The Kidney &The Kidney &Collecting SystemCollecting System

Diseases of Tubules & Interstitium:1.1. Infectious:Infectious:

Acute PyelonephritisChronic Pyelonephriris

2. Non-infectious:2. Non-infectious:

Drug-Induce Interstitial Nephritis• Allergic• Analgesic

Acute Tubular Necrosis

Acute PyelonephritisAcute PyelonephritisGross:

• One /or both Kidneys involved• Normal or/enlarged• Microabscesses in both cortex and medulla (hematogenous)

Glomeruli Not involved

Suppurative inflammation(Abscess)– Interstitium: Neutrophils infiltrate– Tubules (WBCs Casts)

Acute PyelonephritisAcute Pyelonephritis

The Kidney &The Kidney &Collecting SystemCollecting System

Diseases of Tubules & Interstitium:1.1. Infectious:Infectious:

Acute PyelonephritisChronic Pyelonephriris

2. Non-infectious:2. Non-infectious:

Drug-Induce Interstitial Nephritis• Allergic• Analgesic

Acute Tubular Necrosis

Chronic Pyelonephritis &Chronic Pyelonephritis &

Reflux NephropathyReflux Nephropathy

Interstitial inflammation & Scarring of Renal Parenchyma Interstitial inflammation & Scarring of Renal Parenchyma

Gross Scarring & Deformity of Pelvicalyceal SystemGross Scarring & Deformity of Pelvicalyceal System

Important cause of Important cause of Chronic Renal FailureChronic Renal Failure

Chronic PyelonephritisChronic Pyelonephritis

Morphology:Morphology:

The Kidney &The Kidney &Collecting SystemCollecting System

Diseases of Tubules & Interstitium:1.1. Infectious:Infectious:

Acute PyelonephritisChronic Pyelonephriris

2. Non-infectious:2. Non-infectious:

Drug-Induce Interstitial Nephritis• Allergic• Analgesic

Acute Tubular Necrosis

Drug-induced Interstitial NephritisDrug-induced Interstitial Nephritis

1. Acute drug-induced Interstitial Nephritis ARFARF

2. Analgesic Nephropathy CRFCRF

1) Acute drug-induced Interstitial Nephritis1) Acute drug-induced Interstitial Nephritis

Morphology:Morphology:

2) Analgesic Nephropathy2) Analgesic Nephropathy

Drugs:Drugs:

“Combinations” of “large quantities” for “long periods”

Phenacetin

Aspirin

Acetaminophen

Caffeine

Codeine

Leading to Renal Papillary Necrosis & Interstitial Nephritis

The Kidney &The Kidney &Collecting SystemCollecting System

Diseases of Tubules & Interstitium:1.1. Infectious:Infectious:

Acute PyelonephritisChronic Pyelonephriris

2. Non-infectious:2. Non-infectious:

Drug-Induce Interstitial Nephritis• Allergic• Analgesic

Acute Tubular NecrosisAcute Tubular Necrosis

Acute Tubular Necrosis (ATN)Acute Tubular Necrosis (ATN)

Clinico-Pathological entity Characterized by:Clinico-Pathological entity Characterized by:

Destruction of tubular epithelial cells Destruction of tubular epithelial cells

Acute Renal FailureAcute Renal Failure

The The most common causemost common cause of of acute renal failureacute renal failure

Reversible renal lesionsReversible renal lesions

Cont.Cont. Acute Tubular Necrosis (ATN)Acute Tubular Necrosis (ATN)

Morphology:Morphology: