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• Glomerul
• Tubi
• Vase sanguine
• Interstitiu
• Sistem Colector (Calices & Pelvis renal-bazinet)
ANATOMIE
Glomerul
Ansa Henle
TCP, TCD, TC
Cortex,
Medulara,
Pelvis renal.
GLOMERULUL
Ap. Juxta-
glomerular
Renin–angiotensin system
- ACE-
I
- ARB
Inflammasomes are multi-protein signaling complexes that trigger the activation of inflammatory
caspases and the maturation of interleukin-1β. The NLRP3 (nucleotide-binding oligomerization domain-
like receptor) inflammasome is best characterized and has been linked with various human
autoinflammatory and autoimmune diseases.
http://www.medscape.com/viewarticle/835188
Couser WG.. J Am Soc Nephrol 2012; 23: 381–399
Prezentarea Clinică a Bolii Glomerulare
A. Sindromul Nefritic
Pacienţii prezintă frecvent:
hematurie
hematii dismorfe
cilindrii hematici
proteinurie
Proteinuria(non-nefrotică) poate varia de la 200mg/zi la
1-2g/zi
Clinic, este însoţită de hipertensiune şi edeme
Insuficienţa renală este frecventă şi, de obicei,
progresivă
The filtration of plasma fluid across the glomerular barrier, forming primary urine
at a glomerular filtration rate (GFR) of 125 ml/min.
The plasma flow rate (Qp) =700 ml/min, giving a filtration fraction of 20%
Plasma proteins are filtered at the glomerulus according to their size and charge.
SSmall proteins of less than 20 kDa are freely filtered in glomerulus,
then reabsorbed, and degraded in the proximal tubule
Normal daily protein excretion <150 mg; of this, albumin = 10 mg
2) Restricţie de configuraţie
moleculară
– MBG
Hipercolesterolemie
Hipertrigliceridemie
Low-density lipoproteins (LDL)
Very low- density lipoproteins (VLDL)
ATEROSCLEROZA SISTEMICA
AVANSATA, discordanta varstei (IMA, AVC)!!
Mecanismele Hiperlipidemiei
Cresterea sintezei hepatice de LDL,
VLDL si lipoprotein (a) ca raspuns la
hipoalbuminemie
15mmHg H2O
colloid osmotic pressure 26 mmHg
Edema
Edemul
Retentie hidrosalina?!
1. Cresterea porilor transmembranari MBG.
2. Pierderea incarcaturii electrice negative a
MBG.