[A clinicopathological study of 17 cases recovered from acute tubular necrosis]

Renal biopsy specimens of 17 cases recovered from clinical acute renal failure (ARF) and subsequent pathological acute tubular necrosis (ATN) were analyzed clinicopathologically. The cases were divided into two groups: 11 patients who underwent hemodialysis (HD group) and 6 patients who did not need hemodialysis (non-HD group). The varied histopathological findings were assessed by scoring as parameters and were compared between the two groups and with severity of the clinical conditions as well. Among the histopathological parameters, tubulorrhexis and cell infiltration, mainly composed of lymphocytes, in the interstitium as well as in the tubules were significantly marked in the HD group, while other parameters such as necrosis, flattening, vacuolization and regeneration of the tubular epithelial cells and presence of casts were not necessarily significant. Tubulorrhexis were supposed to reflect the severity of the attack factors on the kidney which had caused ARF and subsequent ATN, and to have caused in turn prolongation of the recovery of the impaired renal function. Cell infiltration, which was divided into 4 types according to the corresponding conditions, might probably have affected the prolonged recovery in the HD group. In 8 cases which could be followed up for 2 years, non showed aggravation of the renal function.