Diffuse intermyocardiocytic fibrosis in uraemic patients.
At post-mortem we examined heart tissue of (i) 31 patients with uraemia not on dialysis, (ii) 42 patients on haemodialysis for less than 6 months, (iii) 60 patients on haemodialysis for more than 6 months, (iv) 16 patients after renal transplantation, and (v) 11 patients on CAPD. Patients with stenosing coronary lesions were excluded. Diffuse non-coronary intermyocardiocytic fibrosis, assessed by a score system in trichrome-stained sections, was found in 91% of chronically uraemic patients, but not in non-hypertensive, non-diabetic controls. The lesion was present even in non-dialysed uraemic patients; in dialysed patients its severity was related to the duration of dialysis; it was demonstrable even years after renal transplantation. On electron-microscopy, collagen fibres were seen, while beta 2-M amyloid was consistently absent. Logistic regression analysis showed that uraemia was a determinant of intermyocardiocytic fibrosis independent of hypertension, diabetes mellitus, anaemia, heart weight, and presence or absence of dialysis procedure.
Mall
G
G
Department of Pathology, Ruperto Carola University, Heidelberg, Germany.
Huther
W
W
Schneider
J
J
Lundin
P
P
Ritz
E
E
D000741:Anemia, Aplastic / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004719:Endomyocardial Fibrosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D009206:Myocardium / Q000473:pathology; D012044:Regression Analysis; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications* / Q000628:therapy