【医学】肾病总论(英语)张玖强.pptx

Urinary System DiseaseLiu Fu-You MD.1.Reviews of Anatomy and Physiology of Urinary System(1)kidneyL T11L2R T12L310cm in length5cm in width4cm in thickness134 148g in weight(1)kidney(2)Renal Cortex4renal cortex 8090%of glomerulusGlomerular capsule4 renal medulla renal tubule(3)Glomerulus4Glomerular Filtration Membraneendothelial cellsbasementepithelial cells(4)Renal tubule4proximal convolute reabsorption4distal convolute regulating of acid-base balanceRenal tubular diseases(renal,tubular,acidosis)Type(dRTA)Type(pRTA)+(5)Renal InterstitiumInterstitial cellsFibrocyteExtracelluar matrixPathogenic microorganismimmunoreactionAcute interstitial nephritisChronic interstitial nephritisInterstitium(6)Renal Pelvis,Ureter44Renal pelvisRenal pelvis44ureterureter Pathogenic microorganismpyelonephritis(upper urinary tract)(7)Urinary Bladder,UrethraUrinary bladderUrethra(Lower urinary tract)Pathogenicmicroorganismcystourethritis2.Symptoms of Glomerular Disease4Proteinuria4hematuria4edema 4hypertension nephritis syndrome4(proteinuria3.5g/day)4Proteinuria+nephrotic syndrome4proteinuria150mg/24hrProteinuria analysisProteinuria analysisglomerular tubular overflow secretory or1.5g/24hr 1.5g/24hr immunoglobulin histic2-microglobulinInfectiontoxicity Bence JonesproteinmyelomaSelective(albumin)NonSelective(mixture)hematuriahematuria Dysmorphic Rbc Hemogeneous RbcCalculus,tumor,TB,infectionGlomerular diseasehypertensionhypertensionrenal parenchymaRenal vesselArleriae renalis stenosisvolume dependentrenin dependentEdemaGlomerular Filtrate Rate(GFR)Plasma colloid osmotic pressure AnasarcaLocal edemaLower extremity edemaCommon Clinical Laboratory Assessment of Renal DiseaseCell protein cast glomerular tubular IVP CT renal biopsy MRI Cr Ccr GFR PSP MosthsRenal diseaseurinalysisRenal functionSpecial examination3.Treatment of Glomerular DiseaseRemoval causesCorticosteroidImmunosuppressiveSymptomatic and supportingPrimary Primary Glomerular Glomerular nephritisnephritisAnti-inflammatoryChinese herbsRenal failure4dialysisHDPDRenal transplantation