Diseases of the kidney

Diseases of the kidney

1. DISEASES OF THE KIDNEY RENAL CALCULI AND CHRONIC PYELONEPHRITIS

2. Learning Objectives By the end of this session, you should know about Types of Renal Calculi Chronic Pyelonephritis

3. Renal calculi In the urinary tract, the most common site of origin of stone is the kidney. Males in the age group of 20-30 years are most commonly affected. Formed either due to supersaturation of urine deficiency of crystal formation inhibitors Stones are usually unilateral in 80% of patients Clinical symptoms include hematuria , urinary obstruction, renal colic (if they pass into the ureters ) and increased chances of infection.

4. Prevalence of Various Types of Renal Stones

5. Renal Calculi GROSS The pelvis of the kidney contains a single, large, soft yellow white stone taking the contour of the pelvi-calyceal system. Dilated pelvicalyceal system with atrophied and thin peripheral cortex. Staghorn renal stone

6. Chronic Pyelonephritis Chronic tubulointerstitial disease resulting from repeated attacks of inflammation and scarring due to infection.

7. Chronic Pyelonephritis GROSS The kidneys are usually small and contracted , weighing less than 100 gm each, showing unequal reduction. Outer surface shows the renal capsule adherent to the cortex with irregular scars on the surface.

8. Chronic Pyelonephritis GROSS Sectioned surface shows dilated pelvicalyceal system with atrophied and thin peripheral cortex and increased hilar fat extending inside.

9. Chronic Pyelonephritis The interstitium shows chronic inflammatory infiltrate with pronounced interstitial fibrosis . Dilated atrophic tubules may contain colloid casts producing thyroidisation of tubules. The wall of dilated pelvicalyceal system shows marked chronic inflammation and scarring . Periglomerular fibrosis and hyalinisation of some glomeruli MICROSCOPY