Path - Renal

•Heavy Proteinuria
•Oval Fat Bodies (indicate lipiduria)
•Free Fat Droplets
•Few Cellular Elements
•Fatty Casts
•Hyperlipidemia
•Edema
•Normal Complement Levels

Cone: Due to leaky basement membrane that is no longer negatively charged.

•Red Blood Cells
•Red Cell and Granular Casts
•Variable Proteinuria
•White Blood Cells

Cone: Due to capillary damage

•Most common disorder in children
•15% in adults
•Idiopathic, but may be seen in lymphoma or renal cell carcinoma

Lab Results:
•Serum: Low albumin, normal creatinine
•Urine: Proteinuria, bland urine sediment
•Physical exam: Normal BP, edema (periorbital and pedal)

•Kids can have remission with steroid treatment but can relapse when they are stopped
•No tendency to progress to CRF/ESRD

•LM: normal
•IF: no deposits
•EM: fusion of foot processes and effacement. detachment of basement membrane. (THIS IS DIAGNOSTIC)

•Higher in adults (African American)
•Often idiopathic
•Can be secondary to: HIV, morbid obesity, chronic reflux neuropathy, heroin use and malignancies (such as lymphomas)
•Present with insidious onset of asymptomatic proteinuria
•Progression to nephrotic syndrome with massive proteinuria and microscopic hematuria
•Many are hypertensive and have renal insufficiency

Anything causing reduction in renal mass will result in compensatory hyperfiltration in remaining glomeruli leading injury pattern

•Renal ablation nephropathy
•Glomerulonephritis
•Congenital unilateral renal agenesis or aplasia