Figure 23

The type of renal vessel involved by a vasculitis determines the resultant renal dysfunction. Large vessel vasculitides cause renal dysfunction by injuring the renal arteries and the aorta adjacent to the renal artery ostia. These injuries result in reduced renal blood flow and resultant renovascular hypertension. Medium-sized vessel vasculitis most often affects lobar, arcuate, and interlobular arteries, resulting in infarction and hemorrhage. Small vessel vasculi-tides most often affect the glomerular capillaries (ie, cause glomerulonephritis), but some types (especially the antineutrophil cytoplasmic antibody vasculitides) may also affect extraglomerular parenchymal arterioles, venules, and capillaries. Anti-GBM disease is a form of vasculitis that involves only capillaries in glomeruli or pulmonary alveoli, or both. This category of vasculitis is considered in detail seperately in this Atlas.

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