[Immunology in medical practice. IV. Mechanisms in the development of primary nephropathies]

Humoral immunological reactions play a central part in the development of nephropathies. Immune complexes may form in the circulation and precipitate in the kidney, or form in the kidney by binding of antibodies from the circulation to antigens in the glomerular basement membrane. The localizations of immune complex deposition in the various compartments of the glomeruli determine the development of different forms of glomerulonephritis. Cellular immunological reactions play a part in the development of tubulo-interstitial nephritis and possibly also of minimal change nephropathy' and focal segmental glomerulosclerosis. The role of cellular immunological reactions in the development of most other nephropathies is less clear. Persistence of nephropathies leads to glomerulosclerosis and renal interstitial fibrosis. Ultimately, these cause loss of kidney function and necessitate haemodialysis.