【医学课件】肾病总论（英语）张玖强.pptx

Urinary System DiseaseLiu Fu-You MD.1. Reviews of Anatomy and Physiology of Urinary System(1) kidneyL T11~L2R T12~L3(1) kidney10cm in length5cm in width4cm in thickness134 ~ 148g in weight(2) Renal Cortexrenal cortex 80~90% of glomerulusGlomerular capsule renal medulla renal tubule(3) GlomerulusGlomerular Filtration Membraneendothelial cellsbasementepithelial cells(4) Renal tubuleproximal convolute reabsorptiondistal convolute regulating of acid-base balanceRenal tubular diseases(renal, tubular, acidosis)ⅠType(dRTA)ⅡType(pRTA)Ⅰ+Ⅱ(5) Renal InterstitiumAcute interstitial nephritisChronic interstitial nephritisInterstitial cellsFibrocyteExtracelluar matrixPathogenic microorganismimmunoreactionInterstitium (6) Renal Pelvis, Ureter Pathogenic microorganismRenal pelvisureterpyelonephritis(upper urinary tract)(7) Urinary Bladder,UrethraUrinary bladderUrethraPathogenicmicroorganismcystourethritis(Lower urinary tract)2. Symptoms of Glomerular DiseaseProteinuriahematuriaedema hypertension nephritis syndrome(proteinuria3.5g/day)Proteinuria+++nephrotic syndromeproteinuria150mg/24hrProteinuria analysisglomerular tubular overflow secretory or1.5g/24hr1.5g/24hr immunoglobulin histicSelective(albumin)Β2-microglobulinInfectiontoxicity Bence JonesproteinNonSelective(mixture)myelomaGlomerular disease Dysmorphic RbchematuriaCalculus,tumor,TB,infection Hemogeneous Rbcvolume dependentrenin dependentrenal parenchymahypertensionRenal vessel——Arleriae renalis stenosisGlomerular Filtrate Rate(GFR) ↓AnasarcaLocal edemaLower extremity edemaEdemaPlasma colloid osmotic pressure↓ Common Clinical Laboratory Assessment of Renal DiseaseRenal diseaseurinalysisRenal functionSpecial examinationCell protein cast glomerular tubular IVP CT renal biopsy MRI Cr Ccr GFR PSP Mosths3. Treatment of Glomerular DiseaseRemoval causesCorticosteroidImmunosuppressivePrimary Glomerular nephritisSymptomatic and supportingAnti-inflammatoryChinese herbsRenal f