Amyloid related Nephropathy – Top USMLE Diseases

The kidney is the central filter organ of our body. More specifically, it is the small glomeruli that filter those substances from the blood that have to be excreted and thus produce the primary urine. Various factors may cause damages to the glomeruli, resulting in a malfunctioning filtration process. The type of malfunction can vary, and accordingly, so do its clinical manifestations. Differentiating these variable clinical presentations of glomerulonephritis is for many medical students a rather challenging task. The following article will help you to understand the difficult topic of glomerulonephritides

Membranoproliferative glomerulonephritis (MPGN) is a type of immune mediated glomerular disease. The name is an indication of its pathology, with thickening of the basement membrane and proliferative changes. MPGN is categorized into three types: type I, type II (also called dense deposit disease) and type III. Students should be familiar with an overview of this condition, including its pathological features that set it apart from other glomerular disorders, as well as the diagnostic approach and management of MPGN.

Diabetic glomerulopathy is the leading cause of chronic renal failure in adults. Long-standing type 1 or type 2 diabetes mellitus is associated with this microvascular complication, along with peripheral neuropathy and retinopathy. The pathology of diabetic glomerulopathy is distinguishable based on certain features, including the presence of pathognomonic Kimmelstiel-Wilson nodules, hence the term Kimmelstiel-Wilson disease. A diagnosis of diabetic glomerulopathy does not require a renal biopsy – rather, it is established based on the presence of significant proteinuria and a history of diabetes for >10 years or diabetic retinopathy. Students should be aware about this important complication of diabetes, including its pathology, pathophysiology, clinical course and management.