Transcripts
DR. BRANDT:
This is a more detailed picture of what goes on in the kidney. On the right is a normal glomerular capillary. It's made up of an endothelial cell, here in yellow. It is a very fine, thin and delicate cell. Under it is the glomerular basement membrane (black) and finally, there are the epithelial cells which wrap around the glomerular blood vessels (green).
Normally, there's a very short distance between the blood here and urine out here, which water, salts and wastes must cross to make urine.
However, in HUS, Thrombotic Microangiopathy (TMA), leads to swelling of the endothelial cells and subepithelial space. This leads to narrowing of the vessel lumen and finally clot formation.
TMA results in two problems. The first is decreased perfusion and oxygenation of the glomerulus because we have less volume of blood going through delivering oxygenation. The second is the increased transit space
that waste products and water must cross. This makes it much more difficult for waste products to cross that filtration barrier and make urine.
