Okuda S, Oh Y, Tsuruda H, Onoyama K, Fujimi S, Omae T, Fujishima M
Nephron. 1985;41(4):359-64. doi: 10.1159/000183615.
The effects of nephron loss on the clinical and histological picture of experimental membranous nephropathy were examined for 18 weeks in five-sixths nephrectomized rats with Heymann nephritis (HN-5/6N group). Heymann nephritis-induced rats without nephrectomy (HN group), normal rats with 5/6 nephrectomy (5/6N group) and normal rats without nephrectomy (control group) were also examined for comparison. A rapidly progressive increase in urinary protein, BUN and serum creatinine was observed after renal ablation in the HN-5/6N group. Light microscopic study revealed global or segmental sclerosis in most of the glomeruli, crescent formation in some of the glomeruli and marked tubulointerstitial changes. Electron microscopic study demonstrated vacuolation and necrosis of podocytes, detachment of podocytes from the glomerular basement membrane (GBM) and fibrin exudation into Bowman's space. Proteinuria was also marked but renal function was not impaired in the HN group. In the 5/6N group, proteinuria was mild and elevation in BUN and serum creatinine was apparent but not progressive. There were no differences in the depositions of IgG, C3 and electron-dense materials on GBM between the HN-5/6N group and the HN group. In conclusion, renal mass reduction associated with high flow and pressure to the remnant glomeruli could lead to extensive glomerular sclerosis and to a deterioration in renal function, in the case of pre-existing nephritic lesions.
在患有海曼肾炎的六分之五肾切除大鼠(HN-5/6N组)中,研究了肾单位丧失对实验性膜性肾病临床和组织学表现的影响,为期18周。还对未进行肾切除的海曼肾炎诱导大鼠(HN组)、进行了5/6肾切除的正常大鼠(5/6N组)和未进行肾切除的正常大鼠(对照组)进行了比较,以作对照。在HN-5/6N组肾切除后,观察到尿蛋白、血尿素氮和血清肌酐迅速进行性增加。光镜研究显示,大多数肾小球出现全球性或节段性硬化,部分肾小球有新月体形成,肾小管间质有明显改变。电镜研究显示足细胞空泡化和坏死,足细胞从肾小球基底膜(GBM)脱离,纤维蛋白渗出到鲍曼间隙。HN组蛋白尿也很明显,但肾功能未受损。在5/6N组,蛋白尿轻微,血尿素氮和血清肌酐升高明显但无进行性加重。HN-5/6N组和HN组之间,GBM上IgG、C3和电子致密物质的沉积没有差异。总之,在已有肾炎病变的情况下,与残余肾小球高血流和高压相关的肾质量减少可导致广泛的肾小球硬化和肾功能恶化。