TUBULAR AND INTERSTITIAL LESIONS AND MONONUCLEAR CELL INFILTRATION IN PRIMARY FORMS OF GLOMERULONEPHRITIS

被引:5
作者
GRCEVSKA, L
POLENAKOVIC, M
机构
[1] Department of Nephrology, Faculty of Medicine, Skopje
关键词
INTERSTITIAL INFILTRATION; PRIMARY GLOMERULONEPHRITIS; TUBULAR ATROPHY;
D O I
10.3109/08860229309054963
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In the present study of 246 patients with primary forms of glomerulonephritis (GN) we investigated their tubular and interstitial changes, especially mononuclear cell infiltration and optical microscopy, and compared this finding with the outcome of the disease (5-year survival rate). Only first biopsies were analyzed in order to detect early tubulointerstitial changes which occur together with the glomerular changes. Different degrees of the lesions of tubules and interstitium were present in different forms of GN. Mononuclear cell infiltration was present in 100% of the patients with crescentic, in 90.9% in focal sclerosing, in 89% in membranoproliferative, and in 76.4% of patients with chronic diffuse GN. Less than 50% of the other patients showed infiltration. Using monoclonal antibodies it was demonstrated that mononuclear cell infiltrates mainly consisted of T and T4 cells. Interstitial edema was expressed in the same forms of GN and in similar proportions. Interstitial fibrosis was found only in patients with: focal sclerosing GN (13.7%), IgA GN (4.1%), membranoproliferative GN (31.4%), chronic diffuse GN (23%), and crescentic GN (27.7%). Tubular atrophic changes were again dominantly present in: crescentic GN (94.2%), focal sclerosing GN (77.8%), chronic diffuse GN (76.4%), and membranoproliferative GN (68.4%). Patients with severe tubulointerstitial changes together with the glomerular changes had a low 5-year survival rate of renal function.
引用
收藏
页码:485 / 493
页数:9
相关论文
共 12 条
  • [1] Abe S., Amagasaki Y., Iyori S., Et al., Significance of tubuiointer-stitial lesions in biopsy specimens of glomerulonephritic patients, Am J Nephrol, 9, pp. 30-37, (1989)
  • [2] Bohle A., Mackenzen-Haen S., Gise V.H., Significance of tubu-lointerstitial changes in the renal cortex for the excretory function and concentration ability of the kidney: A morphometric contribution, Am J Nephrol, 7, pp. 421-433, (1987)
  • [3] Honkanen E., GrONhagen-Raska C., Von Willebrand E., Et al., Renal mononuclear inflammatory cell populations in membranous glomerulonephritis: A fine-needle aspiration biopsy study, Clin Nephrol, 28, pp. 232-237, (1987)
  • [4] Hotta O., Yoshizawa N., Oshima S., Et al., Significance of renal hyaline arteriolosclerosis and tubulointerstitial change in IgA glomerulonephropathy and focal glomerular sclerosis, Nephron, 47, pp. 262-265, (1987)
  • [5] Kobayashi Y., Tateno S., Hiki Y., Et al., IgA nephropathy: Prognostic significance of proteinuria and histologic alterations, Nephron, 34, pp. 146-153, (1983)
  • [6] Seron D., Alexopoulos E., Raftery M.J., Et al., Number of interstitial capillary cross-sections assessed by mononuclear antibodies relation to interstitial damage, Nephrol Dial Transplant, 5, pp. 889-893, (1990)
  • [7] Churg J., Renal Disease. Classification and Atlas of Glomerular Diseases, (1982)
  • [8] Cutler S.J., Ederer F., Maximum utilization of the life table method in analyzing survival, J Chron Dis, 8, pp. 699-712, (1958)
  • [9] Beukhof J.R., Kardaun O., Schaafsma W., Et al., Toward individual prognosis of IgA nephropathy, Kidney Int, 29, pp. 549-556, (1986)
  • [10] MarkoviC-Lipkovski S., MULler G.A., Risler T., Et al., Association of glomerular and interstitial mononuclear leukocytes with different forms of glomerulonephritis, Nephrol Dial Transplant, 5, pp. 10-17, (1990)