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Systemic Pathology
urinary system
83
Pathology
Professional
09/04/2011

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Term

renal a -> interlobar a -> arcuate a -> interlobular a -> afferent glomerular a -> efferent glomerular a -> peritubular capillary -> interlobular v -> arcuate v -> interlobar v

 

In the medulla: efferent glomerular a -> descending vasa recta -> ascending vasa recta -> arcuate vein

Definition
order of blood flow in kidneys
Term
Tubular reabsorption
Definition
the process of reclaiming water and solutes from tubular fluid and returning them to the blood
Term
Proximal convoluted tubule
Definition
the part of the nephron that reabsorbs a greater variety of chemicals than any other part of the nephron
Term
Nephron
Definition
the functional unit of the kidney
Term
Juxtaglomerular (J) cell
Definition
a modified smooth muscle cell in the afferent arteriole that secretes renin
Term
Macula densa
Definition
specialized region in distal tubule that regulates blood flow to glomerulus by detecting sodium concentration changes in the distal tubule; secretes ACE
Term
Extraglomerular mesangial cell (Lacis cell)
Definition
secretes erythropoietin
Term
Renal reserve
Definition
percent of nephrons not necessary for normal function (50%)
Term
Renal insufficiency
Definition
begins with loss of renal reserve, no clinical signs but cannot compensate for stresses such as infection or dehydration
Term
Renal disease
Definition
occurrence of morphologic renal lesions of any size or severity or any biochemical abnormalities related to renal function (because of the extensive reserve capacity of the kidney, may be present in the absence of clinical signs or laboratory abnormalities)
Term
Renal failure
Definition
state of decreased renal function where azotemia and inability to concentrate urine persist concurrently (occurs only after substantial loss of nephrons)
Term
Azotemia
Definition
an increased concentration of nonprotein nitrogenous compounds in the blood, usually urea or creatinine
Term
Uremia
Definition
presence of urine products in blood; clinical and biochemical manifestation of renal failure
Term
Uremic syndrome
Definition
clinical signs and lesions of uremia
Term
Renomegaly
Definition
kidney enlargement (unilateral or bilateral)
Term
Micturition
Definition
normal process of urination
Term
Dysuria/stranguria
Definition
difficult urination, often with painful straining
Term
Oliguria/anuria
Definition
production of abnormally small amount of urine/no urine
Term
Polyuria
Definition
increased urine production
Term
Pollakiuria
Definition
increased frequency of urination
Term
Polydipsia
Definition
increased thirst/water consumption
Term
Periuria
Definition
urination in inappropriate locations
Term
Urine retention
Definition
abnormal retention of urine in bladder
Term
Urinary incontinence
Definition
inappropriate passage of urine
Term
Hyposthenuria
Definition
inability to form (concentrate) urine of high specific gravity
Term
Isosthenuria
Definition
excretion of urine with the same osmolality as that of plasma
Term
Proteinuria/hemoglobinuria/hematuria/pyuria
Definition
abnormal presence of protein/hemoglobin/red blood cells/pus in urine
Term
Renal dysplasia
Definition
an abnormality of altered structural organization resulting from abnormal differentiation and the presence of structures not normally present in nephrogenesis; usually bilateral but not necessarily symmetrical; results in small and/or misshapen kidneys
Term
Asynchronous differentiation of nephrons (inappropriate for the age of the animal)
Definition
key microscopic feature of renal dysplasia
Term
Progressive juvenile nephropathy
Definition
seen in breeds such as the lhasa apso, shih tzu, and golden retriever; exhibits asynchronous differentiation of nephrons and to a lesser extent other features of renal dysplasia; may be a variant of renal dysplasia
Term
Renal cysts
Definition
spherical, thin-walled, variably sized distensions principally of the cortical or medullary renal tubules, filled with watery fluid; may be single or multiple
Term
Polycystic kidney disease
Definition
inherited as an autosomal dominant trait in Persian cats and bull terriers
Term
Primary renal glucosuria
Fanconi-like syndrome
Cystinuria
Hyperuricosuria
Definition
inherited abnormalities in renal tubular function
Term
Nephrotic syndrome
Definition
a clinical syndrome characterized by proteinuria/hypoalbuminemia, generalized edema, and hypercholesterolemia
Term
Suppurative glomerulitis (embolic nephritis)
Definition
occurs when bacteria lodge in random glomeruli and occasionally interstitial capillaries, causing microabscesses
Term
Actinobacillosis of foals (Actinobacillus equuli)
Definition
most common cause of suppurative glomerulitis
Term
Immune-mediated glomerulonephritis
Definition
due to deposition of immune complexes in glomeruli; the deposits may be preformed circulating immune complexes or more commonly due to in situ formation; occurs most commonly in dogs and cats in association with persistent infections, use of modified live virus vaccines, or other diseases that have a prolonged antigenemia
Term
Proliferative glomerulonephritis
Definition
increased cellularity of the glomerular tufts caused by proliferation of glomerular endothelial, epithelial, and mesangial cells
Term
Membranous glomerulonephritis
Definition
diffuse glomerular basement membrane thickening because of the presence of subepithelial Ig deposits which are later removed and replaced by basement membrane material, resulting in sclerotic change; often associated with nephrotic syndrome; the most common form of ICGN in cats
Term
Membranoproliferative glomerulonephritis
Definition
hypercellularity following proliferation of glomerular cells and thickening of the capillary basement membrane and mesangium; the most common form of ICGN in domestic animals including dogs
Term
Diffuse (generalized)
Definition
glomerular lesions that involve all or most of the glomeruli
Term
Focal
Definition
glomerular lesions that involve only some glomeruli
Term
Global
Definition
glomerular lesions that involve an entire glomerulus
Term
Segmental
Definition
glomerular lesions that involve only part of the glomerular tuft
Term
Synechiae
Definition
adhesions between the glomerular tufts and Bowman's capsule
Term
Glomerular crescent
Definition
a hypercellular, intraglomerular lesion composed of proliferated parietal epithelium, monocytes, fibrin, and later, fibrosis
Term
Glomerulosclerosis
Definition
shrunken, hyalinized glomeruli because of an increase in both fibrous connective tissue and mesangial matrix and a loss of glomerular capillaries; glomeruli nonfunctional; the end-stage of glomerulonephritis and any chronic disease with severe damage to nephrons
Term
Lugol's iodine plus weak acid (dilute sulfuric acid)
Definition
method for diagnosing amyloidosis
Term
Idiopathic glomerular vasculopathy and cutaneous vasculopathy of greyhounds
Definition
cause unknown but may be due to an E. coli toxin; gross characteristics - congestion and petechial hemorrhages in the renal cortex; microscopic - fibrin thrombi, hemorrhage and necrosis in glomeruli; affected dogs also have cutaneous erythemas and ulcers, distal limb edema, uremic signs, and thrombocytopenia
Term
Intravascular accumulation of metabolic wastes - azotemia, uremia

Reduced blood pH (metabolic acidosis)

Alterations in plasma electrolyte concentrations (K, Ca, P)

Hypertension
Definition
Results of renal failure
Term
Acute renal failure
Definition
occurs when renal functional capacity is abruptly impaired (>75%)
Term
Decreased ultrafiltration
Intratubular obstruction
Fluid back leak
Intrarenal vasoconstriction
Definition
Four main pathophysiologic alterations of acute renal failure
Term
Cardiotoxicity of elevated K+
Metabolic acidosis
Pulmonary edema
Definition
causes of death in acute renal failure
Term
Acute tubular necrosis
Definition
the single most important cause of acute renal failure
Term
Nephrotoxins
Definition
directly damage tubular epithelial cells, particularly those of the proximal convoluted tubules, following the intracellular conversion to reactive metabolites; usually do not damage the tubular basement membrane, thus more efficient regeneration of tubules
Term
Renal ischemia
Definition
can cause sublethal tubular cell injury, necrosis or apoptosis; characterized by disruption of the tubular basement membrane (tubulorrhexis)
Term
Tubulorrhexis
Definition
disruption of the tubular basement membrane
Term
Hypovolemic shock
Renal vascular obstruction
Definition
causes of renal ischemia
Term
Nephrotoxin-associated ischemia
Definition
occurs when nephrotoxins indirectly stimulate vasoconstriction and ischemia
Term
Afferent arteriole vasoconstriction
Back leak of glomerular filtrate
Tubular obstruction
Definition
mechanisms of decreased GFR in ischemic ARF
Term
Hemoglobinuria
Definition
usually occurs secondary to severe intravascular hemolysis
Term
Myoglobinuria
Definition
secondary to acute rhabdomyolysis
Term
Cisplatin
Aminoglycosides (esp. neomycin)
Definition
drugs that cause ATN
Term
Glycolic acid, oxalate
Definition
toxic metabolites of ethylene glycol
Term
Pulpy kidney disease
Definition
Acute tubular epithelial cell degeneration and necrosis, interstitial edema, and hemorrhage caused by epsilon exotoxin produced by Clostridium perfringes type D in small ruminants; must be differentiated from postmortem autolysis
Term
Interstitial nephritis
Definition
primary inflammation in the interstitial vascular structures or connective tissue
Term
Tubulointerstitial nephritis
Definition
a group of inflammatory diseases that involve the interstitium and tubules
Term
Acute tubulointerstitial disease
Definition
characterized by ATN, papillary necrosis, and interstitial inflammation with presence of principally neutrophilic infiltrates in the interstitium and tubules
Term
Chronic tubulointerstitial disease
Definition
characterized by tubular atrophy, sparse mononuclear cell infiltration, fibrosis, and glomerular atrophy and sclerosis
Term
Leptospirosis
Definition
best example of bacterial tubulointerstitial nephritis
Term
Granulomatous nephritis
Definition
a tubulointerstitial disease that often accompanies a systemic disease (FIP, mycobacterium, fungal infection, parasites, hairy vetch)
Term
Pyelonephritis
Definition
inflammation of both the renal pelvis and parenchyma
Term
Pyelitis
Definition
Inflammation of the renal pelvis only
Term
Hydronephrosis
Definition
dilation of the renal pelvis due to obstruction of urine outflow
Term
Renal fibrosis
Definition
replacement of renal parenchyma,including tubules, glomeruli, and interstitium with fibrous connective tissue; common end-point of all reparative stages of renal disease unless healed by tubular epithelial regeneration
Term
End stage kidney
Definition
end point of kidney disease with extensive loss of functional nephron units and fibrosis
Term
Renal infarct
Definition
an area of coagulative necrosis resulting from vascular occlusion (most commonly at the interlobular aa)
Term
NSAID use in horses
Definition
cause of primary papillary necrosis
Term
Papillotoxins
Definition
certain drugs (eg NSAIDs) whose primary targets are medullary interstitial cells
Term
Ectopic ureters
Definition
ureters empty into urethra, vagina, neck of bladder, ductus deferens, prostate, or other secondary sex glands
Term
Parent urachus
Definition
Failure of the urachus and umbilical arteries/ veins to involute; most common malformation of the urinary bladder
Term
Urolithiasis/urinary calculi/uroliths
Definition
concretions formed in the urinary collection system
Term
Struvite, oxalate
Definition
common types of urinary calculi
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