INFLUENCE OF DIFFERENT THERAPEUTIC REGIMENS ON MORPHOGENESIS OF TUBULO STROMAL VASCULAR CHANGES IN CHRONIC GLOMERULONEPHRITIS

THE AIM of the investigation was to assess specific tubulostromalvascular changes in chronic glomerulonephrites and the effects of treatment on morphogenesis of tubulointerstitial component. PATIENTS AND METHODS. Nephrobiopsy was used to verify primary chronic glomerulonephritis in 143 examined patients. Repeated biopsy was performed in 19 (13.3%) of them within at the average 9.4±0.15 months after finishing the course of treatment. The method of light optical microscopy was used. RESULTS. Patients with mesangioproliferative glomerulonephritis were found to have mainly «tubular» lesions, and the treatment favored a decrease of the degree of dystrophy of the tubule epithelium. In mesangiocapillary variant of the disease «vascular» changes prevailed. Membranous nephropathy was characterized by frequently observed protein masses and glial cylinders in the tubule lumen, stroma edema and fibrinoid necrosis. In addition to a considerably decreased occurrence of stroma edema and plasmatic impregnation against the background of treatment there were greater tubular alterations as more frequent signs of dystrophy and necrosis of the epitheliocytes, impaired integrity of the tubule basal membrane. The main signs of impaired tubulointerstitium in focal segmental glomerulosclerosisglialinosis were «stromal» alterations stroma sclerosis and infiltration of it by cellular elements, which were more frequent after treatment, that points to progressing nephrosclerotic processes and accelerated formation of CRF. CONCLUSION. Underestimation of tubulointerstitial alterations in chronic glomerulonephritis is fraught with the progression of the disease in future with the outcome into CRF. Investigations aimed at studying the role of morphological and functional changes of the tubulointerstitium are expedient as well as of the effects of treatment on these processes.

different therapeutic regimens, morphogenesis, tubulostromalvascular alterations, chronic glomerulonephrites

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