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    Benign Nephrosclerosis

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    عوض الكريم
    Benign nephrosclerosis involves hyaline thickening of arterial walls leading to mild functional impairment. Malignant nephrosclerosis arises in malignant hypertension and results in ischemia of the kidney seen as a "flea beaten" appearance on gross examination. It is a medical emergency. Adult polycystic kidney disease is autosomal dominant and causes huge kidneys full of cysts that can lead to end stage renal failure. Childhood polycystic kidney disease is autosomal recessive and involves numerous small cortical cysts often leading to death in infancy.

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    Benign Nephrosclerosis

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    عوض الكريم
    15 views15 pages
    Benign nephrosclerosis involves hyaline thickening of arterial walls leading to mild functional impairment. Malignant nephrosclerosis arises in malignant hypertension and results in ischemia of the kidney seen as a "flea beaten" appearance on gross examination. It is a medical emergency. Adult polycystic kidney disease is autosomal dominant and causes huge kidneys full of cysts that can lead to end stage renal failure. Childhood polycystic kidney disease is autosomal recessive and involves numerous small cortical cysts often leading to death in infancy.

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    Benign nephrosclerosis involves hyaline thickening of arterial walls leading to mild functional impairment. Malignant nephrosclerosis arises in malignant hypertension and results in ischemia of the kidney seen as a "flea beaten" appearance on gross examination. It is a medical emergency. Adult polycystic kidney disease is autosomal dominant and causes huge kidneys full of cysts that can lead to end stage renal failure. Childhood polycystic kidney disease is autosomal recessive and involves numerous small cortical cysts often leading to death in infancy.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    15 views15 pages

    Benign Nephrosclerosis

    Uploaded by

    عوض الكريم
    Benign nephrosclerosis involves hyaline thickening of arterial walls leading to mild functional impairment. Malignant nephrosclerosis arises in malignant hypertension and results in ischemia of the kidney seen as a "flea beaten" appearance on gross examination. It is a medical emergency. Adult polycystic kidney disease is autosomal dominant and causes huge kidneys full of cysts that can lead to end stage renal failure. Childhood polycystic kidney disease is autosomal recessive and involves numerous small cortical cysts often leading to death in infancy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    Benign Nephrosclerosis

    • Found in patients with benign


    hypertension
    • Hyaline thickening of arterial walls
    • Leads to mild functional impairment
    • Rarely fatal
    • Affects only afferent arterioles
    • When seen in diabetes affects both
    afferent and efferent arterioles
    1
    2
    Benign nephrosclerosis
    Malignant Nephrosclerosis

    • Arises in malignant hypertension


    • Hyperplastic vessels
    • Ischemia of kidney
    • “Flea beaten”kidney on gross
    appearance
    • Medical emergency

    3
    4
    Malignant Hypertension
    • 5% of cases of hypertension
    • Super-high blood pressure, encephalopathy,
    heart abnormalities
    • First sign often headache, scotomas
    • Decreased blood flow to kidney leads to
    increased renin, which leads to increased BP!
    • 5y survival: 50%
    • Histology:Necrotising arteriolitis, onion
    skinning,
    5
    6
    Malignant nephrosclerosis
    7
    Malignant nephrosclerosis
    Renal Pathology Outline

    • Introductory stuff
    • Glomerular diseases
    • Tubular and interstitial diseases
    • Diseases involving blood vessels
    • Cystic diseases
    – Adult polycystic kidney disease
    – Childhood polycystic kidney disease
    8
    Adult Polycystic Kidney Disease

    • Autosomal dominant
    • Huge kidneys full of cysts
    • Usually no symptoms until 30s
    • Associated with berry aneurysms and
    Hypertension,hematuria
    • Germline mutation affecting PKD1
    gene on chromosome 16(85-90%). or
    PKD2 gene on chromosome 4(15%)
    9
    ADPKD

    • Cysts can be formed anywhere in the kidney


    i.e. tubules, collecting ducts, bowman’s
    space, etc.

    • Expanding cysts cause pressure on the


    surrounding tissues and lead to ischemic
    changes

    10
    11
    Adult polycystic kidney disease
    ADPKD
    • Clinical findings:
    - Most patients remain asymptomatic until middle age
    - Abdominal mass – massive bilateral kidney enlargement
    - Flank pain
    - Hypertension
    - Gross hematuria
    - Berry aneurysms, liver cysts are extrarenal findings

    • Diagnosis: ultrasound

    • Most patients develop end stage renal failure

    12
    Childhood Polycystic Kidney Disease

    • Autosomal recessive
    • Numerous small cortical
    cysts
    • Associated with liver cysts
    • Patients often die in
    infancy

    13
    Autosomal Recessive (Childhood) Polycystic Kidney disease

    • This rare disease has a autosomal recessive pattern, which result from a
    mutation in the PKHD1 gene-codes for the fibrocystin gene on
    chromosome 6
    • It presents bilaterally as small cysts, which are usually found in the
    cortex and medulla and give a sponge-like appearance
    • Cysts may be found in the liver
    • There is a high mortality rate associated with neonates or young infants.
    In the surviving patient, liver cirrhosis will ensue

    14
    15
    Childhood polycystic kidney disease

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