[Tubulointerstitial component of chronic glomerulonephritis. Clinico-morphological comparisons]

A total of 179 patients with chronic glomerulonephritis were examined for the development of the tubulo-interstitial component (TIC) of the disease. It was established that the rate of the development and intensity of the TIC are linked with different morphological variants of GN and increase successively in mesangiomembranous, membranous, mesangioproliferative, mesangiocapillary (and lobular) GN, reaching a maximum in diffuse fibroplastic GN. In patients with no TIC, the hematuric and latent forms of CGN were mostly encountered. The disease took a stable course, with a frequent occurrence of improvements and remission. The 5-year survival was 100%. In patients with a moderate TIC, the nephrotic form of CGN was encountered more often than in other patients. As regards other characteristics, this form occupied an intermediate position, with the 5-year survival rate amounting to 91%. Patients with a pronounced TIC were marked by progressive CGN, which was largely observed in the hypertonic and mixed patterns of the disease. The three-year survival amounted to 34% in this case. The TIC of CGN is an important prognostic factor and the dissimilar course of different morphological variants of CGN is accounted, to a considerable degree, for by the dissimilar rate of TIC development.