[Clinicopathological analysis of malignant nephrosclerosis].
BACKGROUND
Although pathological changes in the vascular lesions of malignant nephrosclerosis have been quantified, little is understood about interstitial changes. We quantified pathological changes such as glomerular damage (glomerular sclerosis and collapse), vascular patency and interstitial fibrosis to determine statistical correlations with clinical data.


METHODS
We examined 25 patients who were diagnosed with malignant hypertension and investigated correlations among age, urinary protein, SUN, 1/Cre, systolic BP and diastolic BP (from medical charts), interstitial fibrosis, glomerular damage, acute tubular damage (semiquantified by scoring) and arterial and arteriolar patency (from renal biopsies).


RESULTS
Interstitial fibrosis inversely correlated with 1/Cre (p=0.0114), interlobular arterial patency (p= 0.0139) and total vascular patency (p = 0.0499). Glomerular damage tended to correlate with urinary protein, but the values did not reach the level of statistical significance (p=0.0666). On the other hand, glomerular damage correlated with neither interstitial fibrosis nor vascular patency. Acute tubular damage closely correlated with both diastolic (p= 0.0086) and systolic (p = 0.0075) BP.


CONCLUSIONS
Interstitial damage increases with decreasing interlobular arterial patency and renal function decreases with increasing interstitial damage. Since acute tubular damage that can progress to chronic interstitial damage closely correlates with BP, the control of BP might indirectly influence the prognosis of renal function.
Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Sayako
S
Hoshi
Yutaka
Y
Yamaguchi
Tsutomu
T
Sanaka
Tatsuo
T
Hosoya
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009400:Nephrosclerosis / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D012077:Renal Artery / Q000473:pathology / Q000503:physiopathology; D014654:Vascular Patency