Histomorphometric analysis of fibrosis in the renal interstitial compartment

The interstitium is the extravascular intertubular space of the renal parenchyma, which provides structural support to the functional renal units and is included at the same time in nearly all renal functions. Alterations to this renal compartment have been found in almost all glomerular diseases. During the last thirty years the studies of a few groups of investigators have shown that the degree of the renal dysfunction is strongly correlated with the changes in the tubulointerstitial compartment. We made a morphometric study of a group of 10 renal biopsies, previously diagnosed as IgA nephropathy or membranoproliferative glomerulonephritis. For morphometric analysis we made colour extraction of the interstitial area on tissue sections stained with trichrom Masson using the LUCIA M-NIKON image analysing system with integrated software for statistical analysis of the data. We measured the surface of the marked fields and the results were expressed as a percentage of the total scanned area. The results were correlated with the serum creatinine at the time of biopsy. We found fibrosis occupying more than 10% of the tubulointerstitial surface in all 10 patients. Six of them had a moderate level of fibrosis, occupying more that 20% of the tubulointerstitial space. The statistical analysis of these results showed a significant correlation between the degree of the interstitial expansion and the serum creatinine. The results showing the correlation between these parameters will enable the quantitative histological analyses to be included in the process of the nephropathological diagnosis in order to evaluate the histological risk factors in glomerular diseases.