•Review of Normal Kidney (** LQ combine 2 diseases)
• Clinical Manifestations of Renal Diseases
• Glomerular Diseases
• Common Types of Glomerular diseases
• Nephritic syndrome
- Acute Proliferative (Poststreptococcal, Postinfectious) Glomerulonephritis (Table)
• Rapidly progressive glomerulonephritis
• Nephrotic syndrome
- Minimal-change disease
- Membranous glomerulopathy
- Focal segmental glomerulosclerosis
• Tubular and Interstitial Diseases
- Acute kidney injury (AKI) or Acute tubular necrosis
- Tubulointerstitial nephritis
• Renal tumors (Not very important)
- Renal Cell Carcinoma
- Wilm’s tumor
Glomerulus 腎小球
•Structure of glomerulus **(Function of each layer)
a) Fenestrated endothelium
b) Basement membrane (GBM)
- Formed mainly by anionic molecules
c) Podocytes (visceral epithelial cells “foot processes”)
- Adjacent foot processes are separated by 20-30 nm filtration bridged by thin diaphragm–
Slit diaphragm
- Crucial to the maintenance of glomerular barrier function
- Synthesis of GBM components
d) Mesangial cells
- Lying between capillaries, support entire glomerulus
- Phagocytic, contractile, proliferate, secretion of biologically active mediators modified
smooth muscle cells
,- Involved in many types of GN
•Major characteristics of normal glomerular filtration
- High permeability to water and small solutes, because of the highly fenestrated
nature of the endothelium.
- Impermeability to proteins, such as molecules of the size of albumin or larger.
- “Glomerular barrier function”
, • Selective permeability depending on size (the larger, the less permeable) and
charge (the more cationic, the more permeable)
• Podocytes important in maintaining this function
- Slit diaphragm maintain size- selectivity by specific proteins
1.NEPHRIN: extend towards each other from neighboring podocytes comprising the
filtration slit
2.PODOCIN: intracellular (podocyte) protein where nephrin attaches mutations in genes
encoding these proteins give rise to nephrotic syndrome (i.e., glomerular disease)
Some small protein will come out, but large protein should leave inside
Prevent large protein moveout
• Clinical Manifestations of Renal Diseases
• Glomerular Diseases
• Common Types of Glomerular diseases
• Nephritic syndrome
- Acute Proliferative (Poststreptococcal, Postinfectious) Glomerulonephritis (Table)
• Rapidly progressive glomerulonephritis
• Nephrotic syndrome
- Minimal-change disease
- Membranous glomerulopathy
- Focal segmental glomerulosclerosis
• Tubular and Interstitial Diseases
- Acute kidney injury (AKI) or Acute tubular necrosis
- Tubulointerstitial nephritis
• Renal tumors (Not very important)
- Renal Cell Carcinoma
- Wilm’s tumor
Glomerulus 腎小球
•Structure of glomerulus **(Function of each layer)
a) Fenestrated endothelium
b) Basement membrane (GBM)
- Formed mainly by anionic molecules
c) Podocytes (visceral epithelial cells “foot processes”)
- Adjacent foot processes are separated by 20-30 nm filtration bridged by thin diaphragm–
Slit diaphragm
- Crucial to the maintenance of glomerular barrier function
- Synthesis of GBM components
d) Mesangial cells
- Lying between capillaries, support entire glomerulus
- Phagocytic, contractile, proliferate, secretion of biologically active mediators modified
smooth muscle cells
,- Involved in many types of GN
•Major characteristics of normal glomerular filtration
- High permeability to water and small solutes, because of the highly fenestrated
nature of the endothelium.
- Impermeability to proteins, such as molecules of the size of albumin or larger.
- “Glomerular barrier function”
, • Selective permeability depending on size (the larger, the less permeable) and
charge (the more cationic, the more permeable)
• Podocytes important in maintaining this function
- Slit diaphragm maintain size- selectivity by specific proteins
1.NEPHRIN: extend towards each other from neighboring podocytes comprising the
filtration slit
2.PODOCIN: intracellular (podocyte) protein where nephrin attaches mutations in genes
encoding these proteins give rise to nephrotic syndrome (i.e., glomerular disease)
Some small protein will come out, but large protein should leave inside
Prevent large protein moveout
