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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Glomerular disease can be classified according to the clinical syndrome produced, the histopathological appearance or the underlying disease. Glomerular disease is primary if there is no other system affected and secondary if there is another system affected (the renal disease is considered secondary to the systemic condition). The glomerulus consists of the glomerular basement membrane, the glomerular cells, the intraglomerular blood vessels and the mesangium (the supporting connective tissue). Glomerular disease can affect one or more of these components.
Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Hyperglycemia is the primary manifestation of diabetes mellitus. It develops from impaired insulin secretion plus varied amounts of peripheral insulin resistance. Hyperglycemia may also occur in newborns after glucocorticoid hormones are administered, or because of excessive infusion of IV solutions containing glucose. This is common in poorly monitored hyperalimentation over a long period of time. Hyperglycemia causes osmotic diuresis. This is due to glycosuria, which leads to urinary frequency, plus polyuria and polydipsia. Orthostatic hypotension and dehydration can result. Hyperglycemia also causes weight loss, nausea, vomiting, blurred vision, and a predisposition to bacterial or fungal infections. Poorly controlled hyperglycemia that continues for years leads to vascular complications that affect the microvascular or macrovascular vessels, or both. There is glycosylation of the glomerular proteins in the kidneys. This may result in mesangial cell proliferation, expansion of the matrix, and vascular endothelial damage. There is usually a thickening of the glomerular basement membrane.
The kidneys
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
The major genetically determined abnormality of the glomerular basement membrane is Alport's syndrome. This disease usually shows an X-linked pattern of inheritance and is associated with mutation in the type IV collagen genes responsible for encoding the proteins that make up the glomerular basement membrane. Alport's syndrome may present in the first and second decades with proteinuria, haematuria, and progressive renal failure but this may be delayed until later life. Males are often more severely affected than females. The disease is diagnosed by characteristic electron microscopic appearances of the glomerular basement membrane (Figure 14.4), but can also be confirmed by genotyping. It is usually accompanied by high-frequency nerve deafness and sometimes ocular abnormalities.
Linalool exhibits therapeutic and protective effects in a rat model of doxorubicin-induced kidney injury by modulating oxidative stress
Published in Drug and Chemical Toxicology, 2022
Eyup Altinoz, Zulal Oner, Hulya Elbe, Nuray Uremis, Muhammed Uremis
The glomerular filtration barrier consists of the glomerular basement membrane, the glomerular endothelial cells, and podocytes. Elevated ROS levels lead to the disturbance of the glomerular filtration rate (Pedraza-Chaverrí et al.2000). Increased plasma BUN and Cr levels show the disturbance of glomerular function (Mohan et al.2010). Although BUN elevates remarkably in kidney parenchymal injury, Cr might be more important than BUN in the onset of kidney damage (Erdem et al.2000). Our data are in agreement with the previous studies (El‐Sayed et al.2017, Khames et al.2017). Bilgic and Armagan reported that DOX-induced nephrotoxicity in rats led to an increase in BUN and Cr levels (Bilgic and Armagan 2020). Previous studies have demonstrated that many antioxidant chemicals exhibit therapeutic or protective effects on DOX-induced nephrotoxicity in rats. Therefore, in the present study, the use of linalool as therapeutic and protective showed significant improvement in BUN and Cr levels in DOX-induced kidney damage by inhibiting oxidative stress.
Zataria multiflora and its main ingredient, carvacrol, affect on the renal function, histopathological, biochemical and antioxidant parameters in adriamycin-induced nephrotic rats
Published in Archives of Physiology and Biochemistry, 2021
Reza Mohebbati, Mohammad Jalili-Nik, Hossein Saghi, Hamed Sadatfaraji, Mohammad Soukhtanloo
This study indicated that administration of ZM extract and CAR separately contributed to the improvement of nephropathy by enhancement in GFR (decrease of the serum creatinine concentration) and reduction of urine protein excretion. Different studies have shown that the pathogenesis of proteinuria is related to glomerular epithelial cells (podocytes) and ZM and CAR protective mechanism may be through increasing the podocyte slit pore density, keeping the integrity of the glomerular basement membrane and suppressing oxidative stress-mediated glomerulopathy (Venkatesan 1998). Renal basement membrane plays a crucial role in the kidney function containing macromolecule including collagen IV, entactin/nidogen, sulfated proteoglycans, laminin sustaining the integrity of glomerular basement membrane.
Grape seed extract protects against amiodarone - induced nephrotoxicity and ultrastructural alterations associated with the inhibition of biomarkers of inflammation and oxidative stress in rats
Published in Ultrastructural Pathology, 2021
Refaat A. Eid, Mohamed Samir Ahmed Zaki, Mubarak Al-Shraim, Muhammad Alaa Eldeen, Mohamed A. Haidara
Examinations of the renal samples of the control and GSE-treated rat groups showed a glomerulus with its capillary basement membranes, endothelium mesangial and podocytes with foot processes (Figures 3a&4a). Higher magnification of the glomerulus displayed the three layers of the glomerular basement membrane, an inner layer (the lamina rarainterna), an outer layer (the lamina raraexterna), and a dense central layer (the lamina dinsa) with thin diaphragms (Figure 2b & 3b). A cross-section of a proximal convoluted tubule illustrated epithelial cells lining the tubule resting on the basement membrane and brush border in the tubular lumen. itochondria, nucleus and infolding membranes were also seen (Figure 3c & 4c). A cross-section of a distal convoluted tubule showed epithelial cells with short microvilli resting on lumina membrane . Note mitochondria, nucleus, infolding membranes were also seen (Figure 2d & 3d).