Abstract
In order to investigate the importance of tubulo-interstitial changes in renal cortex in evaluating the severity as well as prognosis in biopsy specimen of nephritides, follow up studies were conducted in 101 patients with IgA nephropathy (average follow up periods 61 months) and 75 cases of idiopathic membranous nephropathy (average follow up period: 83 months) subsequent to renal checkups. Degree of tubulo-interstitial changes, assayed semiquantitatively by light microscopic observation, was correlated with the severity of glomerular injuries, incidence of other histo-pathological parameters, clinical variables at renal biopsy and status at final follow up. In both diseases, degree of tubulo-interstitial changes were significantly correlated with the severity of glomerular injury, incidence of segmental sclerosis, global sclerosis, arteriolosclerosis as well as such clinical variables as age at biopsy, blood pressure and serum creatinine level The incidence that retained stable renal function at final follow up was more than 90 percent among the cases with tubulo-interstitial changes less than 20 percent of the cortical area, whereas that decreased to less than 67 percent in the cases with more tubulo-interstitial changes in both diseases (p<0.05). It was thus concluded that semiquantitative evaluation of the tubulo-interstitial changes in cortex would reflect the severity of glomerular injury and therefore would contribute to the prognostification of the primary glomerulonephritic patients such as IgA nephropathy and idiopathic membranous nephropathy.
