Nath K A
Department of Medicine, University of Minnesota, Minneapolis.
Am J Kidney Dis. 1992 Jul;20(1):1-17. doi: 10.1016/s0272-6386(12)80312-x.
Tubulointerstitial injury is an invariant finding in the chronically diseased kidney, irrespective of the type of disease or the compartment in which the disease originates. Such histologic changes are functionally significant in that scores for such damage, rather than glomerular injury, correlate with decline of renal function. This review summarizes (1) clinical evidence attesting to tubulointerstitial changes as an index of functional impairment, (2) mechanisms by which tubulointerstitial injury impairs renal function, and (3) interactions of pathologic processes in the vascular, glomerular, tubular, and interstitial compartments that culminate in tubulointerstitial injury. This report concludes with a review of interstitial fibrosis, a pathologic process regarded as an irreversible outcome from tubulointerstitial injury.
肾小管间质损伤是慢性肾脏病的一个恒定表现，无论疾病类型或疾病起源部位如何。这种组织学改变在功能上具有重要意义，因为这种损伤的评分而非肾小球损伤与肾功能下降相关。本综述总结了：（1）证明肾小管间质变化作为功能损害指标的临床证据；（2）肾小管间质损伤损害肾功能的机制；（3）血管、肾小球、肾小管和间质区病理过程之间的相互作用，这些相互作用最终导致肾小管间质损伤。本报告最后回顾了间质纤维化，这是一种被认为是肾小管间质损伤不可逆结局的病理过程。
