The Kidney & Collecting System  Diseases of Tubules & Interstitium: 1. Infectious:  Acute Pyelonephritis  Chronic Pyelonephriris 2. Non-infectious:

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Presentation transcript:

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

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

n Glomeruli Not involved n Suppurative inflammation (Abscess) –Interstitium: Neutrophils infiltrate –Tubules (WBCs Casts) Acute Pyelonephritis

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

Chronic Pyelonephritis & Reflux Nephropathy n Interstitial inflammation & Scarring of Renal Parenchyma n Gross Scarring & Deformity of Pelvicalyceal System n Important cause of Chronic Renal Failure

Chronic Pyelonephritis Morphology:

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

Drug-induced Interstitial Nephritis ARF 1. Acute drug-induced Interstitial Nephritis  ARF CRF 2. Analgesic Nephropathy  CRF

1) Acute drug-induced Interstitial Nephritis Morphology:

2) Analgesic Nephropathy Drugs: “Combinations” of “large quantities” for “long periods” n Phenacetin n Aspirin n Acetaminophen n Caffeine n Codeine Leading to  Renal Papillary Necrosis & Interstitial Nephritis

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

Acute Tubular Necrosis (ATN) n Clinico-Pathological entity Characterized by:  Destruction of tubular epithelial cells  Acute Renal Failure n The most common cause of acute renal failure n Reversible renal lesions

Cont. Acute Tubular Necrosis (ATN) Morphology: