1983 Volume 74 Issue 2 Pages 188-196
To elucidate progressive renal damage associated with chronic pyelonephritis, histological examination was performed in 114 operative specimens consisting of renal calculi, hydronephrosis, vesicoureteral reflux and others (nephrectomy or partial nephrectomy) and the following results were obtained.
1) Thirty-three of 105 nephrectomy cases showed successive proteinuria even in postoperative stage. Most of them showed significant glomerular sclerosis in the kidney of the operated side.
2) Periodic acid Schiff (PAS) positive material, supposedly Tamm-Horsfall protein, was found in 64 cases (56.1%). They were found mostly in moderate grade of hydronephrosis and in small numbers in slight or server grade.
3) Numerous round cell infiltration was found around PAS positive material which was not rarely seen escaping into venous and/or lymphatic spaces. This predominant lymphatic reaction strongly suggested immunological nature.
4) From these findings it can be speculated that PAS positive material in interstitium could cause immunologically patholigical changes in the opposite kidney and this might account for the progression of chronic pyelonephritis.
