SlideShare una empresa de Scribd logo
1 de 36
FUNDAMENTALS OF
RENAL PATHOLOGY


Renal pathology is a subspecialty of anatomic pathology that deals
with the diagnosis and characterization of medical diseases (nontumor) of the kidneys.



In the academic setting, renal pathologists work closely with
nephrologists and transplant surgeons, who typically obtain
diagnostic specimens via percutaneous renal biopsy.



The renal pathologist must synthesize findings from light
microscopy, electron microscopy, and immunofluorescence to
obtain a definitive diagnosis.



Medical renal diseases may affect the glomerulus, the tubules and
interstitium, the vessels, or a combination of these compartments.
NORMAL HISTOLOGY
THE GLOMERULUS
Typical stains used in renal
evaluating renal biopsy
ELECTRON MICROGRAM
Clinical Presentations of Glomerular
Diseases


symptomatic proteinuria



•nephrotic syndrome



(proteinuria, hypoproteinemia, lyperlipidemia, edema)



•asymptomatic hematuria



•glomerulonephritis



(hematuria, proteinuria, hypertension, renal failure)



•acute glomerulonephritis



(neprhitis with short term renal failure)



•crescentic glomerulonephritis



(nephritis with rapidly progressive renal failure)



•chronic glomerulonephritis



(chronic progression of renal failure)



•End Stage Renal Disease



(irreversible renal failure)
The Nephrotic Syndrome


The nephrotic syndrome is characterized by massive proteinuria,
which leads to hypoproteinemia/hypoalbunemia, hyperlipidemia
with elevated cholesterols, triglicerides and other lipids, and edema.



The edema results not only from the hypoosmolar state caused by
the loss of plasma proteins, but also from abnormal salt and water
retention.
Histologic feature that is found in any
patient with nephrotic range
proteinuria no matter what the cause
OVAL FAT BODIES
Minimal Change Glomerulopathy
IF
ULTRA STRUCTURE
Membranous Glomerulopathy
H&E
SPECIAL STAINS

IA

L STAINS
ELECTRON MICROGRAM
IF
Focal Segmental Glomerulosclerosis
H&E
IF
Type I Membranoproliferative
(Mesangiocapillary)
Glomerulonephritis
IF
ELECRON MICRGRAM
IF
ELECTRON MICROGRAM
Type II Membranoproliferative
Glomerulonephritis, (Dense Deposit
Disease)
ELECTRON MICROGRAM
IF
REFFERENCE


www.uncnephropathology.org/jennette/tutorial.htm

Más contenido relacionado

La actualidad más candente

Urinary system disorders.pptx1
Urinary system disorders.pptx1Urinary system disorders.pptx1
Urinary system disorders.pptx1Eric Pazziuagan
 
OESOPHAGUS PATHOLOGY
OESOPHAGUS PATHOLOGYOESOPHAGUS PATHOLOGY
OESOPHAGUS PATHOLOGYSuraj Dhara
 
Renal Tumors, Renal Cell Carcinoma- Dr. Vandana
Renal Tumors, Renal Cell Carcinoma-  Dr. VandanaRenal Tumors, Renal Cell Carcinoma-  Dr. Vandana
Renal Tumors, Renal Cell Carcinoma- Dr. VandanaDr Vandana Singh Kushwaha
 
Kidney disorders, Laboratory Investigation and Renal Function Tests
Kidney disorders, Laboratory Investigation and Renal Function TestsKidney disorders, Laboratory Investigation and Renal Function Tests
Kidney disorders, Laboratory Investigation and Renal Function TestsMadhukar Vedantham
 
Liver pathology & Disease condition
Liver pathology & Disease conditionLiver pathology & Disease condition
Liver pathology & Disease conditionDr. Deepika Kenjale
 
The KIDNEY: RENAL VASCULAR DISEASES
The KIDNEY: RENAL VASCULAR DISEASESThe KIDNEY: RENAL VASCULAR DISEASES
The KIDNEY: RENAL VASCULAR DISEASESDr. Roopam Jain
 
Renal Cell Carcinoma
Renal Cell CarcinomaRenal Cell Carcinoma
Renal Cell CarcinomaSam
 
Tumor of kidney and urinary tract
Tumor of kidney and urinary tractTumor of kidney and urinary tract
Tumor of kidney and urinary tractessamramdan
 
Pathology of Lower Urinary Tract & Male Genital System
Pathology of Lower Urinary Tract & Male Genital SystemPathology of Lower Urinary Tract & Male Genital System
Pathology of Lower Urinary Tract & Male Genital SystemNilay Nishith
 
Chronic pyelonephritis
Chronic pyelonephritisChronic pyelonephritis
Chronic pyelonephritisLaya Pillai
 
Renal Pathophysiology
Renal PathophysiologyRenal Pathophysiology
Renal PathophysiologyDana Luery
 

La actualidad más candente (20)

Urinary system disorders.pptx1
Urinary system disorders.pptx1Urinary system disorders.pptx1
Urinary system disorders.pptx1
 
Glomerular diseases
Glomerular diseases Glomerular diseases
Glomerular diseases
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
 
OESOPHAGUS PATHOLOGY
OESOPHAGUS PATHOLOGYOESOPHAGUS PATHOLOGY
OESOPHAGUS PATHOLOGY
 
Pathology of Glomerulonephritis
Pathology of GlomerulonephritisPathology of Glomerulonephritis
Pathology of Glomerulonephritis
 
Renal Tumors, Renal Cell Carcinoma- Dr. Vandana
Renal Tumors, Renal Cell Carcinoma-  Dr. VandanaRenal Tumors, Renal Cell Carcinoma-  Dr. Vandana
Renal Tumors, Renal Cell Carcinoma- Dr. Vandana
 
Kidney disorders, Laboratory Investigation and Renal Function Tests
Kidney disorders, Laboratory Investigation and Renal Function TestsKidney disorders, Laboratory Investigation and Renal Function Tests
Kidney disorders, Laboratory Investigation and Renal Function Tests
 
Congenital anomalies of kidney and urinary tract
Congenital anomalies of kidney and urinary tractCongenital anomalies of kidney and urinary tract
Congenital anomalies of kidney and urinary tract
 
Renal pathology version 5
Renal pathology version 5Renal pathology version 5
Renal pathology version 5
 
Liver pathology & Disease condition
Liver pathology & Disease conditionLiver pathology & Disease condition
Liver pathology & Disease condition
 
The KIDNEY: RENAL VASCULAR DISEASES
The KIDNEY: RENAL VASCULAR DISEASESThe KIDNEY: RENAL VASCULAR DISEASES
The KIDNEY: RENAL VASCULAR DISEASES
 
Renal Cell Carcinoma
Renal Cell CarcinomaRenal Cell Carcinoma
Renal Cell Carcinoma
 
Tumor of kidney and urinary tract
Tumor of kidney and urinary tractTumor of kidney and urinary tract
Tumor of kidney and urinary tract
 
Haemolytic anemia
Haemolytic anemia Haemolytic anemia
Haemolytic anemia
 
Pathology of Lower Urinary Tract & Male Genital System
Pathology of Lower Urinary Tract & Male Genital SystemPathology of Lower Urinary Tract & Male Genital System
Pathology of Lower Urinary Tract & Male Genital System
 
Chronic pyelonephritis
Chronic pyelonephritisChronic pyelonephritis
Chronic pyelonephritis
 
Renal Pathophysiology
Renal PathophysiologyRenal Pathophysiology
Renal Pathophysiology
 
Renal Pathology Lectures_Ppt Series (4 in 1)
Renal Pathology Lectures_Ppt Series (4 in 1)Renal Pathology Lectures_Ppt Series (4 in 1)
Renal Pathology Lectures_Ppt Series (4 in 1)
 
Pathology of urinary system
Pathology of urinary systemPathology of urinary system
Pathology of urinary system
 
Hemolytic anemia
Hemolytic anemiaHemolytic anemia
Hemolytic anemia
 

Destacado

Introduction to Renal Pathology
Introduction to Renal PathologyIntroduction to Renal Pathology
Introduction to Renal Pathologyedwinchowyw
 
Renal pathology..at glance
Renal pathology..at glanceRenal pathology..at glance
Renal pathology..at glanceraj kumar
 
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. GawadRenal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. GawadNephroTube - Dr.Gawad
 
Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.Anubhav Singh
 
Renal cell carcinoma for students
Renal cell carcinoma for studentsRenal cell carcinoma for students
Renal cell carcinoma for studentsMohammad Manzoor
 
Glomerulonephritis
GlomerulonephritisGlomerulonephritis
Glomerulonephritismpatjawee
 
Glomerulonephritis =)
Glomerulonephritis =)Glomerulonephritis =)
Glomerulonephritis =)kskb
 
Anatomy and Physilogy of Urinary System (Renal System)
Anatomy and Physilogy of Urinary System (Renal System)Anatomy and Physilogy of Urinary System (Renal System)
Anatomy and Physilogy of Urinary System (Renal System)Yana Paculanan
 
Kidney anatomy, physiology and disorders
Kidney anatomy, physiology and disordersKidney anatomy, physiology and disorders
Kidney anatomy, physiology and disordersUniversity of Mauritius
 

Destacado (20)

Introduction to Renal Pathology
Introduction to Renal PathologyIntroduction to Renal Pathology
Introduction to Renal Pathology
 
Renal Pathology Tutorial
Renal Pathology TutorialRenal Pathology Tutorial
Renal Pathology Tutorial
 
Renal pathology..at glance
Renal pathology..at glanceRenal pathology..at glance
Renal pathology..at glance
 
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. GawadRenal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
 
Special stains
Special stainsSpecial stains
Special stains
 
Kidney histology
Kidney histologyKidney histology
Kidney histology
 
Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.
 
Professor Peivand Pirouzi: Pathophysiology of the urinary system 2016
Professor Peivand Pirouzi: Pathophysiology of the urinary system 2016Professor Peivand Pirouzi: Pathophysiology of the urinary system 2016
Professor Peivand Pirouzi: Pathophysiology of the urinary system 2016
 
renal biopsy
renal biopsyrenal biopsy
renal biopsy
 
Renal cell carcinoma for students
Renal cell carcinoma for studentsRenal cell carcinoma for students
Renal cell carcinoma for students
 
Renal Histology
Renal HistologyRenal Histology
Renal Histology
 
Glomerular diseases
Glomerular diseasesGlomerular diseases
Glomerular diseases
 
Renal cell carcinoma
Renal cell carcinomaRenal cell carcinoma
Renal cell carcinoma
 
Glomerulonephritis
GlomerulonephritisGlomerulonephritis
Glomerulonephritis
 
Glomerulonephritis =)
Glomerulonephritis =)Glomerulonephritis =)
Glomerulonephritis =)
 
Acute and chronic renal failure
Acute and chronic renal failureAcute and chronic renal failure
Acute and chronic renal failure
 
Anatomy and Physilogy of Urinary System (Renal System)
Anatomy and Physilogy of Urinary System (Renal System)Anatomy and Physilogy of Urinary System (Renal System)
Anatomy and Physilogy of Urinary System (Renal System)
 
Kidney anatomy, physiology and disorders
Kidney anatomy, physiology and disordersKidney anatomy, physiology and disorders
Kidney anatomy, physiology and disorders
 
An Unusual Case Of Renal Failure
An Unusual Case Of Renal FailureAn Unusual Case Of Renal Failure
An Unusual Case Of Renal Failure
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
 

Similar a Renal pathology

What Rheumatologists Learn from Nephrologists
What Rheumatologists Learn from Nephrologists What Rheumatologists Learn from Nephrologists
What Rheumatologists Learn from Nephrologists Samar Tharwat
 
Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).Ahmed Redwan
 
Haematuria in pregnancy
Haematuria in pregnancyHaematuria in pregnancy
Haematuria in pregnancydrmcbansal
 
RENAL PARENCHYMAL DISEASE IMAGING.pptx
RENAL PARENCHYMAL DISEASE IMAGING.pptxRENAL PARENCHYMAL DISEASE IMAGING.pptx
RENAL PARENCHYMAL DISEASE IMAGING.pptxdypradio
 
medicine.Kidney 2.(dr.ala)
medicine.Kidney 2.(dr.ala)medicine.Kidney 2.(dr.ala)
medicine.Kidney 2.(dr.ala)student
 
Chronic Kidney Disease
Chronic Kidney Disease Chronic Kidney Disease
Chronic Kidney Disease Hussain Bangi
 
meidicine.Vasculitis 1.(dr.kawa)
meidicine.Vasculitis 1.(dr.kawa)meidicine.Vasculitis 1.(dr.kawa)
meidicine.Vasculitis 1.(dr.kawa)student
 
Nephrotic presentation.ppt9999999999999999999999999999999999999
Nephrotic presentation.ppt9999999999999999999999999999999999999Nephrotic presentation.ppt9999999999999999999999999999999999999
Nephrotic presentation.ppt9999999999999999999999999999999999999JamesAmaduKamara
 
ultrasound guided renal biopsy.pptx
ultrasound guided renal biopsy.pptxultrasound guided renal biopsy.pptx
ultrasound guided renal biopsy.pptxDr.Ahmed M Khalaf
 
Tubulointerstitial Nephritis
Tubulointerstitial NephritisTubulointerstitial Nephritis
Tubulointerstitial Nephritisautumnpianist
 
GENITO-URINARY DISORDERS-1.pptx
GENITO-URINARY DISORDERS-1.pptxGENITO-URINARY DISORDERS-1.pptx
GENITO-URINARY DISORDERS-1.pptxMikeMbuts
 
Management Of Acute Renal Injury In Pediatrics
Management Of Acute Renal Injury In PediatricsManagement Of Acute Renal Injury In Pediatrics
Management Of Acute Renal Injury In Pediatricsmohamed osama hussein
 

Similar a Renal pathology (20)

What Rheumatologists Learn from Nephrologists
What Rheumatologists Learn from Nephrologists What Rheumatologists Learn from Nephrologists
What Rheumatologists Learn from Nephrologists
 
Nephro pathological correlation
Nephro pathological correlationNephro pathological correlation
Nephro pathological correlation
 
Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).
 
Peripheral Neuropathy
Peripheral Neuropathy Peripheral Neuropathy
Peripheral Neuropathy
 
Nephrology lectures
Nephrology lecturesNephrology lectures
Nephrology lectures
 
ARRS5.pptx
ARRS5.pptxARRS5.pptx
ARRS5.pptx
 
Haematuria in pregnancy
Haematuria in pregnancyHaematuria in pregnancy
Haematuria in pregnancy
 
RENAL PARENCHYMAL DISEASE IMAGING.pptx
RENAL PARENCHYMAL DISEASE IMAGING.pptxRENAL PARENCHYMAL DISEASE IMAGING.pptx
RENAL PARENCHYMAL DISEASE IMAGING.pptx
 
medicine.Kidney 2.(dr.ala)
medicine.Kidney 2.(dr.ala)medicine.Kidney 2.(dr.ala)
medicine.Kidney 2.(dr.ala)
 
Uremia
UremiaUremia
Uremia
 
AKI - Approach
AKI - ApproachAKI - Approach
AKI - Approach
 
Chronic Kidney Disease
Chronic Kidney Disease Chronic Kidney Disease
Chronic Kidney Disease
 
multiple sclerosis.pptx
multiple sclerosis.pptxmultiple sclerosis.pptx
multiple sclerosis.pptx
 
Renal anomalies
Renal anomaliesRenal anomalies
Renal anomalies
 
meidicine.Vasculitis 1.(dr.kawa)
meidicine.Vasculitis 1.(dr.kawa)meidicine.Vasculitis 1.(dr.kawa)
meidicine.Vasculitis 1.(dr.kawa)
 
Nephrotic presentation.ppt9999999999999999999999999999999999999
Nephrotic presentation.ppt9999999999999999999999999999999999999Nephrotic presentation.ppt9999999999999999999999999999999999999
Nephrotic presentation.ppt9999999999999999999999999999999999999
 
ultrasound guided renal biopsy.pptx
ultrasound guided renal biopsy.pptxultrasound guided renal biopsy.pptx
ultrasound guided renal biopsy.pptx
 
Tubulointerstitial Nephritis
Tubulointerstitial NephritisTubulointerstitial Nephritis
Tubulointerstitial Nephritis
 
GENITO-URINARY DISORDERS-1.pptx
GENITO-URINARY DISORDERS-1.pptxGENITO-URINARY DISORDERS-1.pptx
GENITO-URINARY DISORDERS-1.pptx
 
Management Of Acute Renal Injury In Pediatrics
Management Of Acute Renal Injury In PediatricsManagement Of Acute Renal Injury In Pediatrics
Management Of Acute Renal Injury In Pediatrics
 

Más de imrana tanvir

Case presentation of acute cough
Case presentation of acute cough Case presentation of acute cough
Case presentation of acute cough imrana tanvir
 
Instruction guides cytology
Instruction guides cytology   Instruction guides cytology
Instruction guides cytology imrana tanvir
 
Tutorial secondary idd aids
Tutorial secondary idd aids Tutorial secondary idd aids
Tutorial secondary idd aids imrana tanvir
 
Cancer lab diagnosis
Cancer lab diagnosisCancer lab diagnosis
Cancer lab diagnosisimrana tanvir
 
Lec 24 24 female reproductive system pathology
Lec 24 24 female reproductive system pathologyLec 24 24 female reproductive system pathology
Lec 24 24 female reproductive system pathologyimrana tanvir
 
Sdl of pul. dis. of vasular origin
Sdl of pul. dis. of vasular originSdl of pul. dis. of vasular origin
Sdl of pul. dis. of vasular originimrana tanvir
 
P 9 male and female genital tract disorders
P 9 male and female genital tract disordersP 9 male and female genital tract disorders
P 9 male and female genital tract disordersimrana tanvir
 
Slides for practical seccion 2021
Slides for practical seccion 2021Slides for practical seccion 2021
Slides for practical seccion 2021imrana tanvir
 
Prac glomerular lesions-2020-i&i 13.11.08
Prac glomerular lesions-2020-i&i 13.11.08Prac glomerular lesions-2020-i&i 13.11.08
Prac glomerular lesions-2020-i&i 13.11.08imrana tanvir
 
Adrenal cortical disorderspptx
Adrenal cortical disorderspptxAdrenal cortical disorderspptx
Adrenal cortical disorderspptximrana tanvir
 
Inflammation and repair
Inflammation and repairInflammation and repair
Inflammation and repairimrana tanvir
 
L5 & 6 effects of htn on vessels & heart 20 (2)
L5 & 6 effects of htn on vessels & heart 20 (2)L5 & 6 effects of htn on vessels & heart 20 (2)
L5 & 6 effects of htn on vessels & heart 20 (2)imrana tanvir
 
uterus pathological lesions
uterus pathological lesionsuterus pathological lesions
uterus pathological lesionsimrana tanvir
 

Más de imrana tanvir (20)

Case presentation of acute cough
Case presentation of acute cough Case presentation of acute cough
Case presentation of acute cough
 
Instruction guides cytology
Instruction guides cytology   Instruction guides cytology
Instruction guides cytology
 
Tutorial secondary idd aids
Tutorial secondary idd aids Tutorial secondary idd aids
Tutorial secondary idd aids
 
Carcinogens
Carcinogens  Carcinogens
Carcinogens
 
Carcinogenesis
Carcinogenesis Carcinogenesis
Carcinogenesis
 
Cancer lab diagnosis
Cancer lab diagnosisCancer lab diagnosis
Cancer lab diagnosis
 
Lec 24 24 female reproductive system pathology
Lec 24 24 female reproductive system pathologyLec 24 24 female reproductive system pathology
Lec 24 24 female reproductive system pathology
 
Sdl of pul. dis. of vasular origin
Sdl of pul. dis. of vasular originSdl of pul. dis. of vasular origin
Sdl of pul. dis. of vasular origin
 
P 9 male and female genital tract disorders
P 9 male and female genital tract disordersP 9 male and female genital tract disorders
P 9 male and female genital tract disorders
 
Slides for practical seccion 2021
Slides for practical seccion 2021Slides for practical seccion 2021
Slides for practical seccion 2021
 
Prac glomerular lesions-2020-i&i 13.11.08
Prac glomerular lesions-2020-i&i 13.11.08Prac glomerular lesions-2020-i&i 13.11.08
Prac glomerular lesions-2020-i&i 13.11.08
 
Adrenal cortical disorderspptx
Adrenal cortical disorderspptxAdrenal cortical disorderspptx
Adrenal cortical disorderspptx
 
Healing and repair
Healing and repairHealing and repair
Healing and repair
 
Inflammation and repair
Inflammation and repairInflammation and repair
Inflammation and repair
 
Faculty new
Faculty newFaculty new
Faculty new
 
L5 & 6 effects of htn on vessels & heart 20 (2)
L5 & 6 effects of htn on vessels & heart 20 (2)L5 & 6 effects of htn on vessels & heart 20 (2)
L5 & 6 effects of htn on vessels & heart 20 (2)
 
uterus pathological lesions
uterus pathological lesionsuterus pathological lesions
uterus pathological lesions
 
Ovarian tumors
Ovarian tumorsOvarian tumors
Ovarian tumors
 
Inflammation
InflammationInflammation
Inflammation
 
Inflammation
InflammationInflammation
Inflammation
 

Último

Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
High Profile Call Girls Coimbatore Saanvi☎️ 8250192130 Independent Escort Se...
High Profile Call Girls Coimbatore Saanvi☎️  8250192130 Independent Escort Se...High Profile Call Girls Coimbatore Saanvi☎️  8250192130 Independent Escort Se...
High Profile Call Girls Coimbatore Saanvi☎️ 8250192130 Independent Escort Se...narwatsonia7
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...Taniya Sharma
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...narwatsonia7
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Último (20)

Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 
High Profile Call Girls Coimbatore Saanvi☎️ 8250192130 Independent Escort Se...
High Profile Call Girls Coimbatore Saanvi☎️  8250192130 Independent Escort Se...High Profile Call Girls Coimbatore Saanvi☎️  8250192130 Independent Escort Se...
High Profile Call Girls Coimbatore Saanvi☎️ 8250192130 Independent Escort Se...
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 

Renal pathology