusely thickened.

• Immune complexes are present on the outer aspect of the basement membrane beneath the podocytes.

• Late stages show diffuse glomerular basement membrane thickening.

• Post-Streptococcal Glomerulonephritis:

• Common in children aged 6-10 years.

• Microscopic features: enlarged glomeruli, diffuse mesangial cell proliferation, endothelial cell proliferation, epithelial cell proliferation, infiltration of neutrophils and mononuclear cells.

• Approximately 90% of children recover completely.

• Chronic Glomerulonephritis:

• Grossly: both kidneys are shrunken, symmetrical, the surface of the renal cortex is granular, the renal cortex is thin, most are fibrotic.

• It is the final stage of many glomerulonephritis diseases.

• Minimal Change Disease (Benign Nephrotic Syndrome):

• Common in children.

• Characteristics: respond well to corticosteroids.

• Podocytes lose their foot processes and the cell layer adheres to the outer aspect of the basement membrane.

• Nephrotic Syndrome:

• The main cause in adults is extramembranous glomerulonephritis.

• Characteristics: Immunoglobulin deposition beneath the podocyte foot processes.

• Clinical manifestations: high proteinuria, nephrotic syndrome.

• Renal Cell Carcinoma:

• Microscopic features: clear cells are round, polyhedral, with clear and wide cytoplasm.

• Clinical manifestations: pain in the ribs-spine, palpable mass, hematuria (10% of cases).

Glomerular Filtration System:

• Endothelial cell layer

• Basement membrane layer

• Podocyte layer