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Archive: Miscellaneous

Membranous Lupus Nephritis

The patient is a 19-year-old female who presents with hematuria, nephrotic range proteinuria, and a creatinine of 1.2 mg/dL. She has a recent diagnosis of systemic lupus erythematosus. Figure 1 shows a normal glomerulus without "spikes" and "holes" of the glomerular basement membranes. Figure 2 shows no significant interstitial fibrosis. Figures 3, 4, 5, & 6 shows IgG, kappa, lambda, and C1q respectively. Image 7 and 8 shows subepithelial deposits. This is a case of membranous lupus nephritis (ISN/RPS Class V). By definition, no proliferative changes (crescents, fibrinoid necrosis, endocapillary hypercellularity) are seen within the glomeruli in a pure class...

Vascular Resistance

The sampled artery in this kidney biopsy shows severe arteriosclerosis.  The deleterious effects of a narrowed arterial lumen and increased stiffness of the artery wall are illustrated mathematically:  resistance to blood flow is directly proportional to vessel length and blood viscosity and inversely proportional to vessel diameter (or radius).  This formula illustrates how vessel diameter (or radius) has the most profound effect on resistance, especially since vessel length and blood viscosity do not usually change significantly in most physiologic states.