西安交通大学医学院泌尿系统疾病课件 glomerular disease.pptVIP

Renal glomerular disease Classification（cause） Primary glomerulopathy: It characterizes disease of kidney without evidence of any associated illness in other organ Secondary glomerulopathy: It is associated with systemic illness that involve the kidneys Hereditary glomerulopathy: It is a hereditary disease Clinical Classification (patterns) of Primary Glomerular Disease 1.Acute glomerulonephritis(AGN) 2.Rapidly progressive glomerulonephritis(RPGN) 3.Chronic glomerulonephritis(CGN) 4.Nephritic syndrome(NS) 5.Latent glomerulonephritis(LGN) Pathologic types of primary glomerular disease 1.Minimal change nephropathy（MCD） 2.Focal segmental glomerulonephritis 3.Diffuse glomerulonephritis Proliferative Glomerulonephritis Mesangial proliferative glomerulonephritis（MsPGN）(IgAN+nonIgAN) Endocapillary proliferative glomerulonephritis Mesangial capillary proliferative glomerulonephritis（MPGN） Dense deposit glomerulonephritis（DDG） Crescentic glomerulonephritis Mechanisms of Glomerular Injury Immune mechanism Inflammatory reaction Nonimmune, noninflammatory injury Immunologic Mechanisms Humoral Immunity 1.Circulating Ag-Ab(CIC) deposites in the glomerular capillary –GBM damage 2. Ag localizes(IC) in the GBM and mesangial section Cellular Immunity glomerulus Inflammatory Reaction Inflammatory cells neutrophil Mono-gigantic cell platelet Renal intrinsic cell(intercapillary cell, epithelium, endothelium) Inflammatory mediator biologically active peptide(vasoactive peptide ,growth factor,TNF) biologically active ester (PG,PAF) complement, blood coagulation factor Nonimmune,Noninflammatory Injury High pressure High perfusion High filtration Clinical Manifestations Proteiuria Hematuria Edema Hypertension Impairment of renal function Proteinuria Filtration barrier: glomerular filtration membrane pore barrier electric charge barrier(negative cha