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Glomerular Anatomy and Physiology

Glomerular Anatomy and Physiology

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Glomerular Anatomy and Physiology

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  1. Glomerular Anatomy and Physiology Renal Physiology 6 10/10/2011 Charles J. Foulks, M.D.

  2. . (Endothelial cell surface layer) Fenestrations Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  3. . Fenestrated endothelium Podocyte foot processes Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  4. . Fenestrations Cupromeronic Blue (charged) Lanthanum Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  5. . In steady state production/removal In steady state production/removal Produced by podocytes and influence endothelial cells Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  6. Cultured human podocytes Actin filaments Foot process buds: white arrows

  7. . Endothelial cell-specific antigen stain Normal endothelial cell culture Endothelial cell specific lectin stain Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  8. Human podocyte culture . Perlecan (green) and actin are labeled red using phalloidin Perlecan antibody stain Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  9. Properties of the Glomerular Barrier and Mechanisms of Proteinuria TABLE 1.Reported sieving coefficients for albumin in studies with "controlled" tubular modification

  10. Properties of the Glomerular Barrier and Mechanisms of Proteinuria TABLE 2.Sieving coefficients for various proteins in selected studies

  11. alb=CB/CP Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  12. . alb=CB/CP Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  13. . - + --- alb=CB/CP Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  14. . alb=CB/CP Pore size increase from 5nm to 6nm. Decreased FR by 50% (Pore radius) Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  15. . alb=CB/CP Haraldsson B et al. Physiol Rev 2008;88:451-487 ©2008 by American Physiological Society

  16. 1= subepithelial, MN 2=subepithelial humps, post-infectiours GN 3=Subendothelial 4=Mesangial 5=GMB-Ab complex e.g., Goodpasture’s 6=effacement, foot process

  17. NORMAL GBM. LEFT - a single glomerulus. There are one million of these in each kidney. RIGHT - a close up of the GBM (G) around part of one tiny blood vessel in a glomerulus (red circle in left hand diagram)

  18. Thin Glomerular Membrane Disease

  19. Lipid Accumulation Patients 1&2, In tubular Epithelial cells.

  20. Overwhelms beta-oxidation High Alb filtration Luminal or apical side Entry of free non-esterified fatty acids into proximal tubule cells and the role of albumin as ‘Trojan horse’

  21. Competes with glutamine

  22. Normal Glomerulus Minimal Change Disease

  23. Normal glomerulus FSGS

  24. Membranous Nephropathy: note EDD in subepithelial area.

  25. Slides courtesy of UNC Kidney Center