病理学精品课件：e111.pptVIP

(一)? Functions of kidney 1. Excretes the waste products of metabolism 2. Precisely regulates the body’s concentration of water and salt 3. Maintains the appropriate acid- alkaline balance of plasma 4. Serves as an endocrine organ: erythropoietin renin prostaglandin (二)?Renal structure (1) Endothelial Cells ① A thin layer of fenestrated EC fenestrum→70~100nm in diameter ② Surface→sialoglycoprotein with negative electric charge (2) G B M ①? Composed of ② Ingredients Collagen: mostly type IV→forms a network suprastructure Laminin: (3)Visceral epithelial C (Podocyte) ①?? Foot process adjacent foot processes → filtration slit → slit diaphragm ②?? Surface→sialoglycoprotein with negative electric charge 2.?Mesangium (1) Mesangial cell Contraction Phagocytosis Producing matrix and collagen Secreting a number of cytokines (2) Mesangial matrix 3.??Renal capsule (1) Size - dependent  barrier function discriminates protein molecules depending on their size (2) Charge - dependent  barrier function ①? important→ because albumin is an anionic molecules ②? endothelial cell epithelial cell basal membrane→heparin sulfate ③ Albumin Normal: can not through the filtration membrane Changes of structure and function proteinuria §1 Glomerulonephritis (GN) Primary glomerulonephritis: Immune mechanisms Secondary glomerulonephritis: SLE , Hypertension , Diabetes and so on 一. Etiology and Pathogenesis Immune mechanisms Primary GN (一) Antigen-Antibody reaction main cause Ab-Ag complexhypersensitivity 1.? Antigen （1）Endogenous