Kidney: End-stage changes

A 54 yr old male succumbed to chronic renal failure.  He had a long history of hypertension.  An autopsy was performed.

1.    What is chronic renal failure?

Chronic renal failure is the end result of all chronic renal diseases characteristic of prolonged uremia.  There is also chronic electrolyte disturbances.

2.    What is the gross appearance of his kidneys?

Kidney appears small, surface shows fine granularity (grain leather appearance)

3.    What are some causes of end-stage kidney (nephrosclerosis)?

Prolonged hypertension, diabetes mellitus

4.    What are the histological features of the kidney with respect to the

Topographical zone most involved

Structures damaged: glomerus and tubules.

Appearance of the renal subcapsular surface

Various causes of end stage kidneys

5.    Relate the structural abnormalities to the renal dysfunction.

Destruction of the glomerulus results in insufficient glomerular filtration, resulting in progressive retention of nitrogenous metabolites, hence increased serum creatinine and increased blood urea nitrogen level.  Failure of tubular function produces widespread abnormalities in biochemical homeostasis, including salt and water retention, metabolic acidosis, and other electrolyte imbalances, particularly hyperkalemia.

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Copyright � Joseph Ong 2003