11. Hyalinised glomeruli

Overview

Staining: HE

Organ: Kidney

Description:

Four typical signs can be seen:

1. Most glomeruli contain globular eosinophilic structures. Some glomeruli are unaffected.
2. The tubulointerstitium is infiltrated by RBCs, lymphocytes and plasma cells
3. The tubules contain eosinophilic substance, making they look like the thyroid histologically. This process is called thyroidisation.
4. Arteriolosclerosis of the vessels in the renal sinus

Diagnosis: End-stage chronic kidney disease

Hyalinised glomeruli versus healthy ones

Causes:

• Diabetic nephropathy
• Chronic pyelonephritis
• Rapidly progressing glomerulonephritis
• Glomerulonephritis

Theory:

Hyalinisation of the glomeruli is the morphology of the end-stage kidney disease (chronic renal failure), which is often the end-result of the conditions mentioned above.

Despite the loss of many glomeruli some are still normal and functioning, so the kidney still produces some urine.

The WBCs here are lymphocytes and plasma cells.

Thyroidisation. From the medulla.

From the sinus. Arteriolosclerosis. The affected vessel has a narrowed lumen and the vessel wall is thickened.