Summary
Morphometric investigations were performed in 33 biopsies with minimal proliferative intercapillary glomerulonephritis with nephrotic syndrome (MPI with NS, minimal changes with nephrotic syndrome) and in 65 biopsies with focal sclerosing glomerulonephritis (FGS). Both diseases are, in our opinion, variants of a single entity. Positive significant correlations (corresponding to linear and parabolic functions) between the relative interstitial volume of the renal cortex and serum creatinine concentration at the time of biopsy could be found. No correlations were observed between percentage of glomeruli affected by segmental and focal sclerosis in FGS and relative interstitial volume, or the percentage of involved glomeruli and serum creatinine concentration. The enlargement of the cortical interstitium by fibrosis may lead to a narrowing of the postglomerular vessels, to an elevation of the postglomerular flow resistance and to a slowing of the glomerular blood flow. In this way the filtrate of the glomerulus could be reduced and lead to a elevation of the serum creatinine concentration. Alternatively the observed tubular atrophy in fibrotic areas — caused by malnutrition or inactivity — could impair the tubular capacity of resorption. This may lead to a reduction of the glomerular filtrate by the so called Thurau mechanism in the case of interstitial fibrosis.
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Bohle, A., Glomb, D., Grund, K.E. et al. Correlations between relative interstitial volume of the renal cortex and serum creatinine concentration in minimal changes with nephrotic syndrome and in focal sclerosing glomerulonephritis. Virchows Arch. A Path. Anat. and Histol. 376, 221–232 (1977). https://doi.org/10.1007/BF00432398
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DOI: https://doi.org/10.1007/BF00432398