Mechanisms of Renal Disease Mechanisms of Renal Disease can be loosely divided into 4 broad categories: • • • • Immune Degenerative: FSGS, hyperfiltration Metabolic: Diabetes, deposition diseases Genetic: Alport’s, Fabry’s Autoimmunity has two components: • • Innate: complement system Adaptive: cell mediated system and the humeral system Features of Normal Renal Histology • • • • • Blood vessels Endothelial cells BM Type 4 collagen Podocytes with distinct foot processes Mesangium Location of Pathology: • Mesangial: proliferating cells are located in the mesangium • • Endocapillary: proliferating cells are o This compresses the capillaries o Cells endothelial, mesangial, inflammatory True Glomerulonephritis Extracapillary/crescents: proliferating cells cells are parietal epithelial and monocytes) located in the glomerular tuft are from diverse origins: in Bowman’s capsule o The inflammatory cells (mostly Types • • • • • • • Global: entire glomerulus Segmental: only a segment of the glomerulus is involved Diffuse: lesion involving all or most glomeruli Focal: lesion only affects some glomeruli Hyalinosis: homogenous, amorphous, glomerular proteinaceous material Sclerosis: type 4 collagen scar in glomerulus Fibrosis: type 1 collagen scar