Summary
48 cases of renal amyloidosis (grade I–IV) were investigated morphologically (point-counting method). Statistically significant positive correlations exist between relative interstitial volume and serum creatinine concentration at the time of biopsy. In amyloidosis there are furthermore connections (positive rank correlations) between the extent of glomerular amyloidosis and renal insufficiency, although single cases of grade III show normal serum creatinine concentrations if the interstitium is not enlarged. With regard to interstitial alterations only fibrosis, not amyloid masses, seems to influence renal function, especially in the case of predamaged glomeruli (grade II to IV). The diminished renal function — reduction of the glom. filtr. rate — may be explained in the case of interstitial fibrosis by slowing of renal blood flow caused by a decreasing cross-sectional area of postglomerular vessels.
Renal insufficiency seems to depend upon both the glomerular and the interstitial factor, but in grades II–IV the interstitial fibrosis is thought to be of more importance for renal function.
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Bohle, A., Grund, K.E., Mackensen, S., Tolon, M.: Correlations between renal interstitium and level of serum creatinine. Morphometric investigations of biopsies in perimembranous glomerulonephritis. Virchows Arch. A Path. Anat. and Histol.373, 15–22 (1977)
Bohle, A., Bader, R., Grund, K.E., Mackensen, S., Neunhoeffer,.: Serum Creatinine Level and Renal Interstitial Volume. Analysis of Correlations in Acute Endocapillary Glomerulonephritis and in Moderately Severe Mesangioproliferative Glomerulonephritis. 1977 Virchows Arch. A Path. Anat. and Histol. (in press)
Brandt, K., Cathcart, E.S., Cohen, A.S.: A Clinical Analysis of the Course and Prognosis of Fourty-Two Patients with Amyloidosis. Am. J. Med.44, 955–969 (1968)
Brenner, B.M., Baylis, Ch., Deen, W.M.: Transport of Molecules across Renal Glomerular Capillaries. Physiological Rev.56, 502–533 (1976)
Brod, J.: The Kidney., pp. 387. London: Butterworths & Co. 1973
Fahr, Th.: Handbuch der speziellen pathologischen Anatomie und Histologie, Bd. VI, Teil I, S. 231 u. 234. Berlin: Springer 1925
Fischbach, H., Mackensen, S., Grund, K.E., Kellner, A., Bohle, A.: Relationship between glomerular lesions, serum creatinine and interstitial volume in membranoproliferative glomerulonephritis. Klin. Wschr.55, 603–608 (1977)
Heptinstall, R.H.: Pathology of the Kidney, pp. 571–589. Boston: Little Brown and Co. 1966
Heptinstall, R.H., Joekes, A.M.: Renal amyloid. A report on 11 cases proven by renal biopsy. Ann. Rheum. Dis.19, 126 (1960)
Muehrcke, R.C., Pirani, C.L., Pollack, U.E., Kark, R.M.: Primary renal amyloidosis with the nephrotic syndrome studied by serial biopsies of the kidney. Guy's hosp. rep.104, 295–310 (1955)
Plate, W.R.: Untersuchungen zur Struktur des Glomerulum. Rekonstruktion eines menschlichen Glomerulum an 0.5 Μ dicken Serienschnitten. Inaugural-Dissertation Tübingen 1976
Reubi, F.: Nierenkrankheiten, pp. 309–315. Berlin-Stuttgart-Wien: Huber 1970
Sohar, E., Gafni, J., Mordehai, P., Heller, H.: Familial mediterranean fever. A survey of 470 cases and review of the literature. Am. J. Med.43, 227–253 (1967)
Watanabe, T., Saniter, T.: Morphological and Clinical features of Renal Amyloidosis. Virchows Arch. A Path. Anat. and Histol.366, 125–135 (1975)
Zollinger, H.: Niere und ableitende Harnwege. In: Doerr, Uehlinger, Spezielle pathologische Anatomie, pp. 207–216. Berlin-Heidelberg-New York: Springer 1966
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Mackensen, S., Grund, K.E., Bader, R. et al. The influence of glomerular and interstitial factors on the serum creatinine concentration in renal amyloidosis. Virchows Arch. A Path. Anat. and Histol. 375, 159–168 (1977). https://doi.org/10.1007/BF01102985
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DOI: https://doi.org/10.1007/BF01102985