1. Glomerular Diseases

2. Glomerular Diseases
Microanatomy
 The nephron is the basic unit of the kidney, each
kidney contain about one million nephron.
 The nephron consist of the glomerulus &the
associated tubules that lead to the collecting
duct .
 The Glomerulus : is a ball of capillaries
surrounded by Bowman’s capsule.
 The glomerulus receive blood from afferent
arteriole & is drained by the efferent arteriole.

3. nephron
the functional unit of the kidney
•capable of forming urine
•has two major components:
glomerulus
tubule:
proximal
loop of Henle
distal
collecting

4. The glomerulus contain 4 different types of
cells:
1- Visceral epithelial cell( podocytes ).
these cells have long projections from
which foot processes arise & attach to the
glomerular basement membrane ( make
support to the GBM ) .
2- Endothelial cells.
these cells line the capillary lumen.

5. 3- Mesangial cells:
the mesangium provide a skeletal framwork to
support the capillary loops & have contractile &
phagocytic properties.
due to it’s contractile capability, can control blood
flow along the glomerular capillaries .
4-Parietal epithelial cells:
cover Bowman’s capsule .
Glomerular Basement Membrane: prodused by
fusion of the basement membrane of epithelial &
endothelial cells .

6. Glomerular syndromes
1- Nephrotic syndrome : Massive
proteinuria ( > 3.5 gm/24hr. ) , with variable
edema, hypoalbuminemia, hyperlipidemia &
hyperlipiduria .
A- NS with “bland” sediment : mean pure NS.
B-NS with “active” sediment : mean “mixed”
Nephrotic/nephritic syndrome .
 Normal proteinuria <150 mg /24 hr(<0.15gm/24
hr) .

7. 2- Acute nephritic syndrom : Nephronal
hematuria (RBC cast &/or dysmorphic RBCs)
temporally associated with acute renal failure .
3- Rapidly progressive glomerulonephritis :
Nephronal hematuria (RBC cast &/or dysmorphic
RBCs) with renal failure developing over weeks to
months &diffuse glomerular crescent formation .
4-Chronic glomerulonephritis : slowly
progressive glomerular damage with proteinuria,
hematuria & hypertension .

8. 5-Asymptomatic urinary abnormalities :
- Isolated proteinuria (usually <2 gm/day )
- hematuria (with or without proteinuria ) .

9. Pathologic features of glomerular
disease
 Focal :mean affect some of glomeruli (but
not all ).
 Diffuse : mean the lesion
affect all glomeruli or >75% .
 Segmental : mean only a part of the
glomerulus is affected by the lesion .
 Proliferative : abnormal proliferation of

10. Misangial :excessive production of misangial
materials.
Membranous :glomeruler basement is damaged
&thickened .
Membranoproliferative :causing both thickening
of glomerular basement membran &proliferation of
mesangial cells .
 Crescent formation: epithelial cell proliferation
& mononuclear cell infiltration in Bowman’s space.