This document summarizes structures and functions of the renal system. It discusses normal kidney anatomy and physiology, as well as renal disorders like acute and chronic glomerulonephritis, nephrotic syndrome, nephrosclerosis, renal failure, and treatment methods including dialysis and transplantation.

1. U R O L O G Y

3. Here is a normal adult kidney. The capsule has been removed and a pattern of fetal lobulations still persists, as it sometimes does. The hilum at the mid left contains some adipose tissue. At the lower right is a smooth-surfaced, small, clear fluid-filled simple renal cyst . Such cysts occur either singly or scattered around the renal parenchyma and are not uncommon in adults.

4. In cross section, this normal adult kidney demonstrates the lighter outer cortex and the darker medulla , with the renal pyramids into which the collecting ducts coalesce and drain into the calyces and central pelvis .

8. Double ureters are seen exiting from each kidney and extending to the bladder that has been opened. A small segment of aorta is seen between the normal, smooth-surfaced kidneys. A partial or complete duplication of one or both ureters occurs in about 1 in 150 persons. There is a potential for obstructive problems due to the abnormal flow of urine and the entrance of two ureters into the bladder in close proximity, but most of the time this is an incidental finding

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57. MATRIX

66. CHRONIC G.N. – PATHOPHYSIO ACUTE G.N. REPEATED AG-AB REACTIONS GLOMERULI BECOME SCARRED; RENAL ARTERIAL BRANCHES THICKENED GLOMERULAR DAMAGE KIDNEY: 1/5 OF ORIGINAL SIZE

67. end stage of chronic glomerulonephritis. Notice their small size. They each measure about 2 x 3". These are severely contracted kidneys. Notice the cortices and the finely granular surfaces.

68. Here's an end stage kidney of chronic glomerulonephritis. Notice again it is extremely contracted and finely granular. This is the kidney of a 38 year old man who presented with an insidious onset of the three signs of uremia, that is loss of appetite, lethargy, and the laboratory finding of an increased BUN. He had no antecedent history of acute glomerulonephritis.

77. HYDRONEPHROSIS OBSTRUCTION OF URINARY FLOW DISTENTION OF PELVIS & CALYCES THINNING OF RENAL PARENCHYMA GRADUAL DESTRUCTION OF THE KIDNEY COMPENSATORY HYPERTROPHY OF THE CONTRALATERAL KIDNEY IMPAIRMENT OF RENAL FUNCTION

84. - KIDNEY- URETER BLADDER URETERO-VESICAL JUNCTION VESICO- URETERAL REFLUX

86. This is an opened urinary bladder. The mucosa shows many petechial hemorrhages and is swollen and congested. This is hemorrhagic cystitis. It is frequently seen with lower urinary tract infections and is particularly common in the presence of an indwelling urinary catheter.

88. This is another section of a kidney with acute suppurative pyelonephritis. Notice the parenchyma is congested and swollen. There is a calculus in the calyx.

101. Alkaline Stone formation UREA-SPLITTING ORGANISMS IN THE URINE URINE BECOMES ALKALINE CALCIUM PHOSPHATE BECOMES INSOLUBE UROLITHIASIS

103. There was a large renal calculus (stone) that obstructed the calyces of the lower pole of this kidney, leading to a focal hydronephrosis (dilation of the collecting system). The stasis from the obstruction and dilation led to infection. The infection with inflammation is characterized by the pale yellowish-tan areas next to the dilated calyces with hyperemic mucosal surfaces. The upper pole is normal and shows good corticomedullary demarcations.

104. Sometimes a very large calculus nearly fills the calyceal system, with extensions into calyces that give the appearance of a stag's (deer) horns. Hence, the name "staghorn calculus". Seen here is a horn-like stone extending into a dilated calyx, with nearly unrecognizable overlying renal cortex from severe hydronephrosis and pyelonephritis. Nephrectomy may be performed because the kidney is non-functional and serves only as a source for infection.

111. In the upper pole of this kidney is a well circumscribed tumor which has a yellowish-brown color and shows central necrosis. This is a renal cell carcinoma.

112. obstructive disease . In the center of the photograph is the sigmoid colon and rectum of a patient with adenocarcinoma of the rectum. This has invaded the bladder and has occluded the orifices of the ureter on both sides. The right ureter shows extreme hydroureter.

133. This is an opened urinary bladder and prostate below The hyperplastic prostate gland has obliterated the lower part of the cystic cavity. There is hemorrhagic cystitis and prominent trabeculae in the hypertrophied bladder.

134. This is another enlarged prostate gland, but it does not show the sharply defined capsule that you saw in hyperplasia of the prostate. This is adenocarcinoma of the prostate gland which is invading the pelvic tissue.