Schmitt H, Cavalcanti de Oliveira V, Bohle A
Pathol Res Pract. 1987 Feb;182(1):6-10. doi: 10.1016/S0344-0338(87)80136-X.
A total of 259 kidney biopsies with type I membranoproliferative glomerulonephritis (MPGN) were evaluated, and five grades of glomerular alterations were compared to the following four categories of tubulo-interstitial findings: no changes, interstitial fibrosis (IF), acute renal failure (ARF), ARF and IF combined. The tubulo-interstitial findings proved to be unrelated to the severity of the glomerular alterations. Severe glomerular lesions can be associated with completely normal interstitium and tubules. Conversely, low-grade glomerular lesions may be accompanied by severe tubular and/or interstitial lesions. When the renal cortical interstitium and tubules were normal, then creatinine and blood pressure values were within the normal range; however, these values were significantly elevated in the presence of IF and/or ARF. It is concluded from these findings that in MPGN type I the disturbance in the excretion function of the kidney is caused primarily by tubulo-interstitial changes rather than by glomerular lesions.
共评估了259例I型膜增生性肾小球肾炎（MPGN）的肾活检病例，并将肾小球病变的五个等级与以下四类肾小管间质表现进行了比较：无变化、间质纤维化（IF）、急性肾衰竭（ARF）、ARF与IF合并存在。结果证明，肾小管间质表现与肾小球病变的严重程度无关。严重的肾小球病变可能与完全正常的间质和肾小管相关。相反，低度的肾小球病变可能伴有严重的肾小管和/或间质病变。当肾皮质间质和肾小管正常时，肌酐和血压值在正常范围内；然而，在存在IF和/或ARF时，这些值会显著升高。从这些发现可以得出结论，在I型MPGN中，肾脏排泄功能的紊乱主要是由肾小管间质变化而非肾小球病变引起的。
