肾病总论（英语）张玖强.pptx

Urinary System DiseaseUrinary System Disease Liu Fu-You MD. 1. Reviews of Anatomy and 1. Reviews of Anatomy and Physiology of Physiology of Urinary SystemUrinary System (1) kidney L T11L2 R T12L3 10cm in length 5cm in width 4cm in thickness 134 148g in weight (1) kidney (2) Renal Cortex 4renal cortex 8090% of glomerulus Glomerular capsule 4 renal medulla renal tubule (3) Glomerulus 4Glomerular Filtration Membrane endothelial cells basement epithelial cells (4) Renal tubule 4proximal convolute reabsorption 4distal convolute regulating of acid-base balance Renal tubular diseases (renal, tubular, acidosis) Type (dRTA) Type (pRTA) + (5) Renal Interstitium Interstitial cells Fibrocyte Extracelluar matrix Pathogenic microorganism immunoreaction Acute interstitial nephritis Chronic interstitial nephritis Interstitium (6) Renal Pelvis, Ureter 44Renal pelvisRenal pelvis 44ureterureter Pathogenic microorganism pyelonephritispyelonephritis (upper urinary tract) (7) Urinary Bladder,Urethra Urinary bladder Urethra(Lower urinary tract) Pathogenic microorganism cystourethritiscystourethritis 2. Symptoms of Glomerular Disease2. Symptoms of Glomerular Disease 44ProteinuriaProteinuria 44hematuriahematuria 44edema edema 44hypertensionhypertension nephritis syndromenephritis syndrome 4(proteinuria3.5g/day) 4Proteinuria+ nephrotic syndrome 4proteinuria150mg/24hr Proteinuria analysisProteinuria analysis glomerular tubular overflow secretory or 1.5g/24hr 1.5g/24hr immunoglobulin histic 2-micro globulin Infection toxicity Bence Jones protein myeloma Selective (albumin) Non Selective (mixture) hematuriahematuria Dysmorphic Rbc Hemogeneous Rbc Calculus,tumor, TB,infection Glomerular disease hypertensionhypertension renal parenchyma Renal vesselArleriae renalis stenosis volume dependent renin dependent Edema Glomerular Filtrate Rate (GFR) Plasma colloid osmotic pressure Anasarca Local edema Lower extremity edema Common Clinical Laboratory Assessment of Renal Disease Cell protein cast glomerular tubular IVP CT renal biopsy MRI Cr Ccr GFR PSP Mosths Renal disease urinalysisRenal functionSpecial examination 3. Treatment of Glomerular Disease3. Treatment of Glomerular Disease Removal causesCorticosteroidImmunosuppressive Symptomatic and supporting Primary Primary Glomerular Glomerular nep