Morphogenesis of Axial Sclerosis and Fibrosis Following Proliferative Glomerulitis and Their Significance for the Nephrotic Syndrome

Abstract

Mode of development of axial sclerosis and fibrosis of glomerular loops following proliferative glomerulitis was studied on the basis of renal biopsies. The analyses of biopsy specimens revealed that mild proliferative glomerulitis with preservation of capillary structure is followed by axial sclerosis or sclerosis of mesangial area of glomerular loops, whereas marked or severe proliferative glomerulitis characterized by disorganization of glomerular architecture due to proliferation of local fixed cells with reticular arrangement, chiefly of endothelial origin, following histolysis of loop walls results in crowding of proliferated cells accompanied by formation of fibers along them toward axis of the loop (axial fibrosis) and recanalization at its periphery. It was also clarified that when cell proliferation and following axial fibrosis of glomerulus are pronounced, lobulation of glomerular loops associated with further formation of centrolobular nodules is brought about, which is the lesion characteristic of lobular glomerulonephritis. Some clinical features concerning these processes were presented and discussed, and significance of glomerular lesions here presented for the nephrotic syndrome was considered.