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Tubulointerstitielle Fibrose

Endstrecke aller Nierenerkrankungen, prognostischer Faktor oder Pathomechanismus?

Tubulointerstitial fibrosis

Final phase of all kidney diseases, prognostic factor or pathomechanism?

Der Nephrologe volume 5, pages 284–292 (2010)Cite this article

Zusammenfassung

Der Begriff interstitielle Fibrose und Tubulusatrophie (IFTA) beschreibt die uniforme Vernarbung des Interstitiums der Niere, die für sich genommen nicht spezifisch für eine zugrunde liegende Erkrankung ist. Sowohl primär glomeruläre als auch primär interstitielle Erkrankungen der Niere (letztere sind deutlich seltener) führen bei chronischem Verlauf gleichermaßen zu IFTA. Dabei bestimmt das Ausmaß der Fibrose wesentlich die Prognose der Erkrankung. Verschiedene Mechanismen für die Entstehung von IFTA, ausgehend von glomerulären Schäden, welche die Bowman-Kapsel einbeziehen, Hypoxie, epithelial-mesenchymale/endothelial-mesenchymale/perizytär-mesenchymale Transdifferenzierung werden diskutiert. IFTA stellt keine Diagnose dar, sondern beschreibt eine vermutlich irreversible Reaktion der Niere auf verschiedene Schädigungen.

Abstract

Interstitial fibrosis and tubular atrophy (IFTA) represent uniform scarring of the interstitial zone of the kidney that is not restricted to a specific disorder. Glomerular as well as primary interstitial disorders lead to IFTA, as they progress to pursue a chronic course. Primary interstitial diseases are much rarer compared to glomerular diseases. The extent of fibrosis mainly determines the prognosis and outcome of renal diseases in general. Different mechanisms have been proposed to explain the development of IFTA: evolvement from glomerular damage that involves Bowman’s capsule, hypoxia, epithelial-mesenchymal, endothelial-mesenchymal and pericytic-mesenchymal transition. IFTA is not a specific diagnosis but forms a final common track of different modalities of damage, which is most likely irreversible.

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Authors and Affiliations

  1. Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    V. Bröcker & H. Kreipe

  2. Klinik für Nieren- und Hochdruckkrankheiten, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    H. Haller

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  1. V. Bröcker
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  2. H. Kreipe
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  3. H. Haller
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Correspondence to V. Bröcker or H. Haller.

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Bröcker, V., Kreipe, H. & Haller, H. Tubulointerstitielle Fibrose. Nephrologe 5, 284–292 (2010). https://doi.org/10.1007/s11560-010-0413-6

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  • DOI: https://doi.org/10.1007/s11560-010-0413-6

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