STRUCTURE AND FUNCTION OF THE KIDNEY IN DIABETIC GLOMERULOSCLEROSIS CORRELATIONS BETWEEN MORPHOLOGICAL AND FUNCTIONAL PARAMETERS
STRUCTURE AND FUNCTION OF THE KIDNEY IN DIABETIC GLOMERULOSCLEROSIS CORRELATIONS BETWEEN MORPHOLOGICAL AND FUNCTIONAL PARAMETERS
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DOI：
10.1016/s0344-0338(80)80051-3
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发表时间：
1980-01-01
影响因子：
2.8
通讯作者：
BOHLE, A
中科院分区：
文献类型：
--
作者：
BADER, R;BADER, H;BOHLE, A
本文报告103例中年糖尿病肾小球硬化（gs）的组织学和临床表现。在糖尿病性肾小球疾病（如其他炎症性和非炎症性肾小球疾病）中，肾皮质纤维化程度与活检时的血清肌酐浓度之间存在统计学高度显著的正相关。血管指数和相对皮质间质体积以及血清肌酐浓度之间存在等级相关性。4级糖尿病患者的皮质骨厚度、血肌酐浓度和血管指数的均值之间存在显著性差异。只有当间质未显示纤维化变化时，严重的肾小球病变才可能伴有正常的血清肌酐浓度。轻度肾小球病变，当伴有间质纤维化时，血清肌酐浓度总是升高。糖尿病患者高血压、蛋白尿、肾病综合征和血尿的发生率差异很大。从高度显着的相关性之间的皮质骨和血清肌酐浓度，肾小球后血管的改变间质纤维化的变化可能会导致肾皮质血流阻力增加，随后减少肾小球灌注。肾小球灌注的减少可能导致血清肌酐浓度升高，与肾小球硬化的严重程度无关。肾小球功能可能受到间质性纤维化区域的萎缩小管功能障碍的影响。
Histological and clinical findings in 103 middle-aged patients suffering from diabetic glomerulosclerosis (gs) (biopsy material) are reported. In diabetic gs (as in other inflammatory and non-inflammatory glomerular disease) a statistically highly significant positive correlation exists between the grade of fibrosis of the renal cortical interstitium and the serum creatinine concentration at the time of biopsy. Rank correlations exist between vessel index and relative cortical interstitial volume as well as serum creatinine concentration. Significant differences exist between the mean values of the cortical interstitium and the serum creatinine concentration and the vessel index in the 4 grades of diabetic gs. Severe glomerular lesions may be accompanied by a normal serum creatinine concentration only if the interstitium shows no fibrotic changes. Mild glomerular lesions, when accompanied by an interstitial fibrosis, always have elevated serum creatinine concentrations. The incidence of hypertension, proteinuria, the nephrotic syndrome and hematuria in diabetic gs appears to vary greatly. From the highly significant correlation between the cortical interstitium and the serum creatinine concentration, alterations of the postglomerular vessels by interstitial fibrotic changes presumably result in an increased resistance to renal cortical blood flow with a subsequent reduction of glomerular perfusion. This reduction of the glomerular perfusion may result in a rise of the serum creatinine concentration, independently of the severity of the glomerulosclerosis. Glomerular function may be affected by the malfunctioning atrophic tubules in areas of interstitial fibrosis.