Benign Nephrosclerosis
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Benign Nephrosclerosis
Benign nephrosclerosis refers to the renal changes most commonly occurring in association with long-standing hypertension. It is termed benign because it rarely progresses to clinically significant chronic kidney disease or kidney failure. __TOC__ Morphology The kidneys appear symmetrically atrophic and there is a reduced nephron mass. The kidneys have a surface of diffuse, fine granularity that resembles grain leather. Microscopically, the basic anatomic change consists of hyaline thickening of the walls of the small arteries and arterioles (hyaline arteriolosclerosis). Under a microscope, this appears as a homogeneous, pink hyaline thickening at the expense of the vessel lumina, with loss of underlying cellular detail. The narrowing of the lumen restricts blood flow, resulting in ischemia. All structures of the kidney can show ischemic atrophy although glomerular ischemic atrophy may be patchy. In advanced cases of benign nephrosclerosis the glomerular tufts may become globally sc ...
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Histopathology Of Arcuate Artery Nephrosclerosis, Annotated
Histopathology (compound of three Greek language, Greek words: ''histos'' "tissue", πάθος ''pathos'' "suffering", and -λογία ''-logy, -logia'' "study of") refers to the light microscope, microscopic examination of Tissue (biology), tissue in order to study the manifestations of disease. Specifically, in clinical medicine, histopathology refers to the examination of a biopsy or surgical Laboratory specimen, specimen by a pathology, pathologist, after the specimen has been processed and histological sections have been placed onto glass slides. In contrast, cytopathology examines free cells or tissue micro-fragments (as "cell blocks"). Collection of tissues Histopathological examination of tissues starts with surgery, biopsy, or autopsy. The tissue is removed from the Human body, body or plant, and then, often following expert dissection in the fresh state, placed in a fixation (histology), fixative which stabilizes the tissues to prevent Decomposition, decay. The most ...
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Ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue i.e. hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction (such as vasoconstriction, thrombosis, or embolism). Ischemia causes not only insufficiency of oxygen, but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial (poor perfusion) or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribed with medi ...
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Hypertensive Kidney Disease
Hypertensive kidney disease is a medical condition referring to damage to the kidney due to chronic high blood pressure. It manifests as hypertensive nephrosclerosis (sclerosis referring to the stiffening of renal components). It should be distinguished from renovascular hypertension, which is a form of secondary hypertension, and thus has opposite direction of causation. Signs and symptoms Signs and symptoms of chronic kidney disease, including loss of appetite, nausea, vomiting, itching, sleepiness or confusion, weight loss, and an unpleasant taste in the mouth, may develop. Causes "Hypertensive" refers to high blood pressure and "nephropathy" means damage to the kidney; hence this condition is where chronic high blood pressure causes damages to kidney tissue; this includes the small blood vessels, glomeruli, kidney tubules and interstitial tissues. The tissue hardens and thickens which is known as nephrosclerosis. The narrowing of the blood vessels means less blood is goin ...
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Proteinuria
Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become foamy (although this symptom may also be caused by other conditions). Severe proteinuria can cause nephrotic syndrome in which there is worsening swelling of the body. Signs and symptoms Proteinuria often causes no symptoms and it may only be discovered incidentally. Foamy urine is considered a cardinal sign of proteinuria, but only a third of people with foamy urine have proteinuria as the underlying cause. It may also be caused by bilirubin in the urine ( bilirubinuria), retrograde ejaculation, pneumaturia (air bubbles in the urine) due to a fistula, or drugs such as pyridium. Causes There are three main mechanisms to cause proteinuria: * Due to disease in the glomerulus * Because of increased quantity of proteins in serum (overflow proteinuria) * Due to low r ...
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Glomerular Filtration Rate
Renal functions include maintaining an acid–base balance; regulating fluid balance; regulating sodium, potassium, and other electrolytes; clearing toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D. One of the measures of kidney function is the glomerular filtration rate (GFR). Glomerular filtration rate describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion, which can be blocked by cimetidine. Both GFR and CCr may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result (eGFR and eCCr) The results of these tests are used ...
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Uremia
Uremia is the term for high levels of urea in the blood. Urea is one of the primary components of urine. It can be defined as an excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be normally excreted in the urine. ''Uremic syndrome'' can be defined as the terminal clinical manifestation of kidney failure (also called ''renal failure''). It is the signs, symptoms and results from laboratory tests which result from inadequate excretory, regulatory, and endocrine function of the kidneys. Both ''uremia'' and ''uremic syndrome'' have been used interchangeably to denote a very high plasma urea concentration that is the result of renal failure. The former denotation will be used for the rest of the article. Azotemia is a similar, less severe condition with high levels of urea, where the abnormality can be measured chemically but is not yet so severe as to produce symptoms. Uremia describes the pathological and symptomatic manif ...
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Internal Elastic Lamina
The internal elastic lamina or internal elastic lamella is a layer of elastic tissue that forms the outermost part of the tunica intima of blood vessels. It separates tunica intima from tunica media. Histology It is readily visualized with light microscopy in sections of muscular arteries, where it is thick and prominent, and arterioles, where it is slightly less prominent and often incomplete. It is very thin in veins and venules. In elastic arteries such as the aorta, which have very regular elastic laminae between layers of smooth muscle cells in their tunica media, the internal elastic lamina is approximately the same thickness as the other elastic laminae that are normally present.http://www.ouhsc.edu/histology/text%20sections/cardiovascular.html There is small amount of subendothelial connective tissue between basement membrane of endothelial cells and internal elastic lamina. Reduplication of internal elastic lamina can be seen in elderly individuals due to intimal fib ...
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Glomerulus
''Glomerulus'' () is a common term used in anatomy to describe globular structures of entwined vessels, fibers, or neurons. ''Glomerulus'' is the diminutive of the Latin ''glomus'', meaning "ball of yarn". ''Glomerulus'' may refer to: * the filtering unit of the kidney; see Glomerulus (kidney). * a structure in the olfactory bulb; see Glomerulus (olfaction). * the contact between specific cells in the cerebellum; see Glomerulus (cerebellum) The cerebellar glomerulus is a small, intertwined mass of nerve fiber terminals in the granular layer of the cerebellar cortex. It consists of post-synaptic granule cell dendrites and pre-synaptic Golgi cell axon terminals surrounding the pre- .... See also * Glomerulation, a hemorrhage of the bladder {{SIA ...
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Lumen (anatomy)
In biology, a lumen (plural lumina) is the inside space of a tubular structure, such as an artery or intestine. It comes . It can refer to: *The interior of a vessel, such as the central space in an artery, vein or capillary through which blood flows. *The interior of the gastrointestinal tract *The pathways of the bronchi in the lungs *The interior of renal tubules and urinary collecting ducts *The pathways of the female genital tract, starting with a single pathway of the vagina, splitting up in two lumina in the uterus, both of which continue through the Fallopian tubes In cell biology, a lumen is a membrane-defined space that is found inside several organelles, cellular components, or structures: *thylakoid, endoplasmic reticulum, Golgi apparatus, lysosome, mitochondrion, or microtubule Transluminal procedures ''Transluminal procedures'' are procedures occurring through lumina, including: *Natural orifice transluminal endoscopic surgery in the lumina of, for example, the ...
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Hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide. High blood pressure is classified as primary (essential) hypertension or secondary hypertension. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such ...
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Hyaline
A hyaline substance is one with a glassy appearance. The word is derived from el, ὑάλινος, translit=hyálinos, lit=transparent, and el, ὕαλος, translit=hýalos, lit=crystal, glass, label=none. Histopathology Hyaline cartilage is named after its glassy appearance on fresh gross pathology. On light microscopy of H&E stained slides, the extracellular matrix of hyaline cartilage looks homogeneously pink, and the term "hyaline" is used to describe similarly homogeneously pink material besides the cartilage. Hyaline material is usually acellular and proteinaceous. For example, arterial hyaline is seen in aging, high blood pressure, diabetes mellitus and in association with some drugs (e.g. calcineurin inhibitors). It is bright pink with PAS staining. Ichthyology and entomology In ichthyology and entomology, ''hyaline'' denotes a colorless, transparent substance, such as unpigmented fins of fishes or clear insect wings. Resh, Vincent H. and R. T. Cardé, Eds. Encyclo ...
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Hyaline Arteriolosclerosis
Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries and is most often associated with hypertension and diabetes mellitus. Types include hyaline arteriolosclerosis and hyperplastic arteriolosclerosis, both involved with vessel wall thickening and luminal narrowing that may cause downstream ischemic injury. The following two terms whilst similar, are distinct in both spelling and meaning and may easily be confused with arteriolosclerosis. * Arteriosclerosis is any hardening (and loss of elasticity) of medium or large arteries (from the Greek '' arteria'', meaning ''artery'', and '' sclerosis'', meaning ''hardening'') * Atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque. The term ''atherogenic'' is used for substances or processes that cause atherosclerosis. Hyaline arteriolosclerosis Also arterial hyalinosis and arteriolar hyalinosis refers to thickening of the walls ...
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