'Medical conditons' are so named because they are generally managed medically by renal physicians (or nephrologists) as opposed to surgeons (or urologists). These are classified according to THREE functional components of the kidney:
I. Glomerular diseases
- Glomeruli are the FILTERS in the kidney – thus TWO things can go wrong:
- 1. They leak – blood, proteins enter the urine –> Causing Nephrotic Syndrome or Haematuria
- 2. They cease to filter – toxic waste materials remain in blood, filtrate does not pass through (urine volume goes down) –> Causing Acute renal failure
Mechanisms of glomerular diseases: These are often immune mediated. Here are 3 examples
- 1. Antibodies bind to antigens in-situ within glomeruli (eg. Anti-Glomerular Basement Membrane in Goodpasture Syndrome)
- 2. Antibodies and antigens are circulating as Immune Complexes – they get trapped in glomeruli and cause tissue damage and inflammatory reactions (eg. SLE, Post-infectious glomerulonephritis)
- 3. Antibodies bind to antigens in cells in glomeruli (eg. ANCA – anti-neutrophilic antibodies, in vasculitis
CLICK HERE to learn about how these conditions present clinically, and correlate this with the conditions and their main histologic appearance (proliferative vs non-proliferative)
II. Tubulointerstitial diseases
Tubules concentrate urine - conditions are often toxic, ischaemic or infectious –> They lead to abnormal urine volume, acute or chronic renal failure and signs and symptoms of infections
CLICK HERE to learn more about tubulointerstitial disesaes
III. Vascular diseases
These are often seen in systemic conditions. CLICK HERE to learn more about them.
Although we have divided the Medical conditions by the THREE main functional units of the kidney, it is important to note that some conditions, eg. Diabetes Mellitus, Amyloidosis and Hypertension can affect more than one compartment. This is elaborated on more in the Glomerular Diseases mindmap.
