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Kidney disease

Guided by the structural and functional principle, two main groups of kidney diseases, or nephropathies, can be distinguished: glomerulo- and tubulopathies, which can be acquired and hereditary.

Glomerulopathies are diseases with primary and primary damage to the renal glomeruli, characterized by impaired filtration. Acquired glomerulopathies include glomerulonephritis, acquired renal amyloidosis, idiopathic nephrotic syndrome (lipoid nephrosis), diabetic glomerulosclerosis, hereditary nephritis with deafness (Alport disease), hereditary nephrotic syndrome, hereditary (familial) nephropathic amyloidosis.

Tubulopathies are kidney diseases with primary and leading lesion of the tubule, a characteristic loss of tubular function. Acquired tubulopathies are necrotic nephrosis (acute renal failure), “myeloma kidney” and “gouty kidney”, hereditary - various forms of tubular enzymopathies.

In addition, a large group of kidney diseases are: pyelonephritis, kidney stone disease, polycystic kidney disease, kidney tumors and nephrosclerosis, which completes the course of many kidney diseases and underlies CRF.

Glomerulonephritis - A disease of an infectious-allergic nature, the basis of which is bilateral diffuse or focal inflammation of the glomeruli of the kidneys with characteristic renal and extrarenal symptoms. Nephrotic syndrome is characterized by high proteinuria, dysproteinemia, hypolipidemia and edema. According to the topography of the process, intra- and extracapillary forms of glomerulonephritis are distinguished. Depending on the nature of the disease, there are: 1) acute glomerulonephritis; 2) subacute, progressive, or malignant, glomerulonephritis; 3) chronic glomerulonephritis, the final stage of all of the above forms is terminal glomerulonephritis (secondary-wrinkled kidneys, chronic renal failure).

Acute renal failure is a syndrome morphologically characterized by tubular epithelial necrosis and deep impairment of renal blood and lymph circulation.

Pyelonephritis is an infectious disease in which the renal pelvis, its calyx and the substance of the kidneys are involved in the process with a primary lesion of the interstitial tissue. Pyelonephritis can be single or double-sided. Complications of acute pyelonephritis are: 1) carbuncle of the kidney; 2) pyonephrosis; 3) perinephritis; 4) paranephritis; 5) papillonecrosis; 6) chronic kidney abscess.

In chronic pyelonephritis, the development of nephrogenic hypertension and arteriolosclerosis in the second (intact) kidney is possible.
Bilateral pyelonephrotic wrinkling of the kidneys leads to chronic renal failure.

Nephrosclerosis - densification and wrinkling of the kidneys due to proliferation of connective tissue.


1. Intracapillary glomerulonephritis (okr. GE).

Designations: 1) proliferation of endothelial cells and mesangium. glomeruli; 2) an increase in the size of the glomeruli; 3) granular dystrophy of the epithelium of the convoluted tubules of the kidneys. 4) hemorrhagic exudate in the stripe of the glomerulus.

2. Chronic pyelonephritis (okr. GE).

Designations: 1) foci of lymphohistiocytic infiltration of the stroma; 2) dystrophy of the convoluted tubule epithelium; 3) areas of the “thyroid” kidney.

3. Hypernephroid cancer of the kidney (env. GE).

Designations: 1) foci of small cell cancer of the kidney with dark cells and signs of cellular atypism; 2) areas of necrosis, hemorrhage and decay of tumor tissue.

4. Amyloid nephrosis with wrinkling (okrug. Congo-mouth).

Designations: deposits of amyloid masses: 1) in glomeruli; 2) in the walls of blood vessels; 3) under the basement membrane of the convoluted tubule epithelium; 4) in the stroma.

Macro preparations

1. Chronic glomerulonephritis with an outcome in wrinkling (secondary-wrinkled kidneys).

2. Amyloidosis of the kidneys.

3. Stones of the renal pelvis.

4. Polycystic kidney disease.

5. Hypernephroid kidney cancer.

6. Amyloid-wrinkled kidneys.

Test questions topics

1. Classification of kidney disease.

2. Etiology and pathogenesis of the most common kidney diseases (glomerulonephritis, pyelonephritis, amyloidosis, necrotic nephrosis).

3. Pathological anatomy of glomerulonephritis, pyelonephritis, renal amyloidosis, acute renal failure.

4. CRF. Uremia. Causes of development and morphological characteristics.

5. Tumors of the kidneys (benign and malignant). Morphological characteristics and features of metastasis.

Situational task

The patient fell ill acutely after hypothermia. There was an increase in blood pressure, hematuria, swelling of the face. Despite treatment, the effects of renal failure increased. After 6 months from the onset of the disease, the patient died. An autopsy revealed: the kidneys were enlarged, flabby, in the section the cortical layer was yellow-gray with red specks, the pyramids were dark red.

1. What disease did the patient have?

2. Describe the characteristic microscopic changes in the kidneys with

this one.

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Kidney disease

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