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Atubular glomeruli in patients with chronic pyelonephritis
1University Institute of Pathology, Aarhus Kommunehospital, Denmark.
Summary
Atubular glomeruli, lacking proximal tubule connections, are prevalent in chronic pyelonephritis (CP). These structures may explain why some chronic kidney diseases are irreversible.
Area of Science:
- Nephrology
- Pathology
- Renal Histology
Background:
- In animal models of chronic nephropathy, many glomeruli lack proximal tubule connections.
- The presence and significance of such atubular glomeruli in human kidney disease remain unclear.
Purpose of the Study:
- To investigate the prevalence of atubular glomeruli in human chronic pyelonephritis (CP).
- To correlate the presence of atubular glomeruli with renal tissue composition in CP.
Main Methods:
- Stereological analysis of renal tissue from 11 patients with CP and 7 controls.
- Serial sectioning to identify glomeruli connected to normal, atrophic, or no proximal tubules.
- Estimation of glomerular volume and volume fractions of tubules and interstitial tissue.
Main Results:
- In the CP group, 35% of glomeruli were atubular, and 15% were connected to atrophic tubules.
- Atubular glomeruli had approximately half the mean volume of glomeruli with normal proximal tubules.
- A higher percentage of atubular glomeruli correlated with reduced proximal tubule volume and increased interstitial tissue.
Conclusions:
- Atubular glomeruli are a significant feature in chronic pyelonephritis, identifiable through serial sectioning.
- The presence of atubular glomeruli may contribute to the irreversibility of chronic kidney diseases not primarily affecting glomeruli.