Diseases of the kidney

1. DISEASES OF THE KIDNEY
RENAL CALCULI AND CHRONIC PYELONEPHRITIS

2. Learning Objectives
By the end of this session, you should know about
• Types of Renal Calculi
• Chronic Pyelonephritis

3. Renal calculi
• In the urinary tract, the most
common site of origin of stone is
the kidney.
• Males in the age group of 20-30
years are most commonly
affected.
• Formed either due to
– supersaturation of urine
– deficiency of crystal formation
inhibitors
• Stones are usually unilateral in
80% of patients
• Clinical symptoms include hematuria, urinary obstruction, renal
colic (if they pass into the ureters) and increased chances of infection.

4. Prevalence of Various Types of Renal Stones

6. Renal Calculi
GROSS
• The pelvis of the kidney
contains a single, large, soft
yellow white stone taking
the contour of the pelvi-
calyceal system.
• Dilated pelvicalyceal
system with atrophied and
thin peripheral cortex.
Staghorn renal stone

7. Chronic Pyelonephritis
Chronic tubulointerstitial disease resulting from repeated attacks of
inflammation and scarring due to infection.

8. Chronic Pyelonephritis
GROSS
• The kidneys are usually
small and contracted,
weighing less than 100 gm
each, showing unequal
reduction.
• Outer surface shows the
renal capsule adherent to
the cortex with irregular
scars on the surface.

9. Chronic Pyelonephritis
GROSS
• Sectioned surface shows
dilated pelvicalyceal system
with atrophied and thin
peripheral cortex and
increased hilar fat
extending inside.

10. Chronic Pyelonephritis
• The interstitium shows chronic
inflammatory infiltrate with
pronounced interstitial fibrosis.
• Dilated atrophic tubules may
contain colloid casts producing
thyroidisation of tubules.
• The wall of dilated pelvicalyceal
system shows marked chronic
inflammation and scarring.
• Periglomerular fibrosis and
hyalinisation of some glomeruli
MICROSCOPY