重庆医科大学：《内科学》课程教学课件（PPT讲稿）Glomerulardisease

Glomerular Diseases Tang Lin Nephrology Department The 2nd Teaching Hospital

Glomerular Diseases Tang Lin Nephrology Department The 2nd Teaching Hospital

Preface The glomerular diseases are the most common cause of end-stage renal disease(ESRD). Glomerular Diseases 2

Glomerular Diseases 2 ◼ The glomerular diseases are the most common cause of end-stage renal disease (ESRD). Preface

Diverse diseases affecting glomerulus may lead to similar manifestations(e.g.hematuria,proteinuria, hypertension etc.). The diseases with same manifestation difference in the causes,pathogeneses,pathologic changes, durations,and prognoses. Glomerular Diseases

Glomerular Diseases 3 ◼ Diverse diseases affecting glomerulus may lead to similar manifestations (e.g. hematuria, proteinuria, hypertension etc.). ◼ The diseases with same manifestation difference in the causes, pathogeneses, pathologic changes, durations, and prognoses

Classification (cause) Hereditary (e.g.polycystic kidneys) Secondary to systemic diseases(DM,systemic lupus erythematosus) ■Primary Glomerular Diseases 4

Glomerular Diseases 4 Classification (cause) ◼ Hereditary (e.g. polycystic kidneys) ◼ Secondary to systemic diseases (DM, systemic lupus erythematosus) ◼ Primary

Primary Glomerular Diseases Glomerular Diseases 5

Glomerular Diseases 5 Primary Glomerular Diseases

Mechanisms of glomerular injury Immune Non-immnue Glomerular Diseases 6

Glomerular Diseases 6 Mechanisms of glomerular injury Immune Non-immnue

Mechanisms of glomerular injury Immune mechanisms In situ immune-complex deposition Circulating immune complex deposition Cytotoxic antibodies Cell-mediated immunity Activation of alternative complement pathway Glomerular Diseases

Glomerular Diseases 7 Mechanisms of glomerular injury Immune mechanisms ◼ In situ immune-complex deposition ◼ Circulating immune complex deposition ◼ Cytotoxic antibodies ◼ Cell-mediated immunity ◼ Activation of alternative complement pathway

Mechanisms of glomerular injury 1.In situ immune-complex deposition o。量。p云2平oY。 O antigen,Y antibody,immune-complex Glomerular Diseases 8

Glomerular Diseases 8 Mechanisms of glomerular injury ◼ ⒈ In situ immune-complex deposition ○ antigen，Y antibody， immune-complex

Mechanisms of glomerular injury 2.Circulating immune complex deposition 9 O antigen,Y antibody,immune-complex Glomerular Diseases 9

Glomerular Diseases 9 Mechanisms of glomerular injury ◼ ⒉ Circulating immune complex deposition ○ antigen，Y antibody， immune-complex

Mechanisms of glomerular injury 3.Cytotoxic antibodies Abs to glomerular cell Ags cause damage without the formation and deposition of IC. 4.Cell-mediated immunity T cells form cell-mediated immune reactions can cause glomerular injury. 5.Activation of alternative complement pathway Glomerular Diseases 10

Glomerular Diseases 10 Mechanisms of glomerular injury ◼ ⒊ Cytotoxic antibodies Abs to glomerular cell Ags cause damage without the formation and deposition of IC. ◼ ⒋ Cell-mediated immunity T cells form cell-mediated immune reactions can cause glomerular injury. ◼ ⒌ Activation of alternative complement pathway