A histometrical study on the development of three glomerulopathies

A histometrical study of the distribution pattern of hyalinized glomeruli in diabetic glomerulosclerosis, malignant nephrosclerosis and chronic glomerulonephritis was achieved using the nearest neighbor method. The features of the circulatory dynamics in each disease are discussed based on the results of this study. The glomeruli were hyalinized at random in diabetic glomerulosclerosis. The distribution of hyalinized glomeruli occurred at random in normal kidney, which suggests that glomeruli become hyalinized with no dependency on the vasculature. Malignant nephrosclerosis on the other hand, shows that the glomeruli are hyalinized in clusters, and that suggests that the kidneys react to hypertensive changes in the interlobular artery and more peripheral arteries. The glomeruli supplied by the interlobular arteries will then hyalinize in clusters. If these two renal diseases are used as an end of a spectrum, the distribution pattern of hyalinized glomeruli in chronic glomerulonephritis showed most similarity with that seen in malignant nephrosclerosis. However, the percentage of hyalinized glomeruli was 21% in malignant nephrosclerosis as opposed to 77% in chronic glomerulonephritis. This marked difference suggests that in malignant nephrosclerosis, the percentage of hyalinized glomeruli was low due to participation of arteries larger than the accurate branches. However, the patients became uremic within a short time. Contrary to this finding, in chronic glomerulonephritis, the effect is from the smaller arteries less than that from the interlobular artery. Ordinarily, if an insufficient number of glomeruli become hyalinized, uremia will not develop. Finally, the difference in the genesis and vascular participation of diffuse type and nodular type of diabetic glomerulosclerosis and the relationship between acute glomerulonephritis and chronic glomerulonephritis are discussed.