The Kidney

1
The Kidney Collecting System

• Diseases of Tubules Interstitium
• 1. Infectious
• Acute Pyelonephritis
• Chronic Pyelonephriris
• 2. Non-infectious
• Drug-Induce Interstitial Nephritis
• Allergic
• Analgesic
• Acute Tubular Necrosis

2

Acute Pyelonephritis

• Gross
• One /or both Kidneys involved
• Normal or/enlarged
• Microabscesses in both cortex and medulla
  (hematogenous)

3
Acute Pyelonephritis

• Suppurative inflammation
• (Abscess)
• Interstitium Neutrophils infiltrate
• Tubules (WBCs Casts)

• Glomeruli
• Not involved

4
The Kidney Collecting System

• Diseases of Tubules Interstitium
• 1. Infectious
• Acute Pyelonephritis
• Chronic Pyelonephriris
• 2. Non-infectious
• Drug-Induce Interstitial Nephritis
• Allergic
• Analgesic
• Acute Tubular Necrosis

5
Chronic Pyelonephritis Reflux Nephropathy

• Interstitial inflammation Scarring of Renal
  Parenchyma
• Gross Scarring Deformity of Pelvicalyceal
  System
• Important cause of Chronic Renal Failure

6
Chronic Pyelonephritis

• Morphology

7
The Kidney Collecting System

• Diseases of Tubules Interstitium
• 1. Infectious
• Acute Pyelonephritis
• Chronic Pyelonephriris
• 2. Non-infectious
• Drug-Induce Interstitial Nephritis
• Allergic
• Analgesic
• Acute Tubular Necrosis

8
Drug-induced Interstitial Nephritis

• Acute drug-induced Interstitial Nephritis ? ARF
• Analgesic Nephropathy ? CRF

9
1) Acute drug-induced Interstitial Nephritis

• Morphology

10
2) Analgesic Nephropathy

• Drugs
• Combinations of large quantities for long
  periods
• Phenacetin
• Aspirin
• Acetaminophen
• Caffeine
• Codeine
• Leading to ? Renal Papillary Necrosis
  Interstitial Nephritis

11
The Kidney Collecting System

• Diseases of Tubules Interstitium
• 1. Infectious
• Acute Pyelonephritis
• Chronic Pyelonephriris
• 2. Non-infectious
• Drug-Induce Interstitial Nephritis
• Allergic
• Analgesic
• Acute Tubular Necrosis

12
Acute Tubular Necrosis (ATN)

• Clinico-Pathological entity Characterized by
• Destruction of tubular epithelial cells
• Acute Renal Failure
• The most common cause of acute renal failure
• Reversible renal lesions

13
Cont. Acute Tubular Necrosis (ATN)

• Morphology